{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"  NEENHOJNOSPAP M ","gend":1,"add":"NIM 4096EVA EIN","city":"NORFOLK","state":"VA","zip":"23513-9998","dob":"1969-12-27","age":"","mstatus":"","insh":"55500210*96","cliId":"","pno":"62\/7576376-6","cno":"757\/266-6736","email":"","ename":"","eno":"","pphy":"FEE, ERIC MD","ppno":"757\/587-0157","pcpadd":"7924 CHESAPEAKE BLVD","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23518,"pcpcounty":"","pcpid":"","pcpname":"Bayview Medical Center","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":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R20.0","M54.5","R11.2","R10.30","E87.6","N12.","E87.2","D72.829","D50.9","K64.4","J44.9","K21.9","M54.9","F17.210","F17.290","Z79.899","Z88.8","Z88.1","Z88.2","Z90.49","M19.012","R10.84","K80.20","F33.2","F41.9","E55.9","F32.9","F43.10","M54.10","M54.2","J44.1","M50.30","M25.519","K25.9","R13.12","K59.00","Z88.3","R07.89","R05.9","J40.","R10.9","S22.42XA","S14.103A","S12.300A","S42.002A","G56.22","R20.2","NO DATA","K44.9","R10.13","R19.8","Z20.822","J20.9","R79.89","Z86.19","Z88.6","T14.90XA","W10.8XXA","R23.3","M94.0","S42.025K","S42.032A","R10.11","R93.2","D64.9","F31.81","F33.1","F41.1","F51.9","F17.200","K31.89","N30.01","G89.29","R10.2","K81.1","V62.84","V62.85","R19.7","K80.50","D53.9","Z98.1","S12.250A","E87.1","T39.395A","K83.8","E86.0","Z87.440","D50.0","D18.00","R91.1","B96.81","K62.5","S42.032K","K29.61","R07.81","S22.43XA","S40.012A","R40.20","M17.12","S42.022A","M75.122","S83.242A","K64.8","V54.16","S12.200A","E27.8","S91.312A","S91.012A","S12.400A","F31.9","M43.12","R33.9","M25.562","K64.9","K29.60","D63.8","R16.0","R19.5","Z87.11","Z82.49","R93.3"],"date":["2022-05-12","2021-09-03","2022-09-19","2021-07-21","2021-07-28","2021-07-22","2021-10-26","2021-07-22","2021-09-15","2021-09-15","2022-09-21","2022-08-11","2021-09-15","2022-09-19","2021-09-15","2021-11-16","2022-09-19","2022-09-19","2022-09-19","2021-09-15","2021-09-29","2022-06-07","2021-11-10","2021-12-02","2022-10-10","2022-05-12","2022-10-10","2022-05-12","2022-05-12","2022-05-12","2022-10-10","2022-05-12","2022-05-12","2022-08-11","2022-08-11","2022-08-11","2022-08-11","2022-09-19","2022-09-19","2022-09-21","2022-09-21","2020-07-27","2020-07-27","2020-07-27","2020-07-27","2021-05-20","2021-05-20","2021-10-25","2021-10-25","2022-09-17","2022-06-07","2022-07-06","2022-09-17","2022-09-17","2022-09-17","2022-09-19","2020-07-20","2020-07-21","2020-12-16","2020-12-16","2021-07-12","2021-09-29","2021-10-28","2021-10-22","2021-10-26","2020-12-28","2020-12-28","2020-12-28","2020-12-28","2020-12-28","2021-08-17","2021-11-02","2021-10-28","2021-10-28","2021-11-16","2021-12-01","2021-12-01","2022-02-23","2021-11-16","2021-11-16","2021-11-16","2020-07-22","2021-07-25","2021-07-25","2021-07-25","2021-07-25","2021-07-25","2021-07-25","2021-07-25","2021-07-25","2021-08-30","2021-08-30","2021-09-29","2021-10-25","2022-10-10","2020-07-20","2020-07-20","2020-07-20","2021-06-29","2021-06-29","2021-06-29","2021-06-29","2021-09-15","2022-03-02","2020-07-20","2020-07-20","2020-07-20","2020-07-20","2020-07-20","2020-07-20","2020-07-20","2020-07-20","2021-04-13","2021-09-15","2021-10-21","2021-10-21","2021-10-21","2021-10-21","2021-10-21","2021-10-21","2021-08-17"],"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":[["","69238117309","DOXEPIN","CAP 100MG","60","Select","Select",""],["","65862069790","VENLAFAXINE","CAP 150MG ER","60","Select","Select",""],["","55111018015","TIZANIDINE","TAB 4MG","90","Select","Select",""],["","59267102504","PFIZER","INJ ADLT RTU","0","Select","Select",""],["","64380080707","IBUPROFEN","TAB 