{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KIMBERLY KNOWLES","gend":1,"add":"524 SHENADOAH ST","city":"PORTSMOUTH","state":"VA","zip":"23707-9998","dob":"1965-09-06","age":"","mstatus":"","insh":"1452087*01","cliId":"","pno":"757\/295-7664","cno":"","email":"","ename":"","eno":"","pphy":"MUSSELMANI, ZATTAM MD","ppno":"757\/543-3557","pcpadd":"1422 POINDEXTER ST","pcpcity":"CHESAPEAKE","pcpstate":"VA","pcpzip":23324,"pcpcounty":"","pcpid":"","pcpname":"ZATTAM MUSSELMANI","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/543-0053","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M79.7","Z01.818","H26.9","H53.121","R06.83","T86.840","H18.231","H40.1121","J30.9","J01.90","H16.041","G47.33","M54.12","R26.9","Z96.1","Z98.49","H52.03","H52.223","H52.4","M25.572","M76.72","K58.9","Z23.","T81.30XA","M25.50","E66.3","R11.0","T86.8401","H40.1131","Z94.7","M54.5","M79.662","M25.561","M54.9","M54.6","R68.89","M76.892","R11.10","R74.8","K58.2","Z86.010","Z83.71","Z20.822","K21.9","M19.90","Z53.20","Z79.2","Z79.899","Z79.51","M46.1","M79.605","H17.89","E16.2","M65.332","H16.011","H69.91","R09.81","J01.91","S91.131A","L03.031","M54.16","M70.61","R12.","NO DATA","R19.00","M54.2","Z74.09","M77.52","F51.01","R53.1","D12.8","C81.00","I70.233","M65.272","R63.5","R53.83","R04.0","G89.4","M54.30","H04.123","H02.409","K58.0","K22.70","L94.0","T86.848","M79.643","Z13.820","S16.1XXA","S30.1XXA","K57.32","F41.9","E07.89","D22.72","E03.9","E66.9","Z68.34","S93.402A","X58.XXXA","K57.30","M66.272","S39.012A","N83.201","R07.81","N83.8","K22.2","K44.9","K31.7","K25.9","I10.","E66.01","Z68.43","Z68.33","M62.81","J06.9","M79.672","M19.072","Z82.61","H18.51","H25.811","H40.043","J01.00","H02.422","L71.8","H26.492","R19.7","S86.312A","V58.89","H25.11","H02.402","I80.02","M47.816","R50.9","R11.2","L71.9","L81.0","R10.84","Z87.19","N39.0","S93.401A","M25.571","M47.22","M50.10","M50.13","S13.4XXA","H26.491","G45.3","M25.562","W18.30XA","R06.7","Z68.32","Z88.2","Z88.5","Z88.0","Z88.1","Z91.040","Z88.8","H04.122","M47.812","M50.30","M50.11","X58.XXXD","H90.3","M79.641","M79.642","M48.02","R14.3","J30.1","J34.3","H69.81"],"date":["2022-05-31","2020-06-02","2020-06-02","2020-06-02","2020-06-02","2020-09-17","2020-09-17","2021-03-02","2021-01-25","2022-05-25","2021-03-02","2021-03-29","2022-01-28","2021-06-22","2021-06-24","2021-06-24","2021-06-24","2021-06-24","2021-06-24","2021-08-11","2021-08-11","2022-03-28","2020-09-21","2020-06-15","2020-09-21","2021-07-20","2022-03-28","2021-03-02","2022-03-01","2022-05-11","2021-09-01","2021-03-02","2021-03-02","2021-05-12","2021-09-01","2021-10-04","2021-09-01","2021-12-22","2021-09-01","2021-09-01","2022-03-28","2022-03-28","2022-01-03","2022-05-25","2021-12-22","2021-12-22","2021-12-22","2022-08-17","2021-12-22","2020-03-13","2021-01-26","2021-05-04","2020-02-14","2021-07-20","2020-12-11","2021-06-24","2022-01-03","2022-07-25","2020-02-06","2020-02-06","2020-02-17","2020-02-17","2020-09-16","2021-12-22","2021-04-07","2021-12-03","2021-10-04","2021-10-04","2021-10-27","2022-08-11","2021-12-08","2021-12-22","2021-12-22","2021-12-22","2020-01-17","2022-08-12","2021-02-10","2022-10-25","2021-02-10","2021-08-10","2021-08-10