{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LINDA WALK","gend":1,"add":"401   CHOWAN PLACE","city":"NEWPORT NEWS","state":"VA","zip":23608,"dob":"1981-03-27","age":"","mstatus":"","insh":4500951,"cliId":"","pno":7579174784,"cno":"","email":"","ename":"","eno":"","pphy":"GASINK, EMMELINE C","ppno":7579174784,"pcpadd":"1000 OLD DENBIGH BLVD,","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":23602,"pcpcounty":"","pcpid":"","pcpname":"THE GARDENS AT WARWICK FOREST","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"TIDEWATER","aligned":"","ano":"","add2":"401   CHOWAN PLACE","add3":"","madd1":"401 CHOWAN PLACE","madd2":"","madd3":"","mcity":"NEWPORT NEWS                  ","mstate":"VA","mzip":"23608-1333","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F25.0","F43.20","F43.10","F70","Z62.810","Z91.5","M25.512","M75.82","M25.632","F31.5","M75.42","G47.33","Z01.818","S46.012D","E11.9","R10.84","R19.7","Z12.31","R00.2","Z91.030","J45.40","Z68.42","E66.01","R06.83","H16.223","H25.13","Z01.812","Z20.822","M24.812","X58.XXXA","M75.102","M75.22","S43.432A","J45.909","K21.9","I10","Z68.43","F31.9","Z79.51","Z79.84","Z79.1","G89.18","R10.2","N89.8","Z47.89","F41.3","F31.32","R11.0","Z87.11","E11.42","F90.0","F90.2","R10.814","R10.812","Z87.19","I63.9","M62.81","R20.2","R47.89","N28.9","Z86.73","I69.30","Z90.49","Z79.899","R29.898","Z12.4","R53.1","R47.81","E86.9","R55","R00.0","I95.89","E86.1","H53.459","K59.00","Z90.710","F31.70","I95.2","G45.9","F80.81","R20.9","I63.89","H54.7","R20.0","Z79.82","R29.818","I12.9","E11.22","E83.51","I65.23","N18.9","R47.9","D72.829","E11.40","F90.9","R11.2","Z09","E11.3293","H53.10","H16.221","H16.222","Z20.828","R05","J40","R05.3","F10.20","F11.20","M54.2","M54.6","V89.2XXA","F31.0","F12.20","F41.9","J98.4"],"date":["2021-08-11","2021-07-08","2021-07-08","2021-07-08","2021-07-08","2021-07-08","2021-04-19","2021-03-17","2021-03-03","2021-04-15","2021-04-19","2021-03-22","2021-03-22","2021-03-22","2021-07-22","2021-06-08","2021-06-08","2021-06-22","2021-05-24","2021-03-22","2021-12-06","2021-06-23","2021-06-23","2021-03-25","2021-07-22","2021-03-29","2021-04-13","2021-04-13","2021-04-19","2021-04-19","2021-04-19","2021-04-19","2021-04-19","2021-06-23","2021-06-08","2021-11-15","2021-04-19","2021-06-08","2021-06-18","2021-06-08","2021-04-19","2021-04-19","2021-04-26","2021-04-26","2021-04-28","2021-07-06","2021-07-06","2021-06-08","2021-06-08","2021-06-23","2021-05-14","2021-05-11","2021-06-08","2021-06-08","2021-05-13","2021-06-05","2021-06-05","2021-06-05","2021-06-05","2021-06-05","2021-06-18","2021-06-05","2021-06-05","2021-06-18","2021-06-05","2021-06-07","2021-06-19","2021-06-19","2021-06-08","2021-06-08","2021-06-08","2021-06-08","2021-06-08","2021-06-08","2021-06-08","2021-06-08","2021-06-08","2021-06-08","2021-06-17","2021-06-18","2021-06-18","2021-06-18","2021-06-18","2021-06-19","2021-06-23","2021-06-18","2021-06-18","2021-06-18","2021-06-18","2021-06-18","2021-06-18","2021-06-18","2021-06-19","2021-06-19","2021-06-19","2021-06-25","2021-06-25","2021-07-22","2021-07-26","2021-07-22","2021-07-22","2021-08-05","2021-09-30","2021-11-15","2021-10-04","2021-10-07","2021-10-07","2021-11-15","2021-11-15","2021-10-14","2021-10-28","2021-11-11","2021-11-15","2021-12-06"],"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":[["","68382005101","MELOXICAM","TAB 