{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"   SAMOHTONALED E","gend":0,"add":"OB OP856 X","city":"IRVINGTON","state":"VA","zip":"22480-9998","dob":"1965-08-06","age":"","mstatus":"","insh":"69500210*24","cliId":"","pno":"03\/4085565-9","cno":"804\/309-5655","email":"","ename":"","eno":"","pphy":"DODSON-MCADOO, SHIRLEY NP","ppno":"757\/275-8121","pcpadd":"110 KINGSLEY LANE SUITE 312","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23505,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","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":["F33.2","R42.","R20.0","E11.9","E78.00","E78.5","F17.210","F31.9","G45.0","G89.29","I10.","I65.23","J43.8","K21.9","K74.60","K76.0","M48.02","Z79.01","Z86.718","M47.812","M47.816","R25.1","R26.9","M54.2","M54.5","H93.13","U07.1","J44.9","F33.9","R07.9","R10.9","R52.","K59.00","Z92.29","I82.409","M75.82","E11.65","M19.90","G43.909","M47.819","F17.200","F41.8","E66.9","E11.69","R73.9","M54.9","F32.9","B35.1","E11.51","I79.8","M79.676","M21.619","R60.0","R26.2","M62.830","F31.60","F41.1","M25.511","M25.512","R53.83","M75.52","M75.51","F11.23","F41.0","M62.831","M62.838","F41.9","M48.00","R05.","R00.2","R94.31","G47.00","I82.533","I51.7","I36.1","M62.81","R53.1","R26.89","R47.9","M79.641","Z79.02","R05.9","H25.13","G45.9","M51.36","NO DATA","F44.9","Z68.28","M25.562","G89.4","E11.42","Z68.34"],"date":["2020-03-25","2020-09-02","2020-08-30","2022-02-01","2022-02-01","2022-02-01","2020-08-30","2022-07-12","2020-08-30","2022-10-25","2022-07-07","2020-10-20","2020-08-30","2020-08-30","2022-02-01","2022-02-01","2021-04-20","2022-05-09","2022-08-22","2022-10-25","2022-10-25","2022-04-04","2021-05-24","2021-12-12","2021-09-01","2021-01-24","2021-04-01","2022-02-01","2022-07-12","2022-02-01","2022-10-25","2022-02-01","2022-02-01","2022-02-13","2022-07-07","2021-12-01","2022-08-22","2022-08-30","2022-02-01","2022-10-25","2022-10-05","2022-10-05","2022-10-25","2022-10-25","2022-10-25","2022-10-25","2022-10-25","2021-02-11","2021-02-11","2021-02-11","2021-02-11","2021-02-11","2021-02-11","2021-02-11","2022-08-22","2022-08-22","2022-10-25","2022-09-01","2022-09-01","2021-10-01","2022-03-02","2022-03-02","2022-03-31","2022-08-22","2022-08-22","2022-03-31","2022-04-04","2022-08-30","2020-10-09","2021-01-24","2021-02-11","2022-06-07","2020-03-16","2020-09-01","2020-09-01","2020-10-02","2020-10-02","2020-10-02","2020-10-02","2022-07-07","2022-07-07","2022-10-25","2021-03-04","2020-10-20","2021-04-20","2020-10-20","2020-10-20","2020-10-20","2020-06-19","2021-04-20","2021-04-20","2021-04-20"],"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":[["","59762135101","PREGABALIN","CAP 150MG","15","Select","Select",""],["","61874013030","VRAYLAR","CAP 3MG","30","Select","Select",""],["","51224000760","METFORMIN","TAB 500MG ER","26","Select","Select",""],["","31604002517","CALCIUM\/VITD","TAB 500-400","24","Select","Select",""],["","00115180302","HYDROXYZ","CAP 25MG","90","Select","Select",""],["","00003089421","ELIQUIS","TAB 5MG","28","Select","Select",""],["","00904386575","DEEP","SPR 0.0065","44","Select","Select",""],["","69315030660","NYSTATIN","POW 100000","60","Select","Select",""],["","11845011145","MELATONIN\/","TAB VIT B-6","30","Select","Select",""],["","00904673061","ACETAMIN","TAB 500MG","82","Select","Select",""],["","65162076610","WARFARIN","TAB 5MG","27","Select","Select",""],["","65162062711","TRAMADOL","TAB 50MG","30","Select","Select",""],["","00002773701","INSULIN","INJ 