{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KIMBERLY   L BUTLER","gend":1,"add":"1508 RAVEN ST","city":"SUFFOLK","state":"VA","zip":"23434-9998","dob":"1974-01-09","age":"","mstatus":"","insh":"1262390*01","cliId":"","pno":"757\/334-0810","cno":"757\/334-0810","email":"","ename":"","eno":"","pphy":"HOLLERAN, JAMES D MD","ppno":"757\/539-0251","pcpadd":"2000 MEADE PKWY","pcpcity":"SUFFOLK","pcpstate":"VA","pcpzip":23434,"pcpcounty":"","pcpid":122519,"pcpname":"Lakeview Internal Medicine Meade","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/934-9409","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N28.89","D72.829","E87.2","N17.9","M79.89","R73.9","A41.9","E11.9","L02.215","S31.819A","M54.5","K52.9","F17.210","M72.6","N17.0","L02.415","L03.315","E66.2","Z68.42","E11.65","G40.909","E86.0","I10.","R65.20","T50.8X5A","T36.8X5A","B37.3","K08.89","Z86.39","R19.7","Z20.828","R00.0","M25.531","G89.29","M54.6","Z71.89","Z88.1","Z88.8","Z88.2","Z91.018","M54.9","L03.90","G47.33","G56.01","K21.9","D64.9","E78.5","Z79.84","Z91.81","Z86.79","E87.6","E11.622","F17.218","E66.01","R56.9","L98.411","T81.89XA","E13.69","G56.03","M54.40","M62.830","V58.89","S39.94XS","M25.521","M77.11","M79.2"],"date":["2020-08-26","2020-08-26","2020-08-26","2020-08-26","2020-08-25","2020-08-26","2020-08-26","2020-12-04","2020-10-08","2021-01-05","2020-06-21","2020-06-21","2020-08-15","2021-01-05","2020-08-15","2020-10-06","2020-08-15","2020-08-15","2020-08-15","2020-08-15","2020-12-04","2020-08-15","2020-12-04","2020-08-26","2020-08-15","2020-08-15","2020-08-15","2020-04-21","2020-08-26","2020-08-13","2020-08-13","2020-08-13","2020-05-16","2020-05-16","2020-05-16","2020-05-16","2020-05-16","2020-05-16","2020-05-16","2020-05-16","2020-05-16","2020-08-20","2021-04-23","2020-12-04","2020-12-04","2020-12-04","2020-12-04","2020-12-04","2020-12-04","2020-08-15","2020-08-15","2021-01-05","2021-01-05","2021-01-05","2020-10-01","2021-01-05","2020-08-25","2020-08-25","2021-05-22","2021-05-22","2020-03-27","2020-10-01","2020-10-01","2020-11-04","2020-11-04","2021-06-04"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}},{"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":[["","00093727398","PIOGLITAZONE ","45MG","30","Select","Select",""],["","65862020190","LOSARTAN ","25MG","30","Select","Select",""],["","00093742698","MONTELUKAST ","10MG","30","Select","Select",""],["","51991074890","DULOXETINE ","60MG","30","Select","Select",""],["","71093014005","METHOCARBAM ","500MG","40","Select","Select",""],["","59746017710","CYCLOBENZAPR ","10MG","15","Select","Select",""],["","68308015260","NYSTATIN ","100000","60","Select","Select",""],["","64980014612","FLORANEX ","","60","Select","Select",""],["","53746010901","HYDROCO\/APAP ","5-325MG","20","Select","Select",""],["","49483060350","IBUPROFEN ","600MG","30","Select","Select",""],["","00378064110","PREDNISONE ","10MG","42","Select","Select",""],["","42571016242","AMOX\/K ","875-125","20","Select","Select",""],["","00603188016","LIDOCAINE ","5%","30","Select","Select",""],["","00143122701","DICYCLOMINE ","20MG","30","Select","Select",""],["","43598029390","PREGABALIN ","75MG","60","Select","Select",""],["","70377000612","ROSUVASTATIN ","5MG","90","Select","Select",""],["","68180072103","AMLODIPINE ","10MG","30","Select","Select",""],["","00006022131","JANUVIA ","25MG","30","Select","Select",""],["","00245531911","KLOR-CON ","20MEQ ER","30","Select","Select",""],["","40985022368","THERAPEUTIC- ","M\/LUTEIN","30","Select","Select",""],["","45802048678","DOCUSATE ","100MG","30","Select","Select",""],["","70710113908","FLUCONAZOLE ","150MG","1","Select","Select",""],["","68180012202","CEPHALEXIN ","500MG","8","Select","Select",""],["","76385011150","CARVEDILOL ","6.25MG","60","Select","Select",""],["","00536104710","SODIUM ","650MG","60","Select","Select",""],["","53885027210","ONETOUCH ","VERIO","100","Select","Select",""],["","59746000103","METHYLPRED ","4MG","21","Select","Select",""],["","00093742698","MONTELUKAST","10MG","30","Select","Select",""],["","51991074890","DULOXETINE","60MG","30","Select","Select",""],["","65862020190","LOSARTAN","25MG","30","Select","Select",""],["","00093727398","PIOGLITAZONE","45MG","30","Select","Select",""],["","59746017710","CYCLOBENZAPR","10MG","15","Select","Select",""],["","71093014005","METHOCARBAM","500MG","40","Select","Select",""],["","42571016242","AMOX\/K","875-125","20","Select","Select",""],["","00603188016","LIDOCAINE","5%","30","Select","Select",""],["","00378064110","PREDNISONE","10MG","42","Select","Select",""],["","53746010901","HYDROCO\/APAP","5-325MG","11","Select","Select",""],["","68308015260","NYSTATIN","100000","60","Select","Select",""],["","64980014612","FLORANEX","","60","Select","Select",""],["","40985022368","THERAPEUTIC-","M\/LUTEIN","30","Select","Select",""],["","00006022131","JANUVIA","25MG","30","Select","Select",""],["","00245531911","KLOR-CON","20MEQ ER","30","Select","Select",""],["","00536104710","SODIUM","650MG","60","Select","Select",""],["","53885027210","ONETOUCH","VERIO","100","Select","Select",""],["","55111014512","FLUCONAZOLE","150MG","1","Select","Select",""],["","76385011150","CARVEDILOL","6.25MG","60","Select","Select",""],["","68180012202","CEPHALEXIN","500MG","8","Select","Select",""],["","49483060350","IBUPROFEN","600MG","30","Select","Select",""],["","45802048678","DOCUSATE","100MG","30","Select","Select",""],["","72189003260","PREGABALIN","75MG","60","Select","Select",""],["","70377000612","ROSUVASTATIN","5MG","90","Select","Select",""],["","59746000103","METHYLPRED","4MG","21","Select","Select",""],["","00143122701","DICYCLOMINE","20MG","30","Select","Select",""],["","68180072103","AMLODIPINE","10MG","30","Select","Select",""],["","00093005805","TRAMADOL ","TAB 50MG","30","Select","Select",""],["","42858010201","OXYCOD\/APAP ","TAB 5-325MG","30","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","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["Yes","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":""}]}]}