{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"  ATTENNODSREGOR A ","gend":1,"add":"KCAB YHTOROD O\/CTS ROYAHT 427 SU","city":"NORFOLK","state":"VA","zip":"23504-9998","dob":"1972-01-25","age":"","mstatus":"","insh":"30400210*94","cliId":"","pno":"87\/7570036-5","cno":"","email":"","ename":"","eno":"","pphy":"BEVERLY, VERNIS MD","ppno":"757\/484-2001","pcpadd":"STE A 3800 POPLAR HILL RD","pcpcity":"CHESAPEAKE","pcpstate":"VA","pcpzip":23321,"pcpcounty":"","pcpid":"","pcpname":"Adult and Pediatric Medical Associates","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I10.","B20.","Q05.9","J45.909","D57.1","E03.9","F41.9","G47.00","G62.9","M54.9","R10.9","T83.9XXA","N30.00","Z13.220","Z23.","Z01.818","N31.9","G89.4","G89.18","R10.84","Z93.6","F13.10","Z21.","Z90.710","F17.210","Z88.5","Z88.0","Z88.8","G89.29","K59.09","Z87.442","Z79.899","F31.9","F31.81","K21.9","L20.9","N39.0","Z90.6","N17.9","N12.","E87.6","E87.2","E83.51","E83.42","F14.14","E87.8","V62.84","N18.9","I12.9","A60.00","N31.8","F14.10","F33.9","F31.4","Z98.890","Z87.728","F14.20","F39.","F11.20","T14.91XA","N28.89","R31.9","N28.1","R11.0","R50.9","E66.9","Z68.34","Z53.21","R11.2","R10.13","R19.7","F31.5","F15.10","I95.9","R10.31","B97.35","F31.30","Q05.8","R32.","S32.010S","M54.5","N30.01","F13.20","Z11.59","F31.12","F32.9","B37.3","F41.1","F11.19","Z63.4","F31.10","Z01.810","Z01.812","R33.9","R60.9","F19.10","N30.90","F33.2","K59.00","E07.9","I95.89","F41.0","F17.200","E86.0","Z88.1","M79.673","Q05.7","T14.90XA","R52.","T83.198A","I51.7","N99.522","M79.89","J44.9","J45.40","Z87.440","N99.528","N10.","B96.20","R41.82","Z96.0","Z79.891","M48.56XA","E87.1","K56.7","R33.8","B37.9","Z93.50","F11.10","B95.2","Z76.0","G56.00","M19.90","G56.03","G56.01","G56.02","N20.2","N20.0","NO DATA","Z88.6","N28.9","F13.239","R10.2","Z43.6","R53.1","F29.","M62.838","Z76.5","R10.30","N17.0","E87.3","R69.","T81.9XXA","F32.2","R31.0","N13.30","M62.89","J06.9","N76.0","R39.81","F13.230","F13.232","Q76.0","F31.31","R30.0","Z86.79","F11.90","J32.9","R05.","M79.641","M25.631","M62.541","F19.959","R19.8","J20.9","G47.9","N32.9","Z53.20","D57.3","F43.10","D57.00","Z01.419","Z11.3","Z02.83","M79.672","F99.","L03.115","N89.8","R10.11","Z20.822","R30.9","F41.8","J00.","Z79.51","Z79.890"],"date":["2022-09-21","2022-09-19","2022-11-18","2022-04-01","2022-09-21","2020-09-11","2022-09-16","2022-09-19","2021-10-11","2022-04-01","2022-01-08","2019-03-13","2020-01-12","2022-09-19","2020-11-05","2021-01-08","2021-07-19","2021-07-27","2019-08-08","2019-08-01","2021-05-27","2021-09-21","2022-09-21","2019-08-01","2022-09-21","2022-09-21","2022-09-21","2022-09-21","2021-11-27","2021-08-02","2020-01-07","2022-09-16","2022-11-18","2019-09-13","2022-09-19","2021-07-02","2021-11-27","2019-12-09","2019-12-14","2019-12-17","2019-10-07","2019-09-26","2019-09-29","2019-09-30","2019-09-26","2019-09-26","2020-07-13","2019-09-26","2019-09-26","2019-09-26","2019-09-26","2020-01-07","2020-05-30","2020-06-12","2021-05-05","2019-11-05","2019-12-07","2019-11-12","2022-11-18","2020-01-05","2019-12-14","2020-05-22","2020-01-07","2021-10-11","2021-04-01","2020-01-07","2019-12-25","2019-12-25","2020-10-12","2019-12-30","