{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"S NAIRBYENEEW","gend":0,"add":"BRAM 319HCRA EL","city":"CHESAPEAKE","state":"VA","zip":"23322-9998","dob":"1958-09-16","age":"","mstatus":"","insh":"79300210*52","cliId":"","pno":"84\/7571183-2","cno":"","email":"","ename":"","eno":"","pphy":"BARKHURST, MEGAN T NP","ppno":"757\/312-3132","pcpadd":"736 BATTLEFIELD BLVD N","pcpcity":"CHESAPEAKE","pcpstate":"VA","pcpzip":23320,"pcpcounty":"","pcpid":"","pcpname":"CHESAPEAKE REGIONAL MEDICAL GROUP","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":["R91.8","C34.11","Z51.0","Z51.11","R53.0","R05.","G93.9","G93.6","E83.42","E86.0","I25.10","Z95.5","I10.","G89.4","C34.91","C79.31","I82.C13","C34.90","Z98.890","Z51.12","Z20.822","R07.89","R10.9","D70.9","N17.9","E83.52","R50.81","D69.6","Z45.2","F17.210","Z79.82","Z79.899","Z88.0","Z82.49","M54.5","E78.00","F32.5","G89.29","Z95.818","G89.3","M54.9","M48.061","I82.622","N10.","C77.1","NO DATA","B19.20","Z85.118","Z92.21","Z92.3","Z23.","I70.0","E53.8","C34.32","N13.6","D61.810","J90.","E87.1","E87.2","N17.0","T45.1X5A","Z86.718","I25.2","N13.30","M54.2","M54.6","M81.0","R42.","G93.5","R90.0","N28.89","N20.0","Z12.5","R91.1","F98.8","R27.0","F32.9","I82.C12","G08.","D51.0","R11.2","Z85.841","Z09.","F11.23","J44.9","E55.9","R13.10","R59.0","Z20.828","Z01.812","R60.9","R00.0","I65.23","R79.89","M25.511","M25.521","Z12.2"],"date":["2020-10-19","2021-12-17","2021-01-04","2021-12-17","2020-12-01","2020-12-01","2021-05-14","2021-05-14","2021-05-14","2021-05-14","2021-12-31","2021-07-06","2021-12-30","2021-12-31","2021-05-14","2021-12-26","2021-07-06","2021-12-30","2021-08-26","2021-12-17","2021-12-26","2021-12-26","2021-12-27","2021-12-28","2021-12-31","2021-12-30","2021-12-30","2021-12-30","2020-11-16","2021-12-26","2020-11-23","2020-11-23","2020-11-23","2020-11-23","2021-07-14","2021-04-16","2021-07-04","2021-12-15","2021-05-12","2021-12-26","2021-07-06","2021-07-14","2021-12-15","2021-12-31","2021-05-01","2021-12-29","2021-05-02","2021-07-04","2021-05-01","2021-10-06","2021-05-01","2021-05-01","2021-11-17","2021-11-17","2021-12-26","2021-12-26","2021-12-26","2021-12-27","2021-12-26","2021-12-26","2021-12-26","2021-12-26","2021-12-26","2021-12-30","2020-03-18","2020-03-18","2020-08-25","2021-05-02","2021-05-06","2021-05-11","2021-12-27","2021-12-27","2020-08-25","2020-08-25","2021-04-19","2021-05-02","2021-07-06","2021-07-06","2021-07-13","2021-08-11","2021-12-27","2021-07-04","2021-07-13","2020-02-19","2020-02-28","2020-05-14","2021-01-04","2021-10-06","2020-10-16","2020-10-16","2021-07-03","2021-12-26","2019-10-17","2019-10-17","2019-10-17","2019-10-17","2019-10-17"],"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":{"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":[["","00406851501","OXYCODONE","TAB 15MG","60","Select","Select",""],["","47781064090","LEVOTHYROXIN","TAB 25MCG","30","Select","Select",""],["","72305002530","EUTHYROX","TAB 25MCG","30","Select","Select",""],["","","ONDANSETRON","TAB 4MG ODT","","Select","Select",""],["","69097067805","PREGABALIN","CAP 50MG","20","Select","Select",""],["","67877025520","CEPHALEXIN","CAP 750MG","10","Select","Select",""],["","59011041020","OXYCONTIN","TAB 10MG CR","60","Select","Select",""],["","66993068030","OLANZAPINE","TAB 2.5MG","16","Select","Select",""],["","00955100810","ENOXAPARIN","INJ 80\/0.8ML","16","Select","Select",""],["","65162036111","FOLIC","TAB 1MG","30","Select","Select",""],["","60258018601","POLY-IRON","CAP 150 FORT","30","Select","Select",""],["","00003089421","ELIQUIS","TAB 5MG","60","Select","Select",""],["","","POT  CHLORIDE","CAP 10MEQ ER","","Select","Select",""],["","","DEXAMETHASON","TAB 4MG","","Select","Select",""],["","","MORPHINE","TAB 15MG","","Select","Select",""],["","","TRAMADOL","TAB 50MG","","Select","Select",""],["","","METAXALONE","TAB 800MG","","Select","Select",""],["","","OXYCOD\/APAP","TAB 5-325MG","","Select","Select",""],["","","PROCHLORPER","TAB 10MG","","Select","Select",""],["","68645049554","ATORVASTATIN","TAB 80MG","30","Select","Select",""],["","64380073706","VITAMIN","CAP 50000UNT","4","Select","Select",""],["","65862035705","CLOPIDOGREL","TAB 75MG","30","Select","Select",""],["","00093081001","NORTRIPTYLIN","CAP 10MG","90","Select","Select",""],["","57237001930","DULOXETINE","CAP 60MG","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":""}]}]}