","2020-02-17","2020-02-17","2020-02-17","2020-03-17","2022-05-31","2021-01-25","2021-03-23","2021-03-23","2021-03-23","2021-03-23","2021-03-23","2021-08-17","2021-12-08","2022-01-03","2021-10-12","2021-11-22","2022-03-17","2021-12-08","2021-12-22","2021-03-19","2021-03-19","2021-03-19","2021-04-07","2021-10-12","2021-10-12","2021-10-12","2021-10-12","2021-10-12","2021-10-12","2021-10-12","2021-04-07","2019-01-23","2022-01-19","2019-08-12","2019-10-16","2019-10-21","2019-12-12","2019-12-12","2019-12-12","2019-05-07","2019-06-14","2019-08-08","2019-11-11","2019-09-10","2019-10-16","2022-04-25","2019-01-08","2019-06-10","2019-11-18","2019-01-31","2019-06-03","2019-06-03","2019-01-14","2019-01-14","2019-02-22","2019-02-22","2022-08-12","2019-07-08","2019-07-08","2022-05-19","2022-04-05","2022-05-19","2022-03-17","2022-02-08","2022-03-16","2022-09-09","2022-09-09","2022-01-03","2022-01-03","2022-01-03","2022-01-03","2022-01-03","2022-01-03","2022-01-03","2022-01-03","2022-03-01","2022-10-25","2022-10-25","2022-04-25","2022-04-25","2022-05-25","2022-05-31","2022-05-31","2022-01-28","2022-03-28","2022-05-25","2022-05-25","2022-05-25"],"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":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"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":[["","42192034001","HYOSCYAMINE","TAB 0.125MG","120","Select","Select",""],["","","GABAPENTIN","CAP 100MG","","Select","Select",""],["","65862064169","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","","BRIMONIDINE","SOL 0.0015","","Select","Select",""],["","68001025708","DULOXETINE","CAP 60MG","180","Select","Select",""],["","00527128210","DICYCLOMINE","TAB 20MG","120","Select","Select",""],["","31722053301","METHOCARBAM","TAB 500MG","60","Select","Select",""],["","68462039710","OMEPRAZOLE","CAP 40MG","30","Select","Select",""],["","00378034505","DIAZEPAM","TAB 5MG","4","Select","Select",""],["","00074372790","SYNTHROID","TAB 137MCG","30","Select","Select",""],["","76385010001","METHSCOPOLAM","TAB 2.5MG","120","Select","Select",""],["","","VALACYCLOVIR","TAB 500MG","","Select","Select",""],["","57664037718","TRAMADOL","TAB 50MG","6","Select","Select",""],["","00023932115","ALPHAGAN","SOL 0.001","15","Select","Select",""],["","68001024617","ONDANSETRON","TAB 4MG ODT","12","Select","Select",""],["","54092060601","XIIDRA","DRO 0.05","60","Select","Select",""],["","59746017210","PREDNISONE","TAB 5MG","10","Select","Select",""],["","42192060716","BROM\/PSE\/DM","SYP ","150","Select","Select",""],["","68382009605","HYDROXYCHLOR","TAB 200MG","60","Select","Select",""],["","45802006601","AZEL\/FLUTIC","SPR 137-50","23","Select","Select",""],["","","MOXIFLOXACIN","SOL 0.005","","Select","Select",""],["","11534016503","FOLIC","TAB 1MG","30","Select","Select",""],["","08290309623","1ML","MIS 27GX1\/2\"","4","Select","Select",""],["","08290329424","INSULIN","MIS 1ML\/28G","4","Select","Select",""],["","61703035038","METHOTREXATE","INJ 25MG\/ML","2","Select","Select",""],["","","LEVOTHYROXIN","TAB 137MCG","","Select","Select",""],["","68001036400","METRONIDAZOL","TAB 