{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"PAUL   W MATTHEWS JR","gend":0,"add":"564 STERLING ROAD","city":"VIRGINIA BEACH","state":"VA","zip":"23464-9998","dob":"1954-11-28","age":"","mstatus":"","insh":"900041676*01","cliId":"","pno":"757\/424-5545","cno":"","email":"","ename":"","eno":"","pphy":"WHITEHURST-DOSS, SUE NP","ppno":"757\/446-8920","pcpadd":"SUITE 445 825 FAIRFAX AVE","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23507,"pcpcounty":"","pcpid":"","pcpname":"EVMS Internal Medicine","plan":"OHP","program":"MEDICARE","lob":"DSNP","region":"TIDEWATER","aligned":"Y","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/446-7114","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R07.9","R11.2","F10.288","K22.70","M54.2","S19.9XXA","N17.9","E72.20","K76.89","F10.10","R19.7","R17.","K72.90","I35.8","Z46.59","G93.40","R18.8","Z93.1","R55.","S00.83XA","E78.5","I10.","K21.01","Z87.19","Z79.899","Z87.820","H54.62","R13.10","F10.20","K70.9","Z86.010","Z12.11","D12.2","D12.5","K64.1","K21.9","Z88.8","R78.0","F10.239","B16.9","K70.30","E87.1","E87.2","R41.0","E11.22","T17.900A","R10.9","S01.91XA","S09.90XA","T85.528A","M62.81","D64.9","K92.0","K20.90","R16.0","R29.818","E51.2","A41.9","K70.10","N17.0","K92.2","I95.9","R41.82","Z43.1","K21.00","Z87.11","G31.2","E87.6","E46.","A04.72","F43.23","Z71.89","R49.0","K40.90","K42.9","I35.1","K26.9","K31.89","K26.4","K44.9","E86.0","K52.1","A04.71","K92.1","Z20.822","F12.90","E83.42","K29.20","K20.80","Z28.21","K72.00","E43.","J69.0","J96.01","R65.20","A41.50","Z68.1","R64.","E87.0","N39.0","K76.6","J98.11","R91.8","R50.9","R47.02","Z91.81","R26.89","R13.12","R48.8","K70.11","E70.89","L57.0","Z71.9","K22.8","H25.811","H27.02","H35.342","R07.2","R19.5","M79.601","R06.02","Z00.00","Z13.31","N40.0","G47.00","F43.9","Z78.9","R61.","K63.5","K57.30","K64.8","R20.2","E80.6","R40.1","H57.04","K94.23","D72.829","R05.","R09.89","Z23."],"date":["2021-04-09","2021-04-28","2021-02-16","2021-08-18","2021-04-05","2021-05-10","2021-05-07","2021-05-07","2021-05-01","2021-05-26","2021-05-24","2021-04-07","2021-05-11","2021-04-07","2021-05-01","2021-05-08","2021-04-30","2021-05-10","2021-05-10","2021-05-10","2021-08-02","2021-12-16","2021-05-10","2021-08-02","2021-05-25","2021-05-10","2021-05-10","2021-07-06","2021-08-02","2021-08-02","2021-10-12","2021-10-11","2021-10-11","2021-10-11","2021-10-11","2021-10-11","2021-10-11","2021-02-15","2021-05-08","2021-04-28","2021-12-16","2021-04-28","2021-04-28","2021-04-16","2021-04-19","2021-04-30","2021-05-07","2021-05-10","2021-05-10","2021-05-11","2021-05-17","2021-05-25","2021-04-13","2021-04-13","2021-04-22","2021-04-22","2021-05-26","2021-05-17","2021-05-25","2021-05-26","2021-05-26","2021-05-26","2021-05-10","2021-05-17","2021-05-11","2021-05-11","2021-05-11","2021-09-16","2021-05-26","2021-05-25","2021-05-25","2021-05-25","2021-05-26","2021-10-05","2021-10-05","2021-02-16","2021-04-09","2021-08-18","2021-04-09","2021-04-09","2021-05-20","2021-05-20","2021-05-25","2021-02-15","2021-02-15","2021-02-15","2021-02-15","2021-08-02","2021-02-15","2021-02-15","2021-05-24","2021-04-05","2021-05-08","2021-04-05","2021-04-05","2021-04-05","2021-04-05","2021-04-05","2021-04-05","2021-04-05","2021-08-18","2021-04-05","2021-04-24","2021-04-24","2021-05-04","2021-05-13","2021-05-08","2021-05-08","2021-05-08","2021-05-08","2021-05-24","2021-08-12","2021-08-12","2021-08-18","2021-08-23","2021-08-23","2021-08-23","2021-02-15","2021-02-15","2021-02-15","2021-04-14","2021-08-02","2021-08-02","2021-08-02","2021-10-18","2021-09-16","2021-09-16","2021-09-16","2021-10-11","2021-10-11","2021-10-11","2021-12-16","2021-04-05","2021-04-21","2021-04-22","2021-05-18","2021-05-19","2021-05-20","2021-05-20","2021-10-18"],"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":[["","00245531911","KLOR-CON M20                                                          ","20MEQ ER","-60","Select","Select",""],["","59651000305","OMEPRAZOLE DR                                                         ","40MG","90","Select","Select",""],["","57237001401","TAMSULOSIN HYDROCHLORIDE                                              ","0.4MG","90","Select","Select",""],["","68180051303","LISINOPRIL                                                            ","5MG","90","Select","Select",""],["","70461012003","FLUAD QUADRIVALENT INFLUENZA VACCINE FOR ADULTS                       ","0.5ML","0","Select","Select",""],["","40093010588","B-1                                                                   ","100MG","90","Select","Select",""],["","76385011150","CARVEDILOL                                                            ","6.25MG","180","Select","Select",""],["","50428048545","CVS B-1                                                               ","100MG","90","Select","Select",""],["","65649030302","XIFAXAN                                                               ","550MG","60","Select","Select",""],["","42858030101","HYDROMORPHONE HCL                                                     ","2MG","30","Select","Select",""],["","00536354701","DAILY-VITE                                                            ","","30","Select","Select",""],["","00121087316","LACTULOSE                                                             ","10GM\/15","854","Select","Select",""],["","52268001201","SUPREP BOWEL PREP KIT                                                 ","PREP KIT","354","Select","Select",""],["","11534016503","FOLIC ACID                                                            ","1MG","90","Select","Select",""],["","13107000130","MIRTAZAPINE                                                           ","7.5MG","-90","Select","Select",""],["","68382050010","OMEPRAZOLE                                                            ","40MG","90","Select","Select",""],["","68180072003","AMLODIPINE BESYLATE                                                   ","5MG","30","Select","Select",""],["","70069013101","TOBRAMYCIN                                                            ","0.3% OP","10","Select","Select",""],["","17478071510","BRIMONIDINE TARTRATE                                                  ","0.2% OP","5","Select","Select",""],["","60758011905","PREDNISOLONE ACETATE                                                  ","1% OP","15","Select","Select",""],["","17478010212","TROPICAMIDE                                                           ","1% OP","15","Select","Select",""],["","61314012605","KETOROLAC TROMETHAMINE                                                ","0.50%","15","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":""}]}]}