{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"WAYNE H GEDDIS","gend":0,"add":"1633 LECKIE ST","city":"PORTSMOUTH","state":"VA","zip":"23704-9998","dob":"1960-06-13","age":"","mstatus":"","insh":"900032488*01","cliId":"","pno":"8165410215","cno":"8165410215","email":"","ename":"","eno":"","pphy":"DONALDSON, NICOLE","ppno":7572276866,"pcpadd":"3745 Holland Rd","pcpcity":"Virginia Beach","pcpstate":"VA","pcpzip":"23452-2847","pcpcounty":"","pcpid":"","pcpname":"AMERICAN CURRENT CARE PA                                    ","plan":"OHP","program":"MEDICARE","lob":"MA-Non DSNP","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7572770298,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R50.9","Z85.831","K21.9","G89.29","R25.9","R76.8","R13.10","K76.0","K52.89","M96.1","M54.50","R07.9","K21.00","I10.","E78.5","I48.91","R55.","N39.0","G20.","B20.","I72.0","E72.20","G45.9","E87.1","I49.3","I49.1","K55.20","K64.8","R79.89","J69.0","B18.1","R06.2","R06.02","F11.20","I25.10","J42.","M54.2","M54.9","Z23.","R49.0","J44.9","R09.82","J02.9","J30.2","R79.1","I48.92","J30.1","G93.40","N30.00","I95.1","N40.1","N52.8","N13.8","E04.1","R05.","Z01.818","K82.4","K44.9","T18.3XXA","N52.9","F41.9","R39.11","R35.0","R41.82","D64.9","I63.9","Z21.","F10.129","Z79.899","R47.81","Z79.82","Z87.891","E78.2","Z79.51","R93.0","R91.8","S09.90XA","S29.9XXA","Z86.73","R42.","R53.83","T85.192A","E03.9","Z12.11","J30.5","I35.8","K92.1","K63.3","K64.0","G93.41","I48.0","Z86.19","R47.1","R29.90","G62.0","K22.4","Z01.810","R25.1","I65.29","R63.30","R89.9","J41.0","K29.70","T85.9XXA","H61.23","H93.299","D72.89","D50.9","R93.2","R51.9","R22.0","K08.89","R93.89","H04.123","H25.13","H35.372","H43.392","I67.82","G47.00","I82.402","I82.409","E29.1","G20","I10","B20","G20.A1"],"date":["2022-03-17","2021-04-30","2023-10-31","2022-10-25","2021-09-16","2021-11-22","2023-02-22","2022-07-18","2021-12-21","2022-04-25","2022-02-18","2022-04-24","2022-06-02","2023-04-20","2023-03-01","2022-12-02","2022-12-20","2022-11-07","2023-02-20","2023-02-09","2022-11-11","2022-12-01","2023-02-15","2023-02-15","2022-12-02","2022-12-02","2022-12-13","2022-12-05","2023-01-24","2021-04-22","2023-02-15","2021-05-26","2021-05-26","2021-07-21","2022-11-11","2022-11-11","2021-12-16","2022-10-25","2021-12-16","2023-02-22","2023-02-22","2023-02-22","2023-02-22","2023-11-16","2022-08-21","2022-08-29","2023-11-09","2022-10-26","2022-10-27","2022-11-11","2023-04-25","2023-04-25","2023-04-25","2021-04-07","2021-07-23","2021-12-03","2022-04-27","2022-07-19","2022-07-19","2023-04-13","2022-10-20","2022-10-20","2022-10-20","2022-10-25","2022-11-07","2022-11-11","2022-11-11","2022-11-11","2022-11-11","2022-11-11","2022-11-11","2022-11-11","2022-11-11","2022-11-11","2022-11-13","2022-11-11","2022-08-21","2022-08-21","2022-12-12","2022-12-20","2021-04-07","2021-12-08","2021-12-08","2022-05-28","2022-09-26","2022-08-23","2022-10-13","2022-10-13","2022-10-13","2022-10-27","2022-11-09","2022-10-25","2022-11-11","2022-11-14","2021-07-21","2021-08-06","2021-09-14","2022-04-24","2022-10-26","2022-11-14","2021-07-23","2021-08-17","2021-10-05","2021-12-08","2023-02-22","2023-02-22","2022-11-07","2022-12-05","2023-02-15","2023-02-22","2023-02-22","2023-02-22","2021-03-15","2022-11-01","2022-11-01","2022-11-01","2022-11-01","2022-11-11","2023-04-20","2023-04-20","2023-04-20","2023-08-28","2023-05-16","2023-11-02","2023-08-15","2023-10-13"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}}]},{"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":[]},{"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":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","61958250101","BIKTARVY TAB","","30","Select","Select",""],["","68645035059","CARVEDILOL TAB","6.25MG","180","Select","Select",""],["","65862078490","ESOMEPRAZOLE MAGNESIUM","40 MG","180","Select","Select",""],["","55111078401","FEXOFENADINE HCL","180 MG","30","Select","Select",""],["","60219175303","SILDENAFIL CITRATE","100 MG","30","Select","Select",""],["","00093342505","LORAZEPAM","0.5 MG","30","Select","Select",""],["","00003376474","ELIQUIS","5 MG (74)","74","Select","Select",""],["","16714017401","ATORVASTATIN