800MG","21","Select","Select",""],["","68462010530","ONDANSETRON","TAB 4MG","30","Select","Select",""],["","00591024105","LORAZEPAM","TAB 1MG","105","Select","Select",""],["","65162010350","GABAPENTIN","CAP 400MG","60","Select","Select",""],["","00093221001","SUCRALFATE","TAB 1GM","60","Select","Select",""],["","00115132019","COLESEVELAM","TAB 625MG","120","Select","Select",""],["","27808003502","HYDROCO\/APAP","TAB 5-325MG","24","Select","Select",""],["","69097052444","DICLOFENAC","GEL 0.01","200","Select","Select",""],["","00143312601","DICYCLOMINE","CAP 10MG","90","Select","Select",""],["","53746061705","TRAMADL\/APAP","TAB 37.5-325","21","Select","Select",""],["","29300012510","MELOXICAM","TAB 15MG","30","Select","Select",""],["","59651000305","OMEPRAZOLE","CAP 40MG","180","Select","Select",""],["","69452015120","VITAMIN","CAP 50000UNT","12","Select","Select",""],["","53489047901","SULINDAC","TAB 200MG","30","Select","Select",""],["","00093005805","TRAMADOL","TAB 50MG","30","Select","Select",""],["","42806071501","BENZONATATE","CAP 200MG","30","Select","Select",""],["","00121077504","GG\/CODEINE","SOL 100-10\/5","180","Select","Select",""],["","59762219807","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","76204020025","ALBUTEROL","NEB 0.00083","75","Select","Select",""],["","65862049101","QUETIAPINE","TAB 100MG","45","Select","Select",""],["","62542030103","HYD","SUS 10-8\/5ML","50","Select","Select",""],["","58657050016","CODEINE\/GG","SOL 10-100\/5","180","Select","Select",""],["","00173071720","ADVAIR","AER 230\/21","12","Select","Select",""],["","00093342210","CYCLOBENZAPR","TAB 10MG","90","Select","Select",""],["","00093321305","CLONAZEPAM","TAB 2MG","120","Select","Select",""],["","00093520006","BUSPIRONE","TAB 30MG","90","Select","Select",""],["","00378230201","PRAZOSIN","CAP 2MG","60","Select","Select",""],["","69543025216","VIRTUSSIN","SOL 100-10\/5","150","Select","Select",""],["","16571030216","GUAIFENESIN","SYP 100-10\/5","180","Select","Select",""],["","00173086910","ANORO","AER 62.5-25","60","Select","Select",""],["","31722072690","MONTELUKAST","TAB 10MG","90","Select","Select",""],["","51672400201","NORTRIPTYLIN","CAP 25MG","60","Select","Select",""],["","51862094305","DIAZEPAM","TAB 10MG","2","Select","Select",""],["","00143992801","CIPROFLOXACN","TAB 500MG","14","Select","Select",""],["","00406324301","HYDROMORPHON","TAB 2MG","12","Select","Select",""],["","00406052301","OXYCOD\/APAP","TAB 10-325MG","21","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","20","Select","Select",""],["","00781261305","AMOXICILLIN","CAP 500MG","56","Select","Select",""],["","70677003201","SM","DIS 21MG\/24H","28","Select","Select",""],["","65862022660","CLARITHROMYC","TAB 500MG","28","Select","Select",""],["","52268001201","SUPREP","SOL PREP KIT","354","Select","Select",""],["","52268020101","SUTAB","TAB ","24","Select","Select",""],["","64980052810","SODIUM","TAB 650MG","30","Select","Select",""],["","59148003813","REXULTI","TAB 2MG","30","Select","Select",""],["","42799011101","ETODOLAC","TAB 400MG","90","Select","Select",""],["","29300013601","CLONIDINE","TAB 0.2MG","60","Select","Select",""],["","50383008716","GUAIATUSS","SYP 100-10\/5","180","Select","Select",""],["","83490031065","VIOS","MIS SYSTEM","1","Select","Select",""],["","45802086803","POLYETH","POW 3350 NF","510","Select","Select",""],["","00406055201","OXYCODONE","TAB 5MG","30","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","20","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","00536124810","STIMULANT","TAB 8.6-50MG","20","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":""}]}]}