100\/ML","10","Select","Select",""],["","00527133010","BACLOFEN","TAB 10MG","30","Select","Select",""],["","00904688365","ACETAMINOPHE","TAB 650MG ER","90","Select","Select",""],["","00406051205","OXYCOD\/APAP","TAB 5-325MG","15","Select","Select",""],["","00904582460","VITAMIN","TAB 1000UNIT","24","Select","Select",""],["","00006027728","JANUVIA","TAB 100MG","13","Select","Select",""],["","10006070028","MAG","TAB 400MG","60","Select","Select",""],["","87701040814","MELATONIN","TAB 5MG","30","Select","Select",""],["","16729004517","ATORVASTATIN","TAB 20MG","30","Select","Select",""],["","80681014101","CERTAVITE","TAB SENIOR","30","Select","Select",""],["","40985027416","D3","CAP 2000UNIT","30","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","33342015715","CELECOXIB","CAP 200MG","4","Select","Select",""],["","45963055650","GABAPENTIN","CAP 300MG","60","Select","Select",""],["","16729030017","TRAZODONE","TAB 100MG","30","Select","Select",""],["","00093005301","BUSPIRONE","TAB 5MG","60","Select","Select",""],["","43547028211","ESCITALOPRAM","TAB 20MG","30","Select","Select",""],["","74300049254","BENGAY","GEL THERAPY","113","Select","Select",""],["","59316010212","BIOFREEZE","GEL 0.04","89","Select","Select",""],["","00054001820","PREDNISONE","TAB 20MG","12","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","16729048601","METHOTREXATE","TAB 2.5MG","10","Select","Select",""],["","00536344508","CEROVITE","TAB SENIOR","28","Select","Select",""],["","16729000101","GLIMEPIRIDE","TAB 1MG","30","Select","Select",""],["","63402030430","LATUDA","TAB 40MG","14","Select","Select",""],["","41167073003","SPORTSCREME","CRE 0.1","85","Select","Select",""],["","00536589588","NICOTINE","DIS 14MG\/24H","14","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0","Select","Select",""],["","00054418625","DEXAMETHASON","TAB 6MG","2","Select","Select",""],["","00378623301","CITALOPRAM","TAB 40MG","30","Select","Select",""],["","43547035311","LISINOPRIL","TAB 10MG","30","Select","Select",""],["","87701040746","GNP","TAB 1000MG","60","Select","Select",""],["","68180035302","SERTRALINE","TAB 100MG","30","Select","Select",""],["","00904576960","ARTHRTS","TAB 650MG","85","Select","Select",""],["","00168025846","CLOTRIM\/BETA","CRE DIPROP","45","Select","Select",""],["","45802065087","LORATADINE","TAB 10MG","6","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","00378247401","DICLOFEN","TAB 50MG","60","Select","Select",""],["","67877024201","QUETIAPINE","TAB 25MG","90","Select","Select",""],["","00135019502","NICODERM","DIS 14MG\/24H","14","Select","Select",""],["","41167005706","ASPERCREME","LOT 0.1","177","Select","Select",""],["","00527143501","METAXALONE","TAB 800MG","21","Select","Select",""],["","70710122901","AMITRIPTYLIN","TAB 100MG","30","Select","Select",""],["","27241009990","DULOXETINE","CAP 60MG","1","Select","Select",""],["","52817033200","CYCLOBENZAPR","TAB 10MG","12","Select","Select",""],["","53489012002","DOXYCYCL","TAB 100MG","14","Select","Select",""],["","00536120215","LIDOCAINE","PAD 0.04","5","Select","Select",""],["","54629089309","OMEGA-3","CAP 1000MG","90","Select","Select",""],["","13668015590","ESOMEPRA","CAP 40MG DR","9","Select","Select",""],["","00264780000","SOD","INJ 0.009","1000","Select","Select",""],["","69452014320","BENZONATATE","CAP 100MG","10","Select","Select",""],["","24385016553","ARTHRICREAM","CRE 0.1","85","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":""}]}]}