2020-06-22","2020-01-14","2020-01-14","2020-01-08","2020-01-08","2022-11-18","2021-05-05","2022-10-05","2022-10-05","2020-03-27","2021-05-27","2020-03-29","2022-11-18","2020-05-22","2021-01-05","2021-08-22","2021-08-02","2021-07-14","2021-09-21","2022-11-18","2021-09-21","2019-05-13","2019-05-13","2019-11-22","2019-09-06","2019-09-06","2019-12-08","2020-06-09","2022-11-18","2022-01-08","2020-01-07","2020-01-07","2020-01-07","2020-01-07","2022-09-21","2020-01-12","2020-01-12","2020-04-28","2020-07-13","2019-03-22","2019-05-13","2019-07-25","2019-07-25","2021-03-23","2019-09-13","2022-09-21","2019-11-11","2019-12-16","2019-09-08","2020-06-08","2019-06-26","2019-05-25","2019-09-04","2019-12-12","2019-07-10","2019-07-10","2021-07-19","2019-07-25","2019-07-25","2019-09-04","2022-09-21","2020-11-11","2021-08-09","2021-03-02","2021-02-26","2020-12-07","2021-09-10","2021-10-11","2022-09-19","2022-09-21","2020-10-07","2019-03-05","2021-06-08","2019-09-13","2019-09-02","2019-09-07","2019-11-11","2020-03-04","2019-11-11","2019-12-13","2019-12-12","2020-01-30","2020-02-09","2020-05-27","2020-07-13","2020-05-31","2021-07-19","2021-10-11","2021-03-23","2019-04-29","2019-01-30","2019-03-25","2019-03-25","2019-03-25","2022-09-30","2019-06-26","2020-01-20","2020-08-12","2020-09-11","2021-03-02","2021-03-02","2021-03-02","2021-05-27","2021-06-07","2021-07-27","2021-12-29","2019-04-30","2019-12-25","2019-12-07","2019-09-13","2020-04-24","2021-08-02","2022-09-19","2019-11-12","2019-11-12","2019-11-19","2020-07-13","2020-07-13","2019-12-25","2021-01-08","2021-04-26","2021-05-21","2022-04-01","2022-09-16","2022-01-08"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Activities of Daily Living","q":[{"a":[]}]},{"t":"Medical History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Family History","q":[{"a":[]}]},{"t":"Preventive Care","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","65862016001","ZOLPIDEM","TAB 10MG","15","Select","Select",""],["","50804048601","SENNA","TAB 8.6MG","60","Select","Select",""],["","69097084805","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","16729013616","CLONAZEPAM","TAB 0.5MG","45","Select","Select",""],["","16714008211","HYDROXYZ","TAB 25MG","60","Select","Select",""],["","43598057930","BUPREN\/NALOX","MIS 2-0.5MG","48","Select","Select",""],["","12496120203","SUBOXONE","MIS 2-0.5MG","48","Select","Select",""],["","00310737020","BUDES\/FORMOT","AER 160-4.5","10","Select","Select",""],["","59310057922","PROAIR","AER ","17","Select","Select",""],["","67618031030","SENOKOT","TAB 8.6-50MG","60","Select","Select",""],["","52343008722","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","62856040530","DAYVIGO","TAB 5MG","30","Select","Select",""],["","61958250101","BIKTARVY","TAB ","30","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","17","Select","Select",""],["","00186037020","SYMBICORT","AER 160-4.5","10","Select","Select",""],["","16714048203","LORATADINE","TAB 10MG","30","Select","Select",""],["","00591352530","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","00116200116","CHLORHEX","SOL 0.0012","473","Select","Select",""],["","00591544305","PREDNISONE","TAB 