{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BESSIE   L DAVIS","gend":1,"add":"967 CHARLOT TE ST","city":"NORFOLK","state":"VA","zip":"23504-9998","dob":"1953-04-15","age":"","mstatus":"","insh":"20026198*01","cliId":"","pno":"627-2930","cno":"627-2930","email":"","ename":"","eno":"","pphy":"NEWBY, JAMES E MD","ppno":"757\/627-6892","pcpadd":"STE 220 930 MAJESTIC AVE","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23504,"pcpcounty":"","pcpid":100347,"pcpname":"Primary Care Specialists","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"757\/752-5391","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/627-5809","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J44.9","G47.30","R06.89","I48.0","Z01.810","J44.1","E11.9","T14.90XA","K55.9","NO DATA","Z87.891","R10.84","K92.1","R19.7","R93.3","R10.9","M79.604","K55.039","I11.0","I50.32","E11.40","E78.5","I25.10","I25.2","G47.33","Z96.653","Z86.718","Z79.4","Z79.82","K04.7","R22.0","R06.02","I48.91","I50.33","I50.42","R07.89","M06.9","I35.0","R00.1","D64.9","G89.29","K59.00","I63.9","R42.","R55.","Z86.79","I95.1","I67.9","I49.8","E11.8","I50.1","I50.9","R94.30","S06.5X0A","I42.9","I62.03","R04.0","E55.9","I62.00","I10.","I11.9","I82.409","I42.8","I73.9","R52.","K52.9","Z87.09","R26.9","G89.4","M15.9","Z99.81","E11.65","I65.29","R29.6","S06.5X9A","Z79.01","Z87.448","Z86.2","R94.31","W19.XXXA","Z91.81","I50.30","S06.5X9S","Z79.899","D73.5","G62.9","I82.401","I31.3","I77.4","E87.2","K76.1","I35.2","Z91.19","J96.21","M54.9","W01.0XXA","K08.89","E11.51","B35.1","I50.43","D72.829","R53.1","I48.92","R10.31","J18.9","R10.32","I25.119","M16.12","Z20.822","I50.31","J20.9","R00.2","R05.","R09.02","Z68.27","N28.0","L29.9","M79.606","J96.91","Z98.1","Z82.49","Z83.3","Z88.0","Z88.5","E87.6","M25.561","M25.562","Z87.19","I20.9","J96.90","J98.01","R06.82","I51.7","J96.01","I42.0","E87.70","M25.511","M79.652"],"date":["2021-11-01","2021-10-26","2021-09-27","2021-09-27","2020-04-17","2021-09-21","2021-11-01","2020-04-08","2020-05-04","2021-08-12","2021-11-01","2020-04-18","2020-04-18","2020-04-18","2020-04-18","2021-04-13","2020-05-27","2020-05-27","2021-11-01","2021-11-01","2021-04-11","2021-04-11","2021-11-01","2020-10-22","2021-04-11","2021-11-01","2021-11-01","2020-05-27","2020-08-17","2020-07-08","2020-07-08","2020-10-22","2021-09-25","2020-10-23","2020-08-17","2020-08-17","2021-11-01","2021-08-12","2020-08-22","2020-08-17","2020-08-17","2021-04-15","2020-08-18","2020-08-26","2020-10-21","2021-08-09","2020-08-21","2020-08-22","2020-10-27","2020-10-23","2020-10-23","2021-09-26","2021-04-16","2020-01-23","2021-04-11","2020-01-25","2020-01-29","2021-04-11","2020-02-13","2021-08-10","2021-05-06","2020-02-13","2020-10-21","2020-08-21","2021-04-11","2020-04-18","2020-04-12","2020-10-21","2020-05-04","2021-05-06","2021-05-06","2020-07-19","2020-08-26","2020-03-06","2020-07-20","2020-01-27","2020-03-06","2020-01-29","2021-08-13","2020-01-25","2020-01-30","2020-01-30","2020-03-06","2020-03-06","2020-03-06","2020-03-06","2020-03-08","2021-08-12","2020-04-11","2020-10-22","2020-04-11","2021-04-11","2020-04-11","2021-09-23","2020-04-08","2020-04-08","2020-05-06","2020-05-20","2020-05-20","2021-08-16","2020-07-19","2020-08-16","2020-08-16","2020-08-16","2020-10-26","2021-04-11","2021-04-11","2021-04-11","2021-08-09","2021-09-27","2020-10-21","2020-10-21","2020-10-21","2020-10-22","2021-05-06","2020-01-24","2021-04-14","2020-03-10","2020-10-22","2020-10-22","2020-10-22","2020-10-22","2021-11-01","2021-11-01","2020-10-24","2020-03-05","2020-03-05","2020-08-17","2021-04-11","2021-09-20","2021-09-24","2021-08-09","2021-08-12","2021-09-21","2021-09-21","2021-09-20","2021-11-01","2021-11-01"],"priorHcc":[null,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":[["","00904679480","ASPIRIN ","81MG","30","Select","Select",""],["","50458057990","XARELTO ","20MG","30","Select","Select",""],["","00597007541","SPIRIVA ","HANDIHLR","30","Select","Select",""],["","53885024450","ONETOUCH ","ULTRA BL","50","Select","Select",""],["","62037059990","CARTIA ","240\/24HR","30","Select","Select",""],["","00002751001","HUMALOG ","100\/ML","10","Select","Select",""],["","00832532510","POT  CL MICRO","20MEQ ER","30","Select","Select",""],["","43547040211","FUROSEMIDE ","40MG","30","Select","Select",""],["","59310057922","PROAIR ","","8","Select","Select",""],["","00904645780","DOK ","100MG","30","Select","Select",""],["","49348014392","SM ","","510","Select","Select",""],["","00406012305","HYDROCO\/APAP ","5-325MG","30","Select","Select",""],["","42858010201","OXYCOD\/APAP ","5-325MG","5","Select","Select",""],["","00228291809","DILTIAZEM ","360MG ER","30","Select","Select",""],["","63304069201","CLINDAMYCIN ","150MG","28","Select","Select",""],["","68382079901","LABETALOL ","200MG","60","Select","Select",""],["","69547035302","NARCAN ","","2","Select","Select",""],["","00116200116","CHLORHEX ","0.12%","473","Select","Select",""],["","64380073706","VITAMIN ","50000UNT","4","Select","Select",""],["","00173088210","BREO ","200-25","60","Select","Select",""],["","43386091710","POT  CHLORIDE","20MEQ ER","30","Select","Select",""],["","62175089143","ATORVASTATIN ","20MG","30","Select","Select",""],["","00054472831","PREDNISONE ","5MG","21","Select","Select",""],["","57896045101","GERI-KOT ","8.6MG","120","Select","Select",""],["","45802086802","POLYETH ","3350 NF","238","Select","Select",""],["","62135098505","DOXYCYCL ","100MG","10","Select","Select",""],["","66993058597","FLUTIC\/SALME ","250\/50","60","Select","Select",""],["","54629060099","DOCUSATE ","100MG","60","Select","Select",""],["","00173069600","ADVAIR ","250\/50","60","Select","Select",""],["","62037059990","CARTIA","240\/24HR","30","Select","Select",""],["","00832532510","POT CL MICRO","20MEQ ER","30","Select","Select",""],["","50458057990","XARELTO","20MG","30","Select","Select",""],["","00904679480","ASPIRIN","81MG","30","Select","Select",""],["","53885024450","ONETOUCH","ULTRA BL","50","Select","Select",""],["","00597007541","SPIRIVA","HANDIHLR","30","Select","Select",""],["","43547040211","FUROSEMIDE","40MG","30","Select","Select",""],["","00406012305","HYDROCO\/APAP","5-325MG","30","Select","Select",""],["","00904645780","DOK","100MG","30","Select","Select",""],["","49348014392","SM","","510","Select","Select",""],["","59310057922","PROAIR","","8","Select","Select",""],["","00228291809","DILTIAZEM","360MG ER","30","Select","Select",""],["","00002751001","HUMALOG","100\/ML","10","Select","Select",""],["","43386091710","POT CHLORIDE","20MEQ ER","30","Select","Select",""],["","00173088210","BREO","200-25","60","Select","Select",""],["","42858010201","OXYCOD\/APAP","5-325MG","5","Select","Select",""],["","65862018501","CLINDAMYCIN","150MG","84","Select","Select",""],["","00116200116","CHLORHEX","0.12%","473","Select","Select",""],["","68382079901","LABETALOL","200MG","60","Select","Select",""],["","64380073706","VITAMIN","50000UNT","4","Select","Select",""],["","62135098505","DOXYCYCL","100MG","10","Select","Select",""],["","54629060099","DOCUSATE","100MG","60","Select","Select",""],["","00054472831","PREDNISONE","5MG","21","Select","Select",""],["","00173069600","ADVAIR","250\/50","60","Select","Select",""],["","62175089143","ATORVASTATIN","20MG","30","Select","Select",""],["","66993058597","FLUTIC\/SALME","250\/50","60","Select","Select",""],["","00088221905","LANTUS","100\/ML","15","Select","Select",""],["","00597015330","JARDIANCE","25MG","30","Select","Select",""],["","16714066102","GABAPENTIN","100MG","90","Select","Select",""],["","00006027731","JANUVIA","100MG","30","Select","Select",""],["","00904672580","SENNA","8.6MG","30","Select","Select",""],["","62756014202","METFORMIN","500MG ER","60","Select","Select",""],["","69547035302","NARCAN","","2","Select","Select",""],["","57896045101","GERI-KOT","8.6MG","120","Select","Select",""],["","45802086802","POLYETH","3350 NF","238","Select","Select",""],["","62756014202","METFORMIN ","TAB 500MG ER","60","Select","Select",""],["","16714066102","GABAPENTIN ","CAP 100MG","90","Select","Select",""],["","57664037713","TRAMADOL ","TAB 50MG","28","Select","Select",""],["","00006027731","JANUVIA ","TAB 100MG","30","Select","Select",""],["","00904672580","SENNA ","TAB 8.6MG","30","Select","Select",""],["","00088221905","LANTUS ","INJ 100\/ML","15","Select","Select",""],["","00597015330","JARDIANCE ","TAB 25MG","30","Select","Select",""],["","11822046713","PAIN ","TAB 325MG","30","Select","Select",""],["","65162083366","DICLOFENAC ","GEL 0.01","200","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","",""],["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":""}]}]}