{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"FELICKIA   L DUDLEY","gend":1,"add":"1407 CHARLESTON AVE","city":"PORTSMOUTH","state":"VA","zip":"23704-9998","dob":"1975-07-06","age":"","mstatus":"","insh":"900039036*01","cliId":"","pno":"757\/227-2210","cno":"","email":"","ename":"","eno":"","pphy":"YUNAS, MOHAMMAD MD","ppno":"393-6595","pcpadd":"3003 HIGH ST","pcpcity":"PORTSMOUTH","pcpstate":"VA","pcpzip":23707,"pcpcounty":"","pcpid":"","pcpname":"MOHAMMAD YUNAS MD","plan":"OHP","program":"MEDICARE","lob":"DSNP","region":"TIDEWATER","aligned":"Y","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/393-9584","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["L20.9","M54.5","M51.36","M47.817","M19.071","M79.7","Z79.899","Z51.81","K29.50","K63.89","N93.9","R10.9","D25.9","Z12.39","Z72.0","I10.","E66.9","Z92.89","F32.9","G89.29","Z01.818","N93.8","R10.2","Z01.411","N76.0","R19.00","M12.579","K21.9","K59.09","K29.90","K63.5","K64.9","N92.0","N73.6","K42.9","K40.90","Z90.710","L90.5","K59.00","N76.2","Z12.11","K64.8","K29.80","G47.30","F17.210","E66.01","M19.90","Z79.1","Z80.49","Z86.59","Z68.41","L72.0","M48.061","D18.03","Z01.810","K43.2","Z11.51","Z12.4","D25.1","N87.9","N83.8","D25.2","H04.123","K76.9","D48.5","L21.9","Z01.812","Z20.822","K56.7","D62.","G89.4","L29.9","R11.0","Z23.","L73.9","D12.5","L30.9"],"date":["2021-06-22","2020-11-04","2020-11-04","2020-11-04","2021-04-21","2021-11-12","2020-11-04","2020-11-04","2021-01-18","2021-01-18","2021-03-01","2021-03-01","2021-04-21","2021-03-01","2021-03-01","2021-11-12","2021-10-12","2021-03-01","2021-03-01","2021-03-01","2021-04-16","2021-03-24","2021-03-24","2020-10-06","2020-10-06","2020-10-27","2020-11-04","2021-10-12","2021-01-18","2021-01-18","2021-01-18","2021-01-18","2021-04-21","2021-04-21","2021-06-02","2021-06-02","2021-06-02","2021-06-02","2020-11-29","2020-11-29","2021-01-18","2021-01-18","2021-01-18","2021-01-18","2021-04-21","2021-04-21","2021-01-18","2021-01-18","2021-01-18","2021-01-18","2021-04-21","2021-01-27","2020-09-23","2021-01-14","2021-04-16","2021-07-06","2020-10-06","2020-10-06","2021-04-21","2021-04-21","2021-04-21","2021-04-21","2020-10-13","2021-01-14","2021-01-27","2021-06-22","2021-04-16","2021-04-16","2021-04-21","2021-04-21","2021-04-21","2020-09-30","2020-12-22","2021-10-12","2020-11-24","2021-01-18","2021-06-22"],"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":[["","45802005505","TRIAMCINOLONE ACETONIDE                                               ","0.10%","454","Select","Select",""],["","69315012701","FOLIC ACID                                                            ","1000MCG","30","Select","Select",""],["","00555057202","METHOTREXATE                                                          ","2.5MG","24","Select","Select",""],["","68382050010","OMEPRAZOLE                                                            ","40MG","30","Select","Select",""],["","00406052301","OXYCODONE\/ACETAMINOPHEN                                               ","10-325MG","30","Select","Select",""],["","52817033200","CYCLOBENZAPRINE HYDROCHLORIDE                                         ","10MG","-30","Select","Select",""],["","00378875006","DICLOFENAC SODIUM                                                     ","1%","300","Select","Select",""],["","00093506001","HYDROXYZINE HYDROCHLORIDE                                             ","10MG","-30","Select","Select",""],["","00168009930","KETOCONAZOLE                                                          ","2%","30","Select","Select",""],["","45802011942","MOMETASONE FUROATE                                                    ","0.10%","-45","Select","Select",""],["","29300012510","MELOXICAM                                                             ","15MG","30","Select","Select",""],["","70710128403","FLUOCINONIDE                                                          ","0.05%","-60","Select","Select",""],["","50111033401","METRONIDAZOLE                                                         ","500MG","14","Select","Select",""],["","00024591401","DUPIXENT                                                              ","300\/2ML","4","Select","Select",""],["","43598081115","CETIRIZINE HYDROCHLORIDE                                              ","10MG","30","Select","Select",""],["","45802031801","BENZOYL PEROXIDE WASH                                                 ","10% WASH","142","Select","Select",""],["","00116200116","CHLORHEXIDINE GLUCONATE                                               ","0.12%","-16","Select","Select",""],["","51991074790","DULOXETINE HCL                                                        ","30MG","30","Select","Select",""],["","41100082071","MIRALAX                                                               ","3350 NF","1020","Select","Select",""],["","00093117410","PENICILLIN V POTASSIUM                                                ","500MG","-40","Select","Select",""],["","63304069301","CLINDAMYCIN HCL                                                       ","300MG","30","Select","Select",""],["","49483060450","IBUPROFEN                                                             ","800MG","20","Select","Select",""],["","00093310905","AMOXICILLIN                                                           ","500MG","21","Select","Select",""],["","65162052110","PROMETHAZINE HYDROCHLORIDE                                            ","25MG","30","Select","Select",""],["","50428690111","CVS GENTLE LAXATIVE                                                   ","10MG","30","Select","Select",""],["","42858030101","HYDROMORPHONE HCL                                                     ","2MG","60","Select","Select",""],["","00406012401","HYDROCODONE\/ACETAMINOPHEN                                             ","7.5-325","15","Select","Select",""],["","45802048678","DOCUSATE SODIUM                                                       ","100MG","30","Select","Select",""],["","43386031214","GAVILAX                                                               ","","1020","Select","Select",""],["","68462010530","ONDANSETRON HYDROCHLORIDE                                             ","4MG","30","Select","Select",""],["","45802000403","HYDROCORTISONE                                                        ","2.50%","28","Select","Select",""],["","13668000705","ZOLPIDEM TARTRATE                                                     ","5MG","30","Select","Select",""],["","00574705012","BISACODYL                                                             ","10MG","32","Select","Select",""],["","51672135708","FLUOCINOLONE ACETONIDE SCALP                                          ","0.01% SC","118","Select","Select",""],["","60432026415","FLUTICASONE PROPIONATE                                                ","50MCG","16","Select","Select",""],["","45802086866","POLYETHYLENE GLYCOL 3350                                              ","3350 NF","90","Select","Select",""],["","13107015490","PAROXETINE HYDROCHLORIDE                                              ","10MG","90","Select","Select",""],["","57237000299","HYDROCHLOROTHIAZIDE                                                   ","12.5MG","90","Select","Select",""],["","11917009215","FERROUS SULFATE                                                       ","325MG","90","Select","Select",""],["","10702002801","PHENTERMINE HYDROCHLORIDE                                             ","30MG","30","Select","Select",""],["","70710113908","FLUCONAZOLE                                                           ","150MG","3","Select","Select",""],["","69097012303","TOPIRAMATE                                                            ","50MG","90","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":""}]}]}