20MG","15","Select","Select",""],["","65862018601","CLINDAMYCIN","CAP 300MG","21","Select","Select",""],["","11917016754","MICONAZOLE","KIT COMBINAT","1","Select","Select",""],["","00173088710","TRELEGY","AER 100MCG","60","Select","Select",""],["","65162010350","GABAPENTIN","CAP 400MG","90","Select","Select",""],["","69452017113","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","00093216568","NALOXONE","SPR 4MG","2","Select","Select",""],["","45802046564","KETOCONAZOLE","SHA 0.02","120","Select","Select",""],["","68462018117","CLOTRIMAZOLE","CRE 0.01","15","Select","Select",""],["","00093354143","ESTRADIOL","CRE 0.0001","42","Select","Select",""],["","00456120130","LINZESS","CAP 145MCG","30","Select","Select",""],["","68462015713","ONDANSETRON","TAB 4MG ODT","20","Select","Select",""],["","51224001060","BENZONATATE","CAP 100MG","30","Select","Select",""],["","67877024601","QUETIAPINE","TAB 200MG","30","Select","Select",""],["","49702024613","DOVATO","TAB 50-300MG","30","Select","Select",""],["","68462013701","OXCARBAZEPIN","TAB 150MG","60","Select","Select",""],["","43598055130","LAMOTRIGINE","TAB 50MG ODT","30","Select","Select",""],["","68180071160","CEFDINIR","CAP 300MG","20","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","65862090901","CELECOXIB","CAP 200MG","60","Select","Select",""],["","51672207502","BACITR","OIN 500\/GM","28","Select","Select",""],["","60432053716","NYSTATIN","SUS 100000","80","Select","Select",""],["","11523723403","MIRALAX","POW 3350 NF","238","Select","Select",""],["","41167005840","ASPERCREME","PAD LIDO 4%","30","Select","Select",""],["","00085113204","PROVENTIL","AER HFA","7","Select","Select",""],["","00363007564","BACITRACIN","OIN 500\/GM","28","Select","Select",""],["","00406052201","OXYCOD\/APAP","TAB 7.5-325","28","Select","Select",""],["","65862053820","LEVOFLOXACIN","TAB 750MG","5","Select","Select",""],["","00093314501","CEPHALEXIN","CAP 250MG","40","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","60505265401","TRAZODONE","TAB 100MG","30","Select","Select",""],["","64380080707","IBUPROFEN","TAB 800MG","90","Select","Select",""],["","00597007541","SPIRIVA","CAP HANDIHLR","30","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","14","Select","Select",""],["","43386009019","GAVILYTE-G","SOL ","4000","Select","Select",""],["","29300034905","ALLOPURINOL","TAB 100MG","30","Select","Select",""],["","00173087310","INCRUSE","INH 62.5MCG","30","Select","Select",""],["","68180098003","LISINOPRIL","TAB 10MG","30","Select","Select",""],["","63402030230","LATUDA","TAB 20MG","14","Select","Select",""],["","43598055530","ARIPIPRAZOLE","TAB 5MG","15","Select","Select",""],["","68462030201","INDOMETHACIN","CAP 50MG","90","Select","Select",""],["","51862094205","DIAZEPAM","TAB 5MG","28","Select","Select",""],["","00045029532","IMODIUM","TAB 2MG","24","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","15","Select","Select",""],["","67618011128","COLACE","CAP 50MG","30","Select","Select",""],["","00115164501","NITROFUR","CAP 100MG","20","Select","Select",""],["","60432060416","PROMETHAZINE","SYP DM","120","Select","Select",""],["","00054452725","LITHIUM","TAB 300MG","42","Select","Select",""],["","69238117109","DOXEPIN","CAP 