{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JOHN   M MACMILLAN","gend":0,"add":"1953 TWIN COVE ROAD","city":"VIRGINIA BEACH","state":"VA","zip":"23454-9998","dob":"1957-01-01","age":"","mstatus":"","insh":"1752448*01","cliId":"","pno":"757\/481-3439","cno":"757\/481-3439","email":"","ename":"","eno":"","pphy":"MCDERMOTT, GLENN MD","ppno":"757\/412-0006","pcpadd":"1368 N GREAT NECK RD","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":23454,"pcpcounty":"","pcpid":165136,"pcpname":"","plan":"OHP","program":"ACA","lob":"Individual","region":"TIDEWATER","aligned":"","ano":"757\/855-3127","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["L97.501","E11.9","L85.3","M20.42","M20.41","L60.9","E29.1","E11.65","E78.5","I10.","M51.36","M54.5","I26.92","Z79.01","F33.9","G63.","E66.01","K59.1","N40.1","R79.89","Z68.32","E03.9","C18.9","D68.59","H40.1131","H25.13","H04.123","F90.0","F41.1","F84.0","F43.21","H90.3","R35.1","N52.9","Z68.30","L57.0","L21.9","L82.1","Z71.9","D48.5","H61.23","L30.4","T14.8XXA","L81.4","I78.1","D22.9","Z12.83","Z85.820","Z86.008","L90.5","M25.551","I26.99","N52.8","R19.7","K76.0","Z86.010","L73.9","G47.33","H25.813","R06.83","R53.83","G47.10"],"date":["2020-01-14","2021-04-20","2020-01-14","2020-01-14","2020-01-14","2020-01-14","2021-06-07","2021-10-22","2021-10-22","2021-10-22","2020-07-21","2020-07-21","2021-11-05","2021-11-05","2020-09-14","2020-05-13","2020-05-13","2020-05-13","2020-10-21","2020-09-15","2020-05-13","2020-09-15","2021-01-29","2021-01-29","2021-10-19","2021-04-20","2021-01-19","2021-11-01","2021-11-01","2021-11-01","2021-11-01","2021-06-11","2021-04-21","2021-04-21","2021-01-11","2020-05-05","2020-05-05","2020-05-05","2021-06-01","2021-06-16","2020-06-12","2020-05-05","2020-05-05","2020-05-05","2020-05-05","2020-05-05","2020-05-05","2020-05-05","2020-05-05","2021-05-06","2020-07-07","2021-10-15","2021-06-07","2020-04-07","2020-04-07","2020-04-07","2021-06-01","2021-11-15","2021-10-19","2021-10-15","2021-10-01","2021-10-15"],"priorHcc":["","","","","","","",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":[["","16729000301","GLIMEPIRIDE","4MG","30","Select","Select",""],["","68180032002","BUPROPN","300MG XL","30","Select","Select",""],["","51672403401","WARFARIN","7.5MG","45","Select","Select",""],["","68180051303","LISINOPRIL","5MG","30","Select","Select",""],["","60758080105","TIMOLOL","0.5% OP","5","Select","Select",""],["","68645052754","SIMVASTATIN","40MG","30","Select","Select",""],["","45802046564","KETOCONAZOLE","2%","120","Select","Select",""],["","59417010710","VYVANSE","70MG","30","Select","Select",""],["","00310620530","FARXIGA","5MG","30","Select","Select",""],["","00832003800","OXYBUTYNIN","5MG","60","Select","Select",""],["","24208046325","LATANOPROST","0.01%","2","Select","Select",""],["","59762045001","COLESTIPOL","1GM","120","Select","Select",""],["","67877015905","METFORMIN","500MG