{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DAVID   W HINCHEE","gend":0,"add":"2509 SANDERSON LN","city":"VIRGINIA BEACH","state":"VA","zip":"23456-9998","dob":"1959-05-29","age":"","mstatus":"","insh":"3987949*01","cliId":"","pno":"757\/427-0844","cno":"757\/427-0844","email":"","ename":"","eno":"","pphy":"MALIK, RAJUL MD","ppno":"757\/481-1113","pcpadd":"STE 201 1168 FIRST COLONIAL R","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":23454,"pcpcounty":"","pcpid":113694,"pcpname":"Bridge Road Family Medicine","plan":"OHP","program":"ACA","lob":"Small Group","region":"TIDEWATER","aligned":"","ano":"757\/438-8818","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/496-3822","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N39.0","R97.20","R10.9","C61.","D50.8","D64.9","E53.8","R93.1","I70.0","I65.23","Z12.11","K63.5","G89.29","I10.","M54.5","Z79.899","Z87.01","Z85.828","Z98.890","Z88.8","Z80.42","Z80.0","Z82.49","Z83.71","Z82.3","Z84.1","L82.1","D48.5","L57.0","D22.9","S16.1XXA","D50.9","M48.061","M51.26","M85.89","Z98.0","E83.59","H02.89","H25.11","H57.813","H40.013","H35.373","N40.0","K90.9","Z00.00","R10.84","K91.1","R10.30","M25.552","Z68.24","S70.361A","L08.9","E55.9","D12.6","Z86.010","D12.3","D12.5","Q43.8","K64.8","K57.30","Z71.84","Z20.828","S73.102A","M16.12","Z85.46","H35.341","H31.003","M62.08","H25.812","H31.001","H31.002","H01.004","H04.222","R97.21","Z92.3","M89.9","J32.0","H02.423","M85.68","M76.02","M67.854","S73.192A","D18.01","J30.2","Z79.02","Z88.6","Z87.19","H01.001","H25.13","Z23."],"date":["2020-05-28","2020-10-20","2020-09-10","2021-11-09","2021-06-09","2021-06-09","2021-06-09","2020-06-09","2020-04-13","2020-04-13","2020-05-22","2020-05-22","2020-06-12","2020-10-20","2021-06-24","2020-10-20","2020-06-05","2020-06-05","2020-09-10","2020-10-20","2020-10-20","2020-10-20","2020-10-20","2020-06-05","2020-06-05","2020-06-05","2021-04-22","2021-04-22","2021-04-22","2021-04-22","2021-01-07","2021-04-29","2021-06-24","2021-06-24","2021-07-09","2021-07-09","2021-07-09","2021-03-18","2021-04-08","2021-03-18","2021-10-12","2021-10-12","2021-11-09","2021-05-11","2021-05-11","2020-06-09","2020-06-09","2020-09-10","2021-04-02","2021-04-02","2021-07-05","2021-07-05","2020-10-20","2020-05-22","2020-05-22","2020-05-22","2020-05-22","2020-05-22","2020-05-22","2020-05-22","2020-07-08","2021-09-06","2021-04-20","2021-04-20","2021-04-20","2020-01-09","2020-01-09","2020-09-10","2020-09-15","2020-09-15","2020-09-15","2020-12-15","2020-12-15","2021-06-01","2021-06-01","2021-06-01","2021-06-01","2021-04-08","2021-04-20","2021-04-20","2021-04-20","2021-04-20","2021-04-22","2020-10-20","2020-10-20","2020-10-20","2020-10-20","2020-12-15","2021-10-12","2021-10-13"],"priorHcc":["","","",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":[["","58160082311","SHINGRIX ","50MCG","1","Select","Select",""],["","70069000510","CYANOCOBALAM ","1000MCG","1","Select","Select",""],["","70377000612","ROSUVASTATIN ","5MG","90","Select","Select",""],["","65862053820","LEVOFLOXACIN ","750MG","1","Select","Select",""],["","65862035790","CLOPIDOGREL ","75MG","36","Select","Select",""],["","65862020190","LOSARTAN ","25MG","90","Select","Select",""],["","33332032001","AFLURIA ","2020-21","0","Select","Select",""],["","00065065205","TOBRADEX ","0.3-0.05","5","Select","Select",""],["","47335001083","TADALAFIL ","5MG","90","Select","Select",""],["","69238110005","DOXYCYCL ","100MG","20","Select","Select",""],["","58160082311","SHINGRIX","50MCG","1","Select","Select",""],["","70069000510","CYANOCOBALAM","1000MCG","1","Select","Select",""],["","70377000612","ROSUVASTATIN","5MG","90","Select","Select",""],["","65862053820","LEVOFLOXACIN","750MG","1","Select","Select",""],["","65862035790","CLOPIDOGREL","75MG","36","Select","Select",""],["","65862020190","LOSARTAN","25MG","90","Select","Select",""],["","33332032001","AFLURIA","2020-21","0","Select","Select",""],["","00065065205","TOBRADEX","0.3-0.05","5","Select","Select",""],["","47335001083","TADALAFIL","5MG","90","Select","Select",""],["","69238110005","DOXYCYCL","100MG","20","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":[[["No","Select","","","","","Select","",""],["No","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":""}]}]}