15MG","30","Select","Select",""],["","27241009903","DULOXETINE","CAP 60MG","60","Select","Select",""],["","29300022019","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","00310461612","BREZTRI","AER SPHERE","10.7","Select","Select",""],["","60432026415","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","64380071206","BENZONATATE","CAP 100MG","60","Select","Select",""],["","59746017506","PREDNISONE","TAB 20MG","15","Select","Select",""],["","00093598627","EPINEPHRINE","INJ 0.3MG","2","Select","Select",""],["","51660099830","FEXOFENADINE","TAB 180MG","30","Select","Select",""],["","13668033101","TRAZODONE","TAB 100MG","30","Select","Select",""],["","65862070560","ZIPRASIDONE","CAP 80MG","60","Select","Select",""],["","99073070822","FREESTYLE    TES LITE","TES LITE","50","Select","Select",""],["","00555032302","HYDROXYZ","CAP 25MG","90","Select","Select",""],["","00173069600","ADVAIR","AER 250\/50","60","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","30","Select","Select",""],["","00006483703","PNEUMOVAX","INJ 25\/0.5","0.5","Select","Select",""],["","58160084252","BOOSTRIX","INJ ","0.5","Select","Select",""],["","59267100003","PFIZER","INJ COVID-19","0.3","Select","Select",""],["","11822775350","RA","LIQ 100-10\/5","474","Select","Select",""],["","69097097107","LISINOP\/HCTZ","TAB 20-25MG","30","Select","Select",""],["","99073070805","FREESTYLE    MIS LITE","MIS LITE","1","Select","Select",""],["","99073013001","FREESTYLE    MIS LANCETS","MIS LANCETS","100","Select","Select",""],["","67877019905","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","9","Select","Select",""],["","16571020110","DICLOFENAC","TAB 75MG DR","60","Select","Select",""],["","69367027204","CODEINE\/GG","SOL 10-100\/5","118","Select","Select",""],["","00591292754","LEVALBUTEROL","AER 45\/ACT","15","Select","Select",""],["","72647033104","METHYLPRED","TAB 4MG","21","Select","Select",""],["","69097012303","TOPIRAMATE","TAB 50MG","60","Select","Select",""],["","50228018005","GABAPENTIN","CAP 300MG","30","Select","Select",""],["","72888001405","CYCLOBENZAPR","TAB 10MG","60","Select","Select",""],["","00597015230","JARDIANCE","TAB 10MG","30","Select","Select",""],["","00378932132","WIXELA","AER 250\/50","60","Select","Select",""],["","69238110005","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","00121077504","GG\/CODEINE","SOL 100-10\/5","118","Select","Select",""],["","00904679480","ASPIRIN","CHW 81MG","30","Select","Select",""],["","31722071390","PANTOPRAZOLE","TAB 40MG","180","Select","Select",""],["","99073012101","FREESTYLE    TES","TES ","100","Select","Select",""],["","60505257808","ATORVASTATIN","TAB 10MG","30","Select","Select",""],["","68382004101","PROMETHAZINE","TAB 25MG","30","Select","Select",""],["","00093221001","SUCRALFATE","TAB 1GM","180","Select","Select",""],["","65162046510","IBUPROFEN","TAB 600MG","60","Select","Select",""],["","68462011944","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","76204020025","ALBUTEROL","NEB 0.00083","75","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":""}]}]}