250MG","28","Select","Select",""],["","68001036103","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","68001000100","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","","DUREZOL","EMU 0.0005","","Select","Select",""],["","63824005718","MUCINEX","TAB 60-600MG","18","Select","Select",""],["","69097034135","DIFLUPREDNAT","EMU 0.0005","15","Select","Select",""],["","71858005004","TIROSINT","CAP 150MCG","30","Select","Select",""],["","00406055201","OXYCODONE","TAB 5MG","12","Select","Select",""],["","00363017508","PAIN","TAB 500MG","30","Select","Select",""],["","","SOD","SOL 5% OP","","Select","Select",""],["","","CYCLOBENZAPR","TAB 5MG","","Select","Select",""],["","00591352530","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","","FLUCONAZOLE","TAB 100MG","","Select","Select",""],["","68382005105","MELOXICAM","TAB 15MG","30","Select","Select",""],["","64380080807","IBUPROFEN","TAB 600MG","30","Select","Select",""],["","60758018805","GENTAMICIN","SOL 0.3% OP","5","Select","Select",""],["","00904672059","ACETAMIN","TAB 500MG","30","Select","Select",""],["","24208027715","MURO","SOL 5% OP","15","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","42806031205","DOXYCYCL","TAB 100MG","14","Select","Select",""],["","00299382345","SOOLANTRA","CRE 0.01","45","Select","Select",""],["","00591405289","IVERMECTIN","CRE 0.01","45","Select","Select",""],["","24385046678","FIBER","TAB 500MG","360","Select","Select",""],["","00093220401","METOCLOPRAM","TAB 5MG","2","Select","Select",""],["","00904678744","MAG","SOL LEMON","296","Select","Select",""],["","10572010001","PEG-3350","SOL ELECTROL","4000","Select","Select",""],["","41167432005","ALLEGRA-D","TAB 24 HOUR","30","Select","Select",""],["","60505100301","KETOROLAC","SOL 0.005","5","Select","Select",""],["","55111018010","TIZANIDINE","TAB 4MG","30","Select","Select",""],["","","HYDROCHLOROT","TAB 12.5MG","","Select","Select",""],["","60758011905","PREDNISOLONE","SUS 1% OP","5","Select","Select",""],["","","CIPROFLOXACN","TAB 500MG","","Select","Select",""],["","69097052444","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","","FLUTICASONE","SPR 50MCG","","Select","Select",""],["","","ERYTHROMYCIN","OIN 5MG\/GM","","Select","Select",""],["","42858010250","OXYCOD\/APAP","TAB 5-325MG","10","Select","Select",""],["","","CETIRIZINE","TAB 10MG","","Select","Select",""],["","","DOXYCYC","TAB 100MG","","Select","Select",""],["","17478028810","TIMOLOL","SOL 0.5% OP","5","Select","Select",""],["","65862053750","LEVOFLOXACIN","TAB 500MG","7","Select","Select",""],["","00574402235","BACITRACIN","OIN OP","4","Select","Select",""],["","64376064801","HYDROCO\/APAP","TAB 5-300MG","8","Select","Select",""],["","61314064305","TOBRAMYCIN","SOL 0.3% OP","5","Select","Select",""],["","75987004005","PENNSAID","SOL 0.02","112","Select","Select",""],["","46122014121","GNP","SUS 30MG\/5ML","89","Select","Select",""],["","63481068447","VOLTAREN","GEL 0.01","100","Select","Select",""],["","69452014330","BENZONATATE","CAP 100MG","42","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","20","Select","Select",""],["","59762040105","SUCRALFATE","TAB 1GM","90","Select","Select",""],["","00904671146","FEXOFENADINE","TAB 180MG","30","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":""}]}]}