{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LINDA   E BRAY","gend":1,"add":"1046 HOLT ST","city":"NORFOLK","state":"VA","zip":"23504-9998","dob":"1964-01-24","age":"","mstatus":"","insh":"1574363*01","cliId":"","pno":"757\/319-9464","cno":"","email":"","ename":"","eno":"","pphy":"FEDRO, RANDALL C MD","ppno":"757\/686-3516","pcpadd":"3235 BRIDGE RD STE 15","pcpcity":"SUFFOLK","pcpstate":"VA","pcpzip":23435,"pcpcounty":"","pcpid":"","pcpname":"North Suffolk Family Medicine","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/686-0230","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z01.818","M17.11","N39.0","G89.18","Z47.1","E11.9","I10.","F33.41","G47.33","Z96.651","K21.9","E66.9","Z68.36","M79.669","R22.40","N39.41","N31.9","E11.65","T38.0X5A","Z87.891","Z79.84","M54.5","G47.30","F32.9","Z68.35","Z79.899","Z88.8","M13.161","M70.51","M76.31","A41.9","D72.829","R50.9","Z20.822","N12.","K02.9","M25.561","R26.89","M43.16","M54.16","R06.89","R78.81","R65.10","N10.","K14.8","F41.9","R73.09","U07.1","E78.5","A41.51","L02.01","M51.36","K04.7","K76.89","I25.10","D73.89","E66.01","R05.9","N30.00","B96.89","Z01.810","Z01.812","J96.01","R53.83","M79.609","NO DATA","R09.02","E11.21","E55.9","M25.511","G89.29","M62.81","R31.9","R53.1","R32.","D62.","M54.9","Z83.3","Z82.3","Z82.49","Z82.5","Z82.61","Z80.9","Z84.1","I82.401","M17.0","M17.12","T84.84XA","K76.0","R05.","K12.2","J06.9","J04.0","H15.012","E87.6","E88.81","F10.10","G43.909","B96.1","Z16.11","N28.9","K75.81","H25.813","H17.9","R52.","M25.569","M67.40","M54.41","M54.42","H40.013","M67.432","M25.532","M77.8","Z87.39","L30.9","V58.69","L53.9","Z91.128","L29.9","R53.82","R40.0","G47.20","Z99.89","S80.01XA","Z91.14","N89.8","R73.9","M79.89","M79.661"],"date":["2022-06-10","2022-11-15","2020-08-14","2020-03-13","2020-03-18","2022-07-05","2022-10-19","2021-03-16","2022-03-23","2022-11-15","2022-07-05","2022-06-06","2022-06-06","2020-04-03","2020-04-03","2022-10-17","2022-10-17","2022-10-19","2021-03-08","2022-10-19","2021-05-20","2021-05-20","2022-10-19","2022-07-05","2021-05-20","2022-10-19","2022-10-19","2021-06-25","2021-06-25","2021-06-25","2021-09-15","2021-09-12","2021-09-08","2022-06-10","2021-09-15","2021-09-15","2022-08-09","2020-12-23","2021-02-22","2021-02-22","2021-03-16","2021-09-10","2021-09-12","2021-09-12","2020-06-01","2020-06-01","2021-03-08","2021-03-18","2021-09-09","2021-09-09","2021-09-09","2021-09-09","2021-09-13","2021-09-09","2021-09-09","2021-09-09","2021-09-09","2021-11-24","2021-11-24","2021-11-24","2022-06-10","2022-06-10","2021-03-18","2020-03-31","2020-04-03","2021-03-16","2021-03-16","2021-03-16","2021-03-16","2021-03-16","2022-07-05","2020-04-28","2020-08-14","2020-08-14","2020-02-24","2020-03-12","2020-03-12","2022-10-19","2022-10-19","2022-10-19","2020-03-12","2020-03-12","2020-03-12","2020-03-12","2020-03-14","2020-03-06","2022-10-19","2021-06-03","2021-07-07","2021-07-07","2021-09-13","2021-12-01","2021-12-01","2019-09-11","2019-06-28","2019-06-25","2019-06-25","2019-06-25","2019-06-25","2019-06-25","2019-06-25","2019-06-25","2022-01-13","2019-09-11","2019-06-25","2019-12-31","2022-04-06","2022-08-09","2022-08-09","2022-01-13","2022-06-13","2022-03-20","2022-03-20","2022-03-20","2022-06-06","2022-06-06","2022-06-06","2022-06-06","2022-06-06","2022-02-09","2022-02-09","2022-02-09","2022-03-23","2022-11-15","2022-10-19","2022-10-19","2022-10-19","2022-11-17","2022-11-17"],"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":[["","","ATORVASTATIN","TAB 10MG","","Select","Select",""],["","","CELECOXIB","CAP 200MG","","Select","Select",""],["","68180029506","DULOXETINE","CAP 30MG","30","Select","Select",""],["","67877069601","CHLORTHALID","TAB 