CALCIUM","20 MG","30","Select","Select",""],["","50090624700","BIKTARVY","50-200-25","90","Select","Select",""],["","31722099901","BACLOFEN","20 MG","180","Select","Select",""],["","49502010202","EPINEPHRINE","0.3MG\/0.3","2","Select","Select",""],["","64896066301","RYTARY","48.75-195","120","Select","Select",""],["","31722099901","BACLOFEN TAB","20MG","180","Select","Select",""],["","62756051888","CARB\/LEVO TAB","25-100MG","120","Select","Select",""],["","16729017501","AMITRIPTYLIN TAB","100MG","90","Select","Select",""],["","43547035210","LISINOPRIL TAB","5MG","90","Select","Select",""],["","43547038910","GABAPENTIN TAB","600MG","270","Select","Select",""],["","00406012501","HYDROCO\/APAP TAB","10-325MG","120","Select","Select",""],["","00378911998","FENTANYL DIS","12MCG\/HR","10","Select","Select",""],["","31722077701","ACYCLOVIR TAB","400MG","90","Select","Select",""],["","00603589421","TEMAZEPAM CAP","30MG","90","Select","Select",""],["","60505257909","ATORVASTATIN TAB","20MG","90","Select","Select",""],["","00093645198","ESOMEPRA MAG CAP","40MG DR","30","Select","Select",""],["","67877014701","TEMAZEPAM","30 MG","90","Select","Select",""],["","10702080803","CYCLOSPORINE","0.05 %","60.000","Select","Select",""],["","68382013201","TAMSULOSIN HCL","0.4 MG","90","Select","Select",""],["","00173085910","BREO ELLIPTA INH","100-25","60","Select","Select",""],["","00023916330","RESTASIS","0.05 %","60","Select","Select",""],["","31722077701","ACYCLOVIR","400 MG","90","Select","Select",""],["","58160090952","FLUARIX QUAD","2023-2024 60MCG\/.5ML","0.500","Select","Select",""],["","65862006301","METOPROLOL TARTRATE","50 MG","90","Select","Select",""],["","00093227534","AMOX\/K CLAV TAB","875-125","14","Select","Select",""],["","43598057530","TADALAFIL","5 MG","90","Select","Select",""],["","55111078401","FEXOFENADINE TAB","180MG","90","Select","Select",""],["","64896066301","RYTARY CAP","195MG","360","Select","Select",""],["","57237002801","AMOXICILLIN","500 MG","30","Select","Select",""],["","49502010202","EPINEPHRINE INJ","0.3MG","2","Select","Select",""],["","00003089421","ELIQUIS TAB","5MG","60","Select","Select",""],["","68180098101","LISINOPRIL","20 MG","90","Select","Select",""],["","60505265401","TRAZODONE HCL","100 MG","60","Select","Select",""],["","00121087316","LACTULOSE","10 G\/15 ML","450","Select","Select",""],["","10144034260","INBRIJA CAP","42MG","60","Select","Select",""],["","00186037020","SYMBICORT AER","160-4.5","10","Select","Select",""],["","00527512570","LACTULOSE SOL","10GM\/15","450","Select","Select",""],["","62756051888","CARBIDOPA-LEVODOPA","25MG-100MG","120","Select","Select",""],["","69547035302","NARCAN SPR","","2","Select","Select",""],["","66993001968","ALBUTEROL AER HFA","","18","Select","Select",""],["","45802010901","TRIAMCINOLONE ACETONIDE","55 MCG","16.9","Select","Select",""],["","27241006903","SILDENAFIL TAB","100MG","6","Select","Select",""],["","65862042005","SMZ\/TMP DS TAB","800-160","20","Select","Select",""],["","69315090401","LORAZEPAM TAB","0.5MG","30","Select","Select",""],["","33342020010","LEVOCETIRIZINE DIHYDROCHLORIDE","5 MG","90","Select","Select",""],["","45802010901","TRIAMCINOLON AER","55MCG\/AC","17","Select","Select",""],["","59310082206","AIRDUO RESPI INH","232-14","1","Select","Select",""],["","00093360982","FLUTIC\/SALME INH","232\/14","1","Select","Select",""],["","00310737020","BUDES\/FORMOT AER","160-4.5","10","Select","Select",""],["","00023916360","RESTASIS EMU","0.05%","60","Select","Select",""],["","60505620202","CYCLOSPORINE EMU","0.05%","60","Select","Select",""],["","68462012605","GABAPENTIN","600 MG","270","Select","Select",""],["","00093314701","CEPHALEXIN CAP","500MG","20","Select","Select",""],["","65162046650","IBUPROFEN TAB","800MG","15","Select","Select",""],["","00406055201","OXYCODONE TAB","5MG","28","Select","Select",""],["","59746017509","PREDNISONE TAB","20MG","18","Select","Select",""]]}},{"a":[]},{"a":[]},{"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":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":[]}]},{"t":"Mini-Cog","q":[{"a":[]},{"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":"","a13":""}]}]}