ER","120","Select","Select",""],["","68180035306","SERTRALINE","100MG","45","Select","Select",""],["","00051846233","ANDROGEL","1.62%","75","Select","Select",""],["","68180094111","TESTOSTERONE","1.62%","-75","Select","Select",""],["","65162062750","TRAMADOL","50MG","30","Select","Select",""],["","68382095601","AMPHET\/DEXTR","30MG","30","Select","Select",""],["","70710101002","OSELTAMIVIR","75MG","10","Select","Select",""],["","00527293337","PREDNISONE","10MG","30","Select","Select",""],["","69452015120","VITAMIN","50000UNT","4","Select","Select",""],["","13668018590","SILDENAFIL","20MG","90","Select","Select",""],["","27241011403","TADALAFIL","20MG","10","Select","Select",""],["","54092038501","ADDERALL","15MG","30","Select","Select",""],["","00574082001","TESTOST","200MG\/ML","2","Select","Select",""],["","00168020360","CLINDAMYCIN","1%","60","Select","Select",""],["","59762444002","METHYLPRED","4MG","21","Select","Select",""],["","00006011231","JANUVIA","50MG","90","Select","Select",""],["","49281072010","FLUBLOK","2020-21","0","Select","Select",""],["","59267100002","PFIZER","COVID-19","0","Select","Select",""],["","08290305903","1ML","25GX5\/8\"","30","Select","Select",""],["","68180051303","LISINOPRIL ","5MG","30","Select","Select",""],["","51672403401","WARFARIN ","7.5MG","45","Select","Select",""],["","00310620530","FARXIGA ","5MG","30","Select","Select",""],["","68180032002","BUPROPN ","300MG XL","30","Select","Select",""],["","60758080105","TIMOLOL ","0.5% OP","5","Select","Select",""],["","67877015905","METFORMIN ","500MG ER","120","Select","Select",""],["","68180035302","SERTRALINE ","100MG","45","Select","Select",""],["","68645052754","SIMVASTATIN ","40MG","30","Select","Select",""],["","59417010710","VYVANSE ","70MG","30","Select","Select",""],["","45802046564","KETOCONAZOLE ","2%","120","Select","Select",""],["","16729000301","GLIMEPIRIDE ","4MG","30","Select","Select",""],["","00832003800","OXYBUTYNIN ","5MG","-60","Select","Select",""],["","59762045001","COLESTIPOL ","1GM","120","Select","Select",""],["","68180094111","TESTOSTERONE ","1.62%","-75","Select","Select",""],["","24208046325","LATANOPROST ","0.01%","2","Select","Select",""],["","00051846233","ANDROGEL ","1.62%","75","Select","Select",""],["","70710101002","OSELTAMIVIR ","75MG","10","Select","Select",""],["","69452015120","VITAMIN ","50000UNT","-12","Select","Select",""],["","59762444002","METHYLPRED ","4MG","21","Select","Select",""],["","65162062750","TRAMADOL ","50MG","30","Select","Select",""],["","13668018590","SILDENAFIL ","20MG","90","Select","Select",""],["","00527293337","PREDNISONE ","10MG","30","Select","Select",""],["","49281072010","FLUBLOK ","2020-21","0","Select","Select",""],["","68382095501","AMPHET\/DEXTR ","20MG","30","Select","Select",""],["","27241011403","TADALAFIL ","20MG","10","Select","Select",""],["","54092038501","ADDERALL ","15MG","30","Select","Select",""],["","59267100002","PFIZER ","COVID-19","0","Select","Select",""],["","08290305903","1ML ","25GX5\/8\"","30","Select","Select",""],["","00574082001","TESTOST ","200MG\/ML","2","Select","Select",""],["","00168020360","CLINDAMYCIN ","1%","60","Select","Select",""],["","00006011231","JANUVIA ","50MG","-90","Select","Select",""],["","64764072030","TRINTELLIX ","5MG","30","Select","Select",""],["","64764072030","TRINTELLIX","5MG","30","Select","Select",""],["","65862052730","VENLAFAXINE","37.5 ER","7","Select","Select",""],["","08290305122","BD NEEDLES","25GX5\/8\"","20","Select","Select",""],["","65862052899","VENLAFAXINE ","CAP 75MG ER","30","Select","Select",""],["","08290305122","BD  NEEDLES  ","MIS 25GX5\/8\"","20","Select","Select",""],["","00169413212","OZEMPIC ","INJ 2\/1.5ML","2","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","",""],["N\/A","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","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":""}]}]}