50MG","30","Select","Select",""],["","29300012510","MELOXICAM","TAB 15MG","7","Select","Select",""],["","65862059501","DIVALPROEX","TAB 500MG ER","90","Select","Select",""],["","10702005601","OXYCODONE","TAB 10MG","12","Select","Select",""],["","69238183007","LEVOTHYROXIN","TAB 25MCG","30","Select","Select",""],["","27241009803","DULOXETINE","CAP 30MG","30","Select","Select",""],["","00555015902","CHLORDIAZEP","CAP 25MG","3","Select","Select",""],["","13107003134","MIRTAZAPINE","TAB 15MG","30","Select","Select",""],["","50580041201","TYLENOL","TAB 500MG","100","Select","Select",""],["","31722071290","PANTOPRAZOLE","TAB 20MG","30","Select","Select",""],["","00904672059","ACETAMIN","TAB 500MG","100","Select","Select",""],["","00406012305","HYDROCO\/APAP","TAB 5-325MG","6","Select","Select",""],["","00591024005","LORAZEPAM","TAB 0.5MG","5","Select","Select",""],["","00115166001","PROPRANOLOL","TAB 20MG","60","Select","Select",""],["","00093005401","BUSPIRONE","TAB 10MG","60","Select","Select",""],["","00904645760","DOK","CAP 100MG","30","Select","Select",""],["","00904699960","DOCUSATE","CAP 250MG","14","Select","Select",""],["","65862019301","FLUOXETINE","CAP 20MG","30","Select","Select",""],["","00228202996","ALPRAZOLAM","TAB 0.5MG","3","Select","Select",""],["","52817033010","CYCLOBENZAPR","TAB 5MG","6","Select","Select",""],["","16729017317","AMITRIPTYLIN","TAB 50MG","30","Select","Select",""],["","00093001806","TOLTERODINE","TAB 2MG","60","Select","Select",""],["","00363030603","SMOOTH","POW ","510","Select","Select",""],["","00487020160","IPRATROPIUM\/","SOL ALBUTER","90","Select","Select",""],["","63824000850","MUCINEX","TAB 600MG ER","6","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","60","Select","Select",""],["","00093221005","SUCRALFATE","TAB 1GM","12","Select","Select",""],["","68382031910","TRAMADOL","TAB 50MG","21","Select","Select",""],["","13811071910","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","55111012705","CIPROFLOXACN","TAB 500MG","20","Select","Select",""],["","00574041207","POLYETH","POW 3350 NF","30","Select","Select",""],["","00955100410","ENOXAPARIN","INJ 40\/0.4ML","8","Select","Select",""],["","49702023113","TRIUMEQ","TAB ","30","Select","Select",""],["","74312007901","MELATONIN","TAB 3MG","60","Select","Select",""],["","00574705012","BISACODYL","SUP 10MG","3","Select","Select",""],["","68180031909","BUPROPN","TAB 150MG XL","30","Select","Select",""],["","16714007104","BACLOFEN","TAB 10MG","5","Select","Select",""],["","29300013501","CLONIDINE","TAB 0.1MG","6","Select","Select",""],["","69097052444","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","00904549280","THERA-M","TAB ","30","Select","Select",""]]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Review of Systems and Diagnoses","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":[]}]},{"t":"Mini-Cog","q":[{"a":[]},{"a":[]}]},{"t":"Home Safety & Personal Goals","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Active Problem Conditions","q":[{"a":[]}]},{"t":"Patient Summary","q":[{"a1":"","a2":"","a3":"","a4":"","a5":"","a6":"","a7":[],"a8":"","a9":"","a10":[],"a11":"","a12":"","a13":""}]}]}