{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BARBARA   A ATKINSON","gend":1,"add":"2603 MIDDLE AVE","city":"NORFOLK","state":"VA","zip":"23504-9998","dob":"1954-10-05","age":"","mstatus":"","insh":"900038452*01","cliId":"7M41XX8DJ29","pno":"757\/675-6270","cno":"757\/675-6270","email":"","ename":"","eno":"","pphy":"TUCKER, MICHAEL MD","ppno":"","pcpadd":"110 KINGSLEY LANE SUITE 411","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23505,"pcpcounty":"","pcpid":110850,"pcpname":"","plan":"OHP","program":"MEDICARE","lob":"MA-Non DSNP","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/625-7411","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z00.00","E78.5","I10.","M19.072","U07.1","H81.10","N30.01","R53.1","Z74.3","R07.9","J12.82","E66.01","I48.91","I82.409","I50.31","I82.461","R91.8","R06.02","R22.43","Z12.11","M47.816","R42.","D25.9","R07.89","I67.82","J96.01","L98.9","Z86.16","I50.32","I47.1","R47.89","F43.20","I11.9","I20.9","R00.2","R06.09","M25.572","E78.2","M15.0","E55.9","M17.9","E11.9","J20.9","G47.39","R60.9","M79.609","R10.9","I11.0","I50.33","Z68.41","I47.2","N39.0","I82.442","Z86.718","Z91.14","E87.6","Z88.2","D50.9","E78.00","N95.0","M46.97","M43.17","I82.493","I82.90","R33.9","I21.4","M62.81","R26.81","R41.841","R47.81","R93.89","I50.9","E53.9","M54.17","I82.403","I82.431","I82.441","I82.451","I31.3","G93.40","N17.9","F41.9","I13.10","N18.2","I82.402","I25.119","R77.8"],"date":["2021-07-19","2021-10-29","2021-11-18","2020-02-28","2021-10-15","2021-08-30","2021-08-30","2021-09-22","2021-09-22","2021-09-29","2021-10-15","2021-10-22","2021-10-28","2021-10-19","2021-11-02","2021-11-02","2021-10-22","2021-10-22","2020-11-17","2021-05-23","2021-08-05","2021-08-30","2021-10-26","2021-10-26","2021-10-29","2021-10-01","2021-10-06","2021-11-02","2021-10-28","2021-10-30","2021-10-29","2021-11-01","2021-11-22","2021-11-22","2021-11-22","2021-11-22","2020-02-24","2021-07-19","2020-02-28","2021-06-08","2021-07-01","2021-03-09","2021-03-09","2021-06-08","2021-06-08","2021-06-08","2021-09-08","2021-10-22","2021-10-29","2021-10-22","2021-10-22","2021-10-22","2021-10-22","2021-10-22","2021-10-22","2021-10-22","2021-10-22","2021-10-22","2021-10-22","2021-11-12","2021-08-05","2021-08-05","2021-09-10","2021-10-01","2021-10-01","2021-10-01","2021-10-01","2021-10-01","2021-10-01","2021-10-28","2021-11-12","2021-11-18","2020-10-27","2021-07-01","2021-10-25","2021-09-08","2021-09-08","2021-09-08","2021-09-08","2021-09-08","2021-09-29","2021-09-08","2021-09-08","2021-09-08","2021-10-29","2020-12-11","2021-09-29"],"priorHcc":[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null]}},{"a":[]}]},{"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":[]}]},{"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":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","68645055554","","40MG","30","Select","Select",""],["","68645055554","LISINOPRIL","40MG","30","Select","Select",""],["","59746000103","METHYLPRED","4MG","-21","Select","Select",""],["","00093078701","ATENOLOL","25MG","30","Select","Select",""],["","64380073706","VITAMIN","50000UNT","-8","Select","Select",""],["","51672401801","ETODOLAC","400MG","60","Select","Select",""],["","68382009405","CARVEDILOL","12.5MG","180","Select","Select",""],["","59746021601","SPIRONOLACT","25MG","30","Select","Select",""],["","51663000500","OPTIMAL-D","50000UNT","8","Select","Select",""],["","60631041230","EDARBYCLOR","40-12.5","30","Select","Select",""],["","62175010701","ISOSORB","20MG","90","Select","Select",""],["","00527221537","METOLAZONE","2.5MG","3","Select","Select",""],["","65162062750","TRAMADOL","50MG","28","Select","Select",""],["