{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"K   AIHTNYCTLAWREITS ","gend":1,"add":"LIM 8238TS DRAL","city":"NORFOLK","state":"VA","zip":"23518-9998","dob":"1960-05-14","age":"","mstatus":"","insh":"68300210*33","cliId":"","pno":"35\/7576100-1","cno":"","email":"","ename":"","eno":"","pphy":"PARKER, REBECCA M NP","ppno":"757\/689-8460","pcpadd":"SUITE 100 1925 GLENN MITCHELL DR","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":23456,"pcpcounty":"","pcpid":"","pcpname":"Princess Anne 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":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I95.9","L03.115","N17.9","N39.0","S80.01XA","I10.","V72.85","M81.0","M35.00","M25.551","F41.9","K21.9","T40.4X5A","L29.9","T65.811A","Z51.89","S42.295A","S42.202A","G40.909","Z86.74","J30.9","L30.9","M54.9","S29.9XXA","E78.5","H02.055","H16.041","H40.023","H52.211","H18.50","H04.123","H35.033","I42.8","I50.22","R01.1","I46.9","R55.","F33.1","F40.01","L50.9","Z48.00","Z79.899","Z88.1","Z88.2","Z88.6","Z88.8","Z91.013","G43.909","I50.9","R42.","S52.509A","L30.8","V58.89","L08.9","W57.XXXD","H60.312","G47.00","L03.119","R65.10","R30.0","R82.998","S81.811A","S20.211A","H52.221","W17.2XXA","R60.9","S42.292A","S53.402A","S63.615A","S22.31XA","H18.463","M20.41","M20.22","M20.42","M20.21","M77.41","S80.11XA","S93.411A","S82.831A","S89.91XA","H16.121","H40.013","Z83.71","R56.9","Z12.11","Z86.010","K57.30","K64.8","R06.89","R07.9","R00.2","R26.9","Z82.49","R31.0","G89.29"],"date":["2020-04-28","2020-04-26","2020-04-24","2020-04-28","2020-04-24","2020-04-28","2020-04-24","2021-10-04","2020-04-28","2020-04-24","2020-04-24","2020-04-24","2020-04-24","2020-04-24","2020-04-24","2020-10-07","2020-12-29","2021-02-11","2021-10-04","2021-10-04","2021-10-04","2021-10-04","2021-06-04","2021-06-04","2021-10-04","2020-01-06","2020-01-13","2020-02-05","2020-01-13","2020-01-13","2020-02-05","2020-02-05","2021-11-08","2021-11-08","2021-11-08","2021-11-08","2021-11-08","2021-12-21","2021-12-21","2021-10-04","2020-10-07","2020-10-07","2020-10-07","2020-10-07","2020-10-07","2020-10-07","2020-10-07","2020-11-16","2020-11-16","2020-11-16","2020-11-16","2021-07-05","2021-08-18","2021-08-18","2021-08-18","2021-08-18","2021-09-30","2020-04-28","2020-04-28","2020-12-09","2020-12-03","2020-10-06","2020-10-06","2020-01-02","2020-04-24","2020-04-27","2020-12-31","2020-12-31","2020-12-31","2021-05-21","2019-05-06","2019-04-24","2019-04-24","2019-04-24","2019-04-24","2019-04-24","2019-07-25","2019-07-25","2019-07-25","2019-07-25","2019-03-19","2019-11-04","2019-09-20","2019-11-25","2019-10-08","2019-10-08","2019-10-08","2019-10-08","2019-02-26","2019-02-26","2019-02-26","2019-02-26","2019-02-26","2019-05-21","2019-05-23"],"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":[["","00378400505","ALPRAZOLAM","TAB 1MG","120","Select","Select",""],["","45802042578","FEXOFENADINE","TAB 60MG","60","Select","Select",""],["","51672138603","FLUOCINONIDE","CRE 0.0005","60","Select","Select",""],["","31722070090","LOSARTAN","TAB 25MG","30","Select","Select",""],["","65862016001","ZOLPIDEM","TAB 10MG","30","Select","Select",""],["","65862019105","CYCLOBENZAPR","TAB 10MG","40","Select","Select",""],["","00781286810","OMEPRAZOLE","CAP 20MG DR","30","Select","Select",""],["","","PREMARIN","CRE 0.625MG","","Select","Select",""],["","68382009201","CARVEDILOL","TAB 3.125MG","60","Select","Select",""],["","00406048410","APAP\/CODEINE","TAB 300-30MG","30","Select","Select",""],["","47781030701","NITROFUR","CAP 50MG","30","Select","Select",""],["","13668001101","CITALOPRAM","TAB 40MG","30","Select","Select",""],["","64380080707","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","70010075401","METHOCARBAM","TAB 500MG","40","Select","Select",""],["","41167413104","ALLEGRA","TAB 60MG","180","Select","Select",""],["","23155050105","HYDROXYZ","TAB 25MG","60","Select","Select",""],["","","PREDNISONE","TAB 20MG","","Select","Select",""],["","00143980305","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","72511075001","REPATHA","INJ 140MG\/ML","2","Select","Select",""],["","51672128202","TRIAMCINOLON","CRE 0.001","30","Select","Select",""],["","00781618667","CIPRO\/DEXA","SUS 0.3-0.1%","8","Select","Select",""],["","00406012301","HYDROCO\/APAP","TAB 5-325MG","11","Select","Select",""],["","00093310953","AMOXICILLIN","CAP 500MG","16","Select","Select",""],["","","LOTEPREDNOL","SUS 0.005","","Select","Select",""],["","","CILOXAN","OIN 0.3% OP","","Select","Select",""],["","","DEXAMETH","SOL 0.1% OP","","Select","Select",""],["","","LOTEMAX","SUS 0.005","","Select","Select",""],["","","MOXIFLOXACIN","SOL HCL 0.5%","","Select","Select",""],["","","CIPROFLOXACN","TAB 250MG","","Select","Select",""],["","","ERYTHROMYCIN","OIN 5MG\/GM","","Select","Select",""],["","00006380118","MAXALT-MLT","TAB 10MG","12","Select","Select",""],["","","AMOX\/K","TAB 875-125","","Select","Select",""],["","","DICLOFENAC","TAB 75MG DR","","Select","Select",""],["","11822029233","RA","TAB 5MG EC","4","Select","Select",""],["","","CEPHALEXIN","CAP 500MG","","Select","Select",""],["","","OXYCOD\/APAP","TAB 5-325MG","","Select","Select",""],["","00591299239","PHENADOZ","SUP 25MG","5","Select","Select",""],["","55111018015","TIZANIDINE","TAB 4MG","90","Select","Select",""],["","00378905593","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","65862062690","RIZATRIPTAN","TAB 10MG ODT","12","Select","Select",""],["","43386009019","GAVILYTE-G","SOL ","4000","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":""}]}]}