{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"RAMONA   L TURNER","gend":1,"add":"2809 PARKSIDE DR APT 203","city":"CHESAPEAKE","state":"VA","zip":"23324-9998","dob":"1961-12-31","age":"","mstatus":"","insh":"900039014*01","cliId":"","pno":"757\/962-0042","cno":"","email":"","ename":"","eno":"","pphy":"MUSSELMANI, ZATTAM MD","ppno":"757\/543-3557","pcpadd":"1422 POINDEXTER ST","pcpcity":"CHESAPEAKE","pcpstate":"VA","pcpzip":23324,"pcpcounty":"","pcpid":"","pcpname":"ZATTAM MUSSELMANI","plan":"OHP","program":"MEDICARE","lob":"DSNP","region":"TIDEWATER","aligned":"Y","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/543-0053","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R39.81","R05.","Z20.828","M19.90","G89.29","J44.9","Z86.73","E11.9","Z86.718","K21.9","I10.","N32.81","Z98.84","Z82.49","Z79.899","Z79.4","Z88.8","Z88.5","N39.0","M79.3","N63.11","N39.46","N39.8","G89.4","M96.1","M79.7","E11.40","M48.061","M54.5","M25.78","M43.8X4","M54.14","R10.84","K46.9","Z90.710","K31.7","K29.50","K31.89","R11.2","G47.30","E66.01","Z68.42","A41.51","N13.6","B02.9","G89.28","E11.649","R31.0","E11.51","G44.209","F41.9","M54.9","A41.9","N23.","N20.1","R10.9","Z96.0","R53.83","R51.9","R53.1","R07.9","M50.30","N12.","Z79.84","H25.13","M79.604","Z86.711","R10.11","K58.0","R19.4","L02.215","K29.70","I11.0","I50.9","D75.9","Z01.812","N20.0","Z20.822","R09.02","T81.44XA","Z68.43","J45.901","L50.0","R07.89","E78.5","T36.1X5A","T36.0X5A","N39.3","N39.42","M47.816","G47.33","D13.1","N10.","E66.9","Z48.816","N13.2","M17.11","M47.812","M51.37","D64.9","F32.9","I27.20","E78.00","J44.1","G47.00","Z85.038","Z79.02","Z79.51","Z87.891","K57.30","D18.03","R00.0","R50.9","R92.1","I26.99","R22.41","Z87.19","R06.2","E11.10","M79.661","M43.16","M48.56XA","Z98.1","R11.0","N13.30","E16.2","F51.01","L53.9","Z87.09","M54.50","N30.00","R06.02","R92.8","R33.9","M47.24","R30.0","N76.0","R82.998","M54.2","R06.00","R19.7","N11.1"],"date":["2020-10-27","2020-08-24","2020-08-24","2021-05-14","2021-10-30","2021-10-30","2021-07-28","2021-12-20","2021-09-09","2021-07-23","2021-09-10","2021-10-30","2021-05-14","2020-08-24","2021-11-30","2021-12-20","2020-08-04","2020-08-24","2021-11-12","2020-09-15","2020-09-15","2020-10-09","2020-11-03","2021-11-30","2021-11-30","2021-11-30","2021-11-30","2021-11-30","2021-07-28","2021-07-23","2021-04-26","2021-04-26","2021-05-07","2021-05-07","2021-05-07","2021-05-14","2021-05-14","2021-05-14","2021-05-14","2021-09-09","2021-10-30","2021-09-09","2021-07-23","2021-09-09","2021-07-23","2021-07-23","2021-07-23","2021-07-23","2021-07-23","2021-07-23","2021-09-09","2021-07-23","2021-09-30","2021-09-15","2021-09-24","2021-09-10","2021-09-10","2021-07-29","2021-09-09","2021-09-09","2021-07-29","2021-07-29","2021-09-30","2021-12-20","2021-12-20","2020-08-24","2020-08-24","2021-04-06","2021-05-19","2021-04-06","2021-04-06","2021-05-14","2021-10-30","2021-10-30","2021-05-14","2021-09-06","2021-09-10","2021-09-06","2021-09-10","2021-09-09","2021-09-09","2021-09-09","2021-09-09","2021-09-09","2021-09-09","2021-09-09","2021-09-09","2021-09-24","2021-09-24","2020-10-27","2021-10-30","2021-05-14","2021-07-25","2021-07-25","2021-10-30","2021-10-30","2021-10-30","2021-10-30","2021-10-30","2021-10-30","2021-10-30","2021-10-30","2021-10-30","2020-08-03","2021-09-09","2021-09-09","2021-09-09","2021-09-09","2021-09-09","2021-09-10","2021-09-10","2021-09-10","2021-09-10","2020-10-12","2021-07-23","2020-08-24","2020-08-24","2020-08-24","2020-09-10","2020-09-10","2020-10-27","2020-10-27","2020-10-27","2021-04-19","2021-07-23","2021-08-01","2021-09-02","2021-09-10","2021-09-10","2021-11-30","2020-04-15","2021-07-23","2020-10-12","2021-03-03","2021-04-29","2021-05-13","2021-05-13","2021-07-23","2021-07-28","2020-08-24","2021-05-19","2021-07-23"],"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":[["","57237001401","TAMSULOSIN HYDROCHLORIDE                                              ","0.4MG","90","Select","Select",""],["","68180069906","TRAMADOL HCL ER                                                       ","300MG ER","30","Select","Select",""],["","65649030302","XIFAXAN                                                               ","550MG","-42","Select","Select",""],["","00378877035","ESTRADIOL                                                             ","0.01%","42","Select","Select",""],["","62175061743","PANTOPRAZOLE SODIUM                                                   ","40MG","180","Select","Select",""],["","69097081312","GABAPENTIN                                                            ","100MG","180","Select","Select",""],["","65162052110","PROMETHAZINE HYDROCHLORIDE                                            ","25MG","120","Select","Select",""],["","68180030360","CEFUROXIME AXETIL                                                     ","500MG","14","Select","Select",""],["","68382025601","OXYBUTYNIN CHLORIDE ER                                                ","10MG ER","-90","Select","Select",""],["","00116200116","CHLORHEXIDINE GLUCONATE                                               ","0.12%","473","Select","Select",""],["","00169750111","NOVOLOG                                                               ","100\/ML","30","Select","Select",""],["","65162083366","DICLOFENAC SODIUM                                                     ","1%","100","Select","Select",""],["","08290328411","BD INSULIN SYRINGE ULTRA-FINE\/1ML\/30G X 12.7MM                        ","1ML\/30G","100","Select","Select",""],["","00245531911","KLOR-CON M20                                                          ","20MEQ ER","90","Select","Select",""],["","65862035790","CLOPIDOGREL                                                           ","75MG","90","Select","Select",""],["","59746073501","CYCLOBENZAPRINE HYDROCHLORIDE                                         ","7.5MG","60","Select","Select",""],["","00603233832","ACETAMINOPHEN\/CODEINE                                                 ","300-30MG","21","Select","Select",""],["","68180072103","AMLODIPINE BESYLATE                                                   ","10MG","90","Select","Select",""],["","59651017401","DOXEPIN HYDROCHLORIDE                                                 ","25MG","90","Select","Select",""],["","00378021610","FUROSEMIDE                                                            ","40MG","90","Select","Select",""],["","68180016013","AZITHROMYCIN                                                          ","250MG","-6","Select","Select",""],["","69238120202","BUPRENORPHINE                                                         ","5MCG\/HR","4","Select","Select",""],["","00574014560","TROSPIUM CHLORIDE                                                     ","20MG","60","Select","Select",""],["","67877057505","BENZONATATE                                                           ","200MG","30","Select","Select",""],["","50111043301","TRAZODONE HYDROCHLORIDE                                               ","50MG","30","Select","Select",""],["","57664016758","METOPROLOL TARTRATE                                                   ","100MG","90","Select","Select",""],["","42858010301","OXYCODONE\/ACETAMINOPHEN                                               ","7.5-325","120","Select","Select",""],["","59746000103","METHYLPREDNISOLONE DOSE PACK                                          ","4MG","21","Select","Select",""],["","63304069301","CLINDAMYCIN HCL                                                       ","300MG","21","Select","Select",""],["","65862042005","SULFAMETHOXAZOLE\/TRIMETHOPRIM DS                                      ","800-160","14","Select","Select",""],["","65862050220","AMOXICILLIN\/CLAVULANATE POTASSIUM                                     ","500-125","14","Select","Select",""],["","00469260230","MYRBETRIQ                                                             ","50MG","30","Select","Select",""],["","00832105410","BACLOFEN                                                              ","10MG","90","Select","Select",""],["","43199001401","HYOSCYAMINE SULFATE ER                                                ","0.375 ER","60","Select","Select",""],["","10702005601","OXYCODONE HYDROCHLORIDE                                               ","10MG","90","Select","Select",""],["","00143312601","DICYCLOMINE HYDROCHLORIDE                                             ","10MG","240","Select","Select",""],["","00093221001","SUCRALFATE                                                            ","1GM","120","Select","Select",""],["","47781030301","NITROFURANTOIN MONOHYDRATE\/MACROCRYSTALS                              ","100MG","14","Select","Select",""],["","70710122501","AMITRIPTYLINE HYDROCHLORIDE                                           ","10MG","90","Select","Select",""],["","68462010530","ONDANSETRON HYDROCHLORIDE                                             ","4MG","32","Select","Select",""],["","69842087651","CVS ACETAMINOPHEN                                                     ","325MG","120","Select","Select",""],["","31722070530","VALACYCLOVIR HCL                                                      ","1GM","15","Select","Select",""],["","00904530660","BANOPHEN                                                              ","25MG","30","Select","Select",""],["","69547035302","NARCAN                                                                ","","2","Select","Select",""],["","00093005805","TRAMADOL HCL                                                          ","50MG","60","Select","Select",""],["","00378967130","IPRATROPIUM BROMIDE\/ALBUTEROL SULFATE                                 ","ALBUTER","90","Select","Select",""],["","57664049983","MIRTAZAPINE                                                           ","15MG","30","Select","Select",""],["","68180012202","CEPHALEXIN                                                            ","500MG","21","Select","Select",""],["","51672404801","CLOTRIMAZOLE\/BETAMETHASONE DIPROPIONATE                               ","DIPROP","120","Select","Select",""],["","00603188016","LIDOCAINE                                                             ","5%","30","Select","Select",""],["","00527169505","BUTALBITAL\/ACETAMINOPHEN\/CAFFEINE                                     ","","15","Select","Select",""],["","00799000104","CALMOSEPTINE                                                          ","","678","Select","Select",""],["","00603459321","METHYLPREDNISOLONE                                                    ","4MG","21","Select","Select",""],["","49483034010","ACETAMINOPHEN                                                         ","325MG","120","Select","Select",""],["","70710113803","FLUCONAZOLE                                                           ","100MG","8","Select","Select",""],["","67877056110","METFORMIN HYDROCHLORIDE                                               ","500MG","180","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":""}]}]}