","00054429931","FUROSEMIDE","40MG","90","Select","Select",""],["","50111078751","AZITHROMYCIN","250MG","6","Select","Select",""],["","31722070190","LOSARTAN","50MG","90","Select","Select",""],["","68382005105","MELOXICAM","15MG","30","Select","Select",""],["","72205001390","PREGABALIN","75MG","60","Select","Select",""],["","57237004101","PENICILLN","500MG","40","Select","Select",""],["","00093505698","ATORVASTATIN","10MG","90","Select","Select",""],["","67877057505","BENZONATATE","200MG","30","Select","Select",""],["","00003089421","ELIQUIS","5MG","28","Select","Select",""],["","00555077902","MEDROXYPR","10MG","1","Select","Select",""],["","16714008210","HYDROXYZ","25MG","30","Select","Select",""],["","00054981725","PREDNISONE","10MG","28","Select","Select",""],["","57237001405","TAMSULOSIN","0.4MG","30","Select","Select",""],["","53746064201","FLECAINIDE","100MG","60","Select","Select",""],["","68180012201","CEPHALEXIN","500MG","14","Select","Select",""],["","27808008602","HYD","10-8\/5ML","60","Select","Select",""],["","65162044211","MECLIZINE","25MG","30","Select","Select",""],["","52817036100","METOPROL","50MG","60","Select","Select",""],["","59746000103","METHYLPRED ","TAB 4MG","-21","Select","Select",""],["","00093078701","ATENOLOL ","TAB 25MG","30","Select","Select",""],["","68645055554","LISINOPRIL ","TAB 40MG","30","Select","Select",""],["","64380073706","VITAMIN ","CAP 50000UNT","8","Select","Select",""],["","50111078751","AZITHROMYCIN ","TAB 250MG","6","Select","Select",""],["","59746021601","SPIRONOLACT ","TAB 25MG","30","Select","Select",""],["","68382009405","CARVEDILOL ","TAB 12.5MG","180","Select","Select",""],["","51672401801","ETODOLAC ","TAB 400MG","60","Select","Select",""],["","51663000500","OPTIMAL-D ","CAP 50000UNT","8","Select","Select",""],["","60631041230","EDARBYCLOR ","TAB 40-12.5","-30","Select","Select",""],["","62175010701","ISOSORB ","TAB 20MG","90","Select","Select",""],["","65162062750","TRAMADOL ","TAB 50MG","28","Select","Select",""],["","00378021610","FUROSEMIDE ","TAB 40MG","90","Select","Select",""],["","72205001390","PREGABALIN ","CAP 75MG","60","Select","Select",""],["","00003089421","ELIQUIS ","TAB 5MG","20","Select","Select",""],["","67877057505","BENZONATATE ","CAP 200MG","3","Select","Select",""],["","68382013201","TAMSULOSIN ","CAP 0.4MG","30","Select","Select",""],["","00555077902","MEDROXYPR ","TAB 10MG","90","Select","Select",""],["","75834010901","CHLORTHALID ","TAB 25MG","30","Select","Select",""],["","00093505698","ATORVASTATIN ","TAB 10MG","90","Select","Select",""],["","57237004101","PENICILLN ","TAB 500MG","40","Select","Select",""],["","00527221537","METOLAZONE ","TAB 2.5MG","3","Select","Select",""],["","31722070190","LOSARTAN ","TAB 50MG","90","Select","Select",""],["","68382005105","MELOXICAM ","TAB 15MG","30","Select","Select",""],["","69238112601","ETHACRYNIC ","TAB ACD 25MG","180","Select","Select",""],["","59746012106","MECLIZINE ","TAB 25MG","30","Select","Select",""],["","68180012101","CEPHALEXIN ","CAP 250MG","28","Select","Select",""],["","16714008210","HYDROXYZ ","TAB 25MG","-30","Select","Select",""],["","50268032115","FLECAINIDE ","TAB 100MG","60","Select","Select",""],["","00054981725","PREDNISONE ","TAB 10MG","28","Select","Select",""],["","52817036100","METOPROL ","TAB 50MG","60","Select","Select",""],["","27808008602","HYD ","SUS 10-8\/5ML","60","Select","Select",""]]}},{"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":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[[["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""]]]},{"t":"Mini-Cog","q":[{"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":""}]}]}