{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MARGARET   A STRICKLAND","gend":1,"add":"6177 EDWARD ST APT 303","city":"NORFOLK","state":"VA","zip":"23513-9998","dob":"1964-10-07","age":"","mstatus":"","insh":"900034333*01","cliId":"","pno":"302\/407-2451","cno":"","email":"","ename":"","eno":"","pphy":"PAVON, HUMBERTO F MD","ppno":"757\/502-4840","pcpadd":"SUITE 101 5700 LAKE WRIGHT DR","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23502,"pcpcounty":"","pcpid":"","pcpname":"INTERNAL MEDICINE KIDNEY AND HYPERTENSION CTR PC","plan":"OHP","program":"MEDICARE","lob":"DSNP","region":"TIDEWATER","aligned":"Y","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/502-4841","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R79.89","E78.5","R73.9","C50.912","Z17.0","R00.2","Z85.3","R07.9","Z92.89","I65.23","M89.8X9","M25.562","M25.561","Z90.13","Z92.21","I66.8","G93.89","R55.","M25.552","F31.32","F43.12","F41.1","F41.0","E53.9","M81.8","E03.9","I10.","R73.01","E55.9","R06.83","G47.19","Z91.89","R10.2","L65.9","R53.83","G62.0","M79.606","M79.2","Z79.899","Z78.0","F33.2","Z13.29","R10.32","R53.81","Z87.19","R07.89","R30.0","L65.0","Z71.9","Z01.818","R06.00","N65.0","I73.9","Z87.891","Z98.82","F17.211","N65.1","Z51.81","T07.XXXA","F33.9","M46.1","F11.20","M17.0","G47.33","I70.209","D53.9","I77.6","Z00.00","Z12.11","R42.","E66.9","S00.81XA","S00.91XA","Z79.82","Z88.0","G60.9","H90.42","H91.8X2","R93.89","Z68.30","E78.00","R94.8","M54.5","G89.29","Z79.891","Z95.820","Z98.890","Z88.1","Z91.040","Z88.5","Z91.048","Z82.49","F33.1","E88.81","M25.569","R11.2","Z86.61","J06.9","R05.","M79.604","H53.8","M79.605","M94.0","R73.02","H04.122","R91.8","N26.1","N28.1","I70.90","Z95.828","G89.4","R04.0","I25.10","Z12.2","Z72.0","L30.9","R94.31","M70.62","M54.6","K55.1","I70.8","R06.02","F41.9","Z68.31","R10.84","T78.40XA","R60.0","R07.81","Z68.29","H52.03","Z23.","R70.0","R00.0","B97.89","N30.01","N30.00","H81.13","R05.9"],"date":["2021-08-22","2021-11-19","2019-09-24","2020-05-13","2020-05-12","2018-05-29","2021-10-11","2021-10-11","2018-08-09","2021-09-17","2019-08-12","2019-06-12","2019-06-12","2020-02-02","2019-06-12","2019-08-27","2019-08-27","2019-08-27","2020-01-21","2020-03-20","2021-04-19","2021-04-19","2021-04-09","2020-05-12","2020-05-12","2020-07-30","2021-11-19","2020-07-30","2021-04-08","2020-09-02","2020-09-02","2020-09-02","2021-03-11","2021-09-03","2020-09-09","2021-11-15","2021-11-15","2021-11-15","2021-09-01","2021-03-11","2021-04-08","2021-04-08","2021-09-24","2021-08-12","2021-08-12","2021-08-22","2021-09-24","2021-10-14","2021-10-14","2021-12-02","2018-05-24","2018-05-29","2021-10-11","2021-10-11","2018-07-03","2018-07-03","2019-10-09","2020-09-16","2020-01-17","2020-07-30","2020-07-30","2020-07-30","2020-07-30","2020-07-30","2020-07-30","2020-07-30","2020-07-30","2021-04-08","2021-09-03","2021-11-19","2021-08-22","2018-03-28","2018-03-28","2018-04-30","2021-10-11","2018-10-11","2018-11-01","2018-11-01","2019-09-24","2018-11-09","2019-08-12","2019-08-12","2020-02-02","2020-02-02","2020-02-02","2021-08-22","2020-02-02","2021-10-11","2021-10-11","2021-10-11","2020-02-02","2021-08-22","2021-04-19","2021-06-20","2018-02-11","2021-10-11","2018-04-30","2021-10-11","2019-02-07","2019-09-24","2019-09-24","2019-09-24","2019-10-09","2020-03-04","2020-10-30","2021-09-02","2021-09-02","2021-09-02","2021-09-02","2021-09-02","2018-03-29","2019-07-15","2020-08-20","2020-08-20","2020-08-20","2021-09-03","2018-02-22","2020-03-05","2021-08-22","2021-08-22","2021-08-22","2021-08-22","2021-08-22","2021-08-22","2021-08-22","2018-07-06","2018-07-06","2019-06-11","2019-07-26","2019-10-15","2018-02-22","2018-04-06","2018-05-15","2019-04-05","2020-10-30","2021-10-11","2021-10-11","2021-10-11"],"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":[]}]},{"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":[["","16729003415","LETROZOLE                                                             ","2.5MG","90","Select","Select",""],["","42858010201","OXYCODONE\/ACETAMINOPHEN                                               ","5-325MG","120","Select","Select",""],["","68180016013","AZITHROMYCIN                                                          ","250MG","6","Select","Select",""],["","00591565810","CYCLOBENZAPRINE HYDROCHLORIDE                                         ","10MG","20","Select","Select",""],["","00378247401","DICLOFENAC POTASSIUM                                                  ","50MG","20","Select","Select",""],["","00228202950","ALPRAZOLAM                                                            ","0.5MG","7","Select","Select",""],["","68180072103","AMLODIPINE BESYLATE                                                   ","10MG","90","Select","Select",""],["","13668013601","ESCITALOPRAM OXALATE                                                  ","10MG","14","Select","Select",""],["","49884072501","BUSPIRONE HYDROCHLORIDE                                               ","7.5MG","60","Select","Select",""],["","43547030203","ARIPIPRAZOLE                                                          ","2MG","14","Select","Select",""],["","00093720198","PRAVASTATIN SODIUM                                                    ","20MG","90","Select","Select",""],["","70954001910","PRAZOSIN HYDROCHLORIDE                                                ","1MG","30","Select","Select",""],["","65862085901","FAMOTIDINE                                                            ","20MG","-60","Select","Select",""],["","65162083366","DICLOFENAC SODIUM                                                     ","1%","100","Select","Select",""],["","65162074510","PROMETHAZINE HCL                                                      ","12.5MG","40","Select","Select",""],["","10702001801","OXYCODONE HYDROCHLORIDE                                               ","5MG","120","Select","Select",""],["","69097014260","ALBUTEROL SULFATE HFA                                                 ","HFA","7","Select","Select",""],["","47781030301","NITROFURANTOIN MONOHYDRATE\/MACROCRYSTALS                              ","100MG","14","Select","Select",""],["","31722070190","LOSARTAN POTASSIUM                                                    ","50MG","90","Select","Select",""],["","63304069301","CLINDAMYCIN HCL                                                       ","300MG","21","Select","Select",""],["","59267100003","PFIZER-BIONTECH COVID-19 VACCINE                                      ","COVID-19","0","Select","Select",""],["","59779030501","CVS CLOTRIMAZOLE                                                      ","1%","14","Select","Select",""],["","69097015807","MELOXICAM                                                             ","7.5MG","30","Select","Select",""],["","00143992801","CIPROFLOXACIN HYDROCHLORIDE                                           ","500MG","10","Select","Select",""],["","68462018117","CLOTRIMAZOLE                                                          ","1%","15","Select","Select",""],["","57237007710","ONDANSETRON ODT                                                       ","4MG ODT","10","Select","Select",""],["","59746012106","MECLIZINE HCL                                                         ","25MG","30","Select","Select",""],["","65862042005","SULFAMETHOXAZOLE\/TRIMETHOPRIM DS                                      ","800-160","14","Select","Select",""],["","00143122701","DICYCLOMINE HYDROCHLORIDE                                             ","20MG","120","Select","Select",""],["","16571066101","MECLIZINE HYDROCHLORIDE                                               ","25MG","30","Select","Select",""],["","81421002204","DULCOLAX STOOL SOFTENER                                               ","100MG","4","Select","Select",""],["","45802086802","POLYETHYLENE GLYCOL 3350                                              ","3350 NF","238","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":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"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":""}]}]}