{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"K YRAMGNITRO","gend":1,"add":"DISLLIH 30214H TPA EVA E","city":"NORFOLK","state":"VA","zip":"23503-9998","dob":"1979-06-26","age":"","mstatus":"","insh":"3501110*41","cliId":"","pno":"43\/7579930-8","cno":"","email":"","ename":"","eno":"","pphy":"WOOD, JESSICA V NP","ppno":"757\/622-8358","pcpadd":"930 W 21ST ST SUITE 100","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23517,"pcpcounty":"","pcpid":"","pcpname":"BON SECOURS GHENT STATION MEDICAL ASSOCIATES","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J02.9","F33.2","F43.12","F44.1","H60.90","R42.","F33.1","F41.1","L30.9","Z71.9","I10.","E03.9","E55.9","E53.8","D64.9","R07.9","F40.10","L71.0","J44.9","F41.9","Z21.","E66.01","Z68.43","Z87.891","Z88.6","Z88.5","Z88.8","Z91.010","Z91.013","R20.8","R11.2","R10.9","N88.8","B20.","N30.01","Z68.44","E83.19","R10.31","Z20.822","R11.0","J45.50","R07.89","R09.81","Z76.0","J47.9","K21.9","H10.32","NO DATA","E66.8","F34.1","G47.30","R09.82","R26.89","H90.3","H93.8X3","F33.0","R04.89","R01.1","F33.9","F32.2","B37.0","S81.002A","B35.9","Z90.49","S81.802A","S91.002A","N39.0","J20.9","J45.21","D22.9","Z28.21","Z91.89","G93.2","R52.","L71.9","L21.9","G44.319","Y09.","R55.","H57.9","H93.12","M77.9","S09.93XA","S05.02XA","H52.13","Z79.899","R68.84","Z00.00","J45.909","H81.10","B37.9","R06.02","M25.561","R10.13","J45.40","Z01.419","R20.0","H93.13","B37.2","S00.83XA","M10.9","R10.32","R19.7","R16.0","H66.93","J45.20"],"date":["2021-01-29","2020-05-28","2020-11-11","2020-10-28","2020-04-13","2021-08-21","2021-02-08","2021-02-08","2020-12-01","2021-01-18","2021-12-29","2021-12-29","2021-06-02","2021-06-02","2021-06-04","2021-09-20","2020-08-19","2020-11-27","2021-09-15","2020-11-27","2021-02-09","2021-09-20","2021-02-09","2021-02-09","2021-02-09","2021-02-09","2021-02-09","2021-02-09","2021-02-09","2020-11-27","2020-12-06","2021-08-06","2020-12-06","2021-01-29","2021-01-22","2021-12-29","2021-08-06","2021-08-06","2021-08-21","2021-12-29","2021-09-15","2021-06-04","2020-07-18","2020-07-18","2021-09-01","2021-09-01","2020-03-02","2020-05-13","2020-05-13","2020-05-13","2020-08-07","2021-01-27","2020-02-24","2020-02-24","2020-02-24","2020-04-06","2020-08-07","2020-08-07","2020-08-07","2020-10-08","2021-01-29","2021-02-09","2021-02-09","2021-02-09","2021-02-11","2021-02-09","2021-10-18","2020-01-02","2020-01-02","2020-04-21","2020-04-21","2020-11-04","2020-11-04","2020-12-19","2021-01-18","2021-01-18","2019-08-04","2019-08-04","2019-09-27","2019-09-27","2019-09-27","2019-10-10","2019-01-30","2019-07-24","2019-07-24","2019-07-24","2019-07-24","2019-03-13","2019-03-13","2019-04-23","2019-09-18","2019-12-26","2019-12-05","2019-06-07","2019-06-27","2019-06-27","2019-11-07","2019-11-20","2019-12-20","2019-07-24","2019-09-04","2019-11-13","2019-11-13","2019-11-13","2019-03-02","2019-03-26"],"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":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"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":[["","53489011802","DOXYCYCL","CAP 50MG","30","Select","Select",""],["","","ARIPIPRAZOLE","TAB 5MG","","Select","Select",""],["","","QUETIAPINE"," QUETIAPINE ","30","Select","Select",""],["","","TRINTELLIX"," TRINTELLIX ","30","Select","Select",""],["","","NYSTATIN"," NYSTATIN ","480","Select","Select",""],["","59267100002","PFIZER","INJ COVID-19","0","Select","Select",""],["","","ONDANSETRON"," ONDANSETRON ","12","Select","Select",""],["","","HYDROCHLOROT","TAB 25MG","","Select","Select",""],["","","FLUCONAZOLE"," FLUCONAZOLE ","2","Select","Select",""],["","","LEVOTHYROXIN"," LEVOTHYROXIN ","30","Select","Select",""],["","","DULERA"," DULERA ","13","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","","LIDOCAINE"," LIDOCAINE ","30","Select","Select",""],["","59779043262","NASAL","TAB 30MG","24","Select","Select",""],["","","AZITHROMYCIN"," AZITHROMYCIN ","10","Select","Select",""],["","00009005604","MEDROL","TAB 4MG","21","Select","Select",""],["","","CIPROFLOXACN","SOL 0.3% OP","","Select","Select",""],["","68382013210","TAMSULOSIN","CAP 0.4MG","7","Select","Select",""],["","59746012106","MECLIZINE","TAB 25MG","30","Select","Select",""],["","","SPIRIVA"," SPIRIVA ","30","Select","Select",""],["","","METHYLPRED"," METHYLPRED ","21","Select","Select",""],["","","MONTELUKAST"," MONTELUKAST ","30","Select","Select",""],["","","VENTOLIN"," VENTOLIN ","18","Select","Select",""],["","65162027250","SMZ\/TMP","TAB 800-160","14","Select","Select",""],["","","NAPROXEN"," NAPROXEN ","20","Select","Select",""],["","00597008717","ATROVENT","AER 17MCG","13","Select","Select",""],["","","HYDROXYZ"," HYDROXYZ ","15","Select","Select",""],["","","ADVAIR"," ADVAIR ","12","Select","Select",""],["","","PROAIR"," PROAIR ","1","Select","Select",""],["","","ALBUTEROL"," ALBUTEROL ","54","Select","Select",""],["","","PREDNISONE"," PREDNISONE ","5","Select","Select",""],["","","AMOXICILLIN"," AMOXICILLIN ","20","Select","Select",""],["","","LOSARTAN"," LOSARTAN ","30","Select","Select",""],["","","VITAMIN"," VITAMIN ","4","Select","Select",""],["","","FLUTIC\/SALME"," FLUTIC\/SALME ","60","Select","Select",""],["","","REXULTI"," REXULTI ","30","Select","Select",""],["","","BUPROPN"," BUPROPN ","30","Select","Select",""],["","","ALPRAZOLAM"," ALPRAZOLAM ","2","Select","Select",""],["","","DIAZEPAM"," DIAZEPAM ","12","Select","Select",""],["","","INDOMETHACIN"," INDOMETHACIN ","30","Select","Select",""],["","","TRIAMT\/HCTZ"," TRIAMT\/HCTZ ","30","Select","Select",""],["","","CARAFATE"," CARAFATE ","420","Select","Select",""],["","","ESCITALOPRAM"," ESCITALOPRAM ","30","Select","Select",""],["","","PAROXETINE"," PAROXETINE ","30","Select","Select",""],["","","CLOTRIMAZOLE"," CLOTRIMAZOLE ","70","Select","Select",""],["","","IBUPROFEN"," IBUPROFEN ","90","Select","Select",""],["","","METHOCARBAM"," METHOCARBAM ","40","Select","Select",""],["","","ERYTHROMYCIN"," ERYTHROMYCIN ","4","Select","Select",""],["","","VENLAFAXINE"," VENLAFAXINE ","30","Select","Select",""],["","","DIPHEN\/ATROP"," DIPHEN\/ATROP ","30","Select","Select",""],["","","CODEINE\/GG","SOL 10-100\/5","","Select","Select",""],["","","PROMETHAZINE","TAB 25MG","","Select","Select",""],["","","TOPIRAMATE","TAB 25MG","","Select","Select",""],["","","METRONIDAZOL","CRE 0.0075","","Select","Select",""],["","","BENZONATATE","CAP 200MG","","Select","Select",""],["","","WIXELA","AER 100\/50","","Select","Select",""],["","","KETOCONAZOLE","SHA 0.02","","Select","Select",""],["","","METROCREAM","CRE 0.0075","","Select","Select",""],["","","TRAMADOL","TAB 50MG","","Select","Select",""],["","","CIPRODEX","SUS 0.3-0.1%","","Select","Select",""],["","","FAMOTIDINE","TAB 20MG","","Select","Select",""],["","","SUCRALFATE","TAB 1GM","","Select","Select",""],["","","FLUCLVX","INJ 2020-21","","Select","Select",""],["","","OMEPRAZOLE","CAP 40MG","","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":""}]}]}