{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LISA   M CURRAN","gend":1,"add":"715 MADISON ST APT 115","city":"PORTSMOUTH","state":"VA","zip":"23704-9998","dob":"1964-04-13","age":"","mstatus":"","insh":"20026062*01","cliId":"","pno":"757\/955-5168","cno":"757\/955-5168","email":"","ename":"","eno":"","pphy":"MARKOVIC, VLADIMIR MD","ppno":"757\/393-6363","pcpadd":"3415 GRANBY STREET","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23504,"pcpcounty":"","pcpid":102266,"pcpname":"Hampton Roads Community Health Center","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"757\/452-0198","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/397-0047","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F41.9","F41.0","F42.9","NO DATA","M54.9","M54.2","M76.72","M25.572","Z68.39","M47.812","M18.0","F32.9","M79.672","M17.11","M25.561","M85.861","M25.461","Z68.41","M19.031","M19.032","M18.11","M18.12","I10.","H93.13","M25.532","Z11.3","N39.3","F43.10","R73.03","E78.2","E66.9","Z12.31","F33.2","F40.10","S06.0X0A","I25.10","G51.0","R40.2410","Z68.36","Z95.5","Z87.891","Z91.02","Z91.040","Z91.011","Z88.2","Z88.8","Z91.018","Z91.048","R51.9"],"date":["2021-08-30","2021-08-24","2021-05-25","2021-02-25","2021-02-25","2021-02-25","2021-03-25","2021-03-25","2021-03-04","2020-03-09","2021-03-22","2021-08-30","2021-03-04","2021-03-11","2021-03-11","2021-03-11","2021-03-11","2021-03-11","2021-03-22","2021-03-22","2021-03-22","2021-03-22","2021-09-16","2021-05-13","2021-05-13","2021-05-13","2020-05-28","2021-08-24","2021-08-30","2021-02-23","2021-09-16","2020-06-24","2021-07-20","2021-07-20","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2021-09-16"],"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":[["","00115165701","NABUMETONE ","500MG","180","Select","Select",""],["","68382000105","PAROXETINE ","40MG","30","Select","Select",""],["","69097084615","CYCLOBENZAPR ","10MG","60","Select","Select",""],["","55111019605","CLOPIDOGREL ","75MG","30","Select","Select",""],["","70377003012","ATORVASTATIN ","80MG","30","Select","Select",""],["","69452015120","VITAMIN ","50000UNT","4","Select","Select",""],["","68180072103","AMLODIPINE ","10MG","30","Select","Select",""],["","51660020090","EZETIMIBE ","10MG","30","Select","Select",""],["","69618004610","ASPIRIN ","81MG EC","30","Select","Select",""],["","60505317007","OMEGA-3-ACID ","1GM","120","Select","Select",""],["","68382009405","CARVEDILOL ","12.5MG","60","Select","Select",""],["","68180051703","LISINOPRIL ","40MG","30","Select","Select",""],["","43598043501","NITROGLYCERN ","0.3MG","100","Select","Select",""],["","16729013716","CLONAZEPAM ","1MG","60","Select","Select",""],["","45802065078","LORATADINE ","10MG","30","Select","Select",""],["","43598081115","CETIRIZINE ","10MG","30","Select","Select",""],["","61442010305","DICLOFENAC ","75MG DR","60","Select","Select",""],["","52565000814","LIDOCAINE ","5%","35","Select","Select",""],["","68134020116","NAPROXEN ","125\/5ML","1000","Select","Select",""],["","51672415403","CALCIPOTRIEN ","0.01%","240","Select","Select",""],["","69315011610","FUROSEMIDE ","20MG","14","Select","Select",""],["","00904530660","BANOPHEN ","25MG","90","Select","Select",""],["","00574050801","FERROUS ","324MG","90","Select","Select",""],["","55111078401","FEXOFENADINE ","180MG","90","Select","Select",""],["","51660020090","EZETIMIBE","10MG","30","Select","Select",""],["","69452015120","VITAMIN","50000UNT","4","Select","Select",""],["","68180051703","LISINOPRIL","40MG","30","Select","Select",""],["","61442010305","DICLOFENAC","75MG DR","60","Select","Select",""],["","68180072103","AMLODIPINE","10MG","30","Select","Select",""],["","16729013716","CLONAZEPAM","1MG","60","Select","Select",""],["","68382009405","CARVEDILOL","12.5MG","60","Select","Select",""],["","69618004610","ASPIRIN","81MG EC","30","Select","Select",""],["","00591367001","NABUMETONE","500MG","60","Select","Select",""],["","68382000105","PAROXETINE","40MG","30","Select","Select",""],["","55111019605","CLOPIDOGREL","75MG","30","Select","Select",""],["","43598081115","CETIRIZINE","10MG","30","Select","Select",""],["","45802065078","LORATADINE","10MG","30","Select","Select",""],["","70377003012","ATORVASTATIN","80MG","30","Select","Select",""],["","69097084615","CYCLOBENZAPR","10MG","60","Select","Select",""],["","51672415403","CALCIPOTRIEN","0.01%","240","Select","Select",""],["","60505317007","OMEGA-3-ACID","1GM","120","Select","Select",""],["","52565000814","LIDOCAINE","5%","35","Select","Select",""],["","68134020116","NAPROXEN","125\/5ML","1000","Select","Select",""],["","43598043501","NITROGLYCERN","0.3MG","100","Select","Select",""],["","00904530660","BANOPHEN","25MG","90","Select","Select",""],["","69315011610","FUROSEMIDE","20MG","14","Select","Select",""],["","00574050801","FERROUS","324MG","90","Select","Select",""],["","55111078401","FEXOFENADINE","180MG","90","Select","Select",""],["","00185064810","DIPHENHYDRAM","25MG","90","Select","Select",""],["","00185064810","DIPHENHYDRAM ","CAP 25MG","90","Select","Select",""],["","70954006010","PREDNISONE ","TAB 20MG","7","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","",""],["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":""}]}]}