25MG","30","Select","Select",""],["","55111015810","OMEPRAZOLE","CAP 20MG","30","Select","Select",""],["","00186037220","SYMBICORT","AER 80-4.5","10","Select","Select",""],["","00088221905","LANTUS","INJ 100\/ML","12","Select","Select",""],["","","LOSARTAN","TAB 50MG","","Select","Select",""],["","65862001005","METFORMIN","TAB 1000MG","60","Select","Select",""],["","00310737220","BUDES\/FORMOT","AER 80-4.5","10","Select","Select",""],["","08222440006","ULTICARE","PAD ALCOHOL","100","Select","Select",""],["","49502039475","INSULIN","INJ 100U\/ML","15","Select","Select",""],["","00093216568","NALOXONE","SPR ","4","Select","Select",""],["","64380080807","IBUPROFEN","TAB 600MG","60","Select","Select",""],["","","CEPHALEXIN","CAP 250MG","","Select","Select",""],["","00406012301","HYDROCO\/APAP","TAB 5-325MG","15","Select","Select",""],["","08290320122","BD  PEN NEEDL","MIS 32GX4MM","100","Select","Select",""],["","52817033010","CYCLOBENZAPR","TAB 5MG","30","Select","Select",""],["","08489831510","PEN  NEEDLES","MIS 32GX4MM","100","Select","Select",""],["","","ASPIRIN","TAB 325MG EC","","Select","Select",""],["","68462011944","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","53885013610","ONETOUCH","MIS LANCETS","100","Select","Select",""],["","","OXYCOD\/APAP","TAB 10-325MG","","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","53885004401","ONE","KIT VERIO FL","1","Select","Select",""],["","00054418625","DEXAMETHASON","TAB 6MG","7","Select","Select",""],["","00378064110","PREDNISONE","TAB 10MG","30","Select","Select",""],["","50458057760","XARELTO","TAB 2.5MG","30","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","20","Select","Select",""],["","","AMOXICILLIN","TAB 875MG","","Select","Select",""],["","64380071207","BENZONATATE","CAP 100MG","30","Select","Select",""],["","42858011830","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","70010075401","METHOCARBAM","TAB 500MG","20","Select","Select",""],["","55111012705","CIPROFLOXACN","TAB 500MG","7","Select","Select",""],["","00002803101","GLUCAGON","KIT 1MG","3","Select","Select",""],["","00904701416","ACETAMIN","SOL 160\/5ML","237","Select","Select",""],["","66685100101","AMOX\/K","TAB 875-125","14","Select","Select",""],["","00904671960","ACETAMINOPHE","TAB 325MG","90","Select","Select",""],["","00904676620","ACETAMINOPHN","SUS 160\/5ML","237","Select","Select",""],["","69842080601","CVS","TAB 600MG","30","Select","Select",""],["","","HYDROMORPHON","TAB 2MG","","Select","Select",""],["","29300012501","MELOXICAM","TAB 15MG","30","Select","Select",""],["","","APAP\/CODEINE","TAB 300-30MG","","Select","Select",""],["","","NARCAN","SPR ","","Select","Select",""],["","","TIZANIDINE","TAB 4MG","","Select","Select",""],["","","VIVLODEX","CAP 10MG","","Select","Select",""],["","49884093547","DICLOFENAC","GEL 0.01","300","Select","Select",""],["","63481068447","VOLTAREN","GEL 0.01","300","Select","Select",""],["","60505058204","MOXIFLOXACIN","SOL HCL 0.5%","3","Select","Select",""],["","57664050658","METOPROL","TAB 25MG","30","Select","Select",""],["","00172208380","HYDROCHLOROT","TAB 25MG","30","Select","Select",""],["","68382000106","PAROXETINE","TAB 40MG","30","Select","Select",""],["","00006027754","JANUVIA","TAB 100MG","30","Select","Select",""],["","99073070914","FREESTYLE    KIT FREEDOM","KIT FREEDOM","1","Select","Select",""],["","00093005805","TRAMADOL","TAB 50MG","30","Select","Select",""],["","64380073706","VITAMIN","CAP 50000UNT","4","Select","Select",""],["","65162044210","MECLIZINE","TAB 25MG","20","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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}