{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JORDAN   R SHUMAKER","gend":1,"add":"5 DEANS CIR","city":"NEWPORT NEWS","state":"VA","zip":"23606-9998","dob":"1988-07-09","age":"","mstatus":"","insh":"1752430*01","cliId":"","pno":"757\/713-0806","cno":"","email":"","ename":"","eno":"","pphy":"HOLLOWAY, SAMUEL K PA","ppno":"757\/659-6287","pcpadd":"860 OMNI BLVD SUITE 112","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":23606,"pcpcounty":"","pcpid":"","pcpname":"TPMG CITY CENTER FAMILY MEDICINE","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/586-5284","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G43.909","E66.01","I10.","Z68.42","R07.89","R25.2","R21.","Z00.00","I49.3","I49.1","R00.2","R06.02","R06.09","M79.602","Z88.0","M79.605","R07.9","Z79.82","Z79.899","R06.00","J45.909","B00.9","L55.1","Z20.828","K25.9","Z13.220","I48.91","I45.10","I48.0","J11.1","J02.9","R68.89","R05.","R10.13","R63.4","R11.0","K29.70","H93.8X3","R19.7","K62.5","K31.89","K57.30","K64.8","F41.8","K52.9"],"date":["2021-02-16","2021-09-15","2021-02-16","2021-09-15","2021-09-14","2021-09-14","2021-09-15","2021-09-15","2020-12-23","2020-12-23","2021-06-08","2020-12-23","2021-06-08","2021-07-15","2021-09-14","2021-08-31","2021-08-31","2021-09-14","2021-09-14","2021-09-14","2021-09-14","2021-09-14","2021-08-16","2021-10-08","2019-04-12","2019-04-12","2019-04-12","2019-04-12","2019-04-30","2019-05-24","2019-05-24","2019-05-24","2019-12-30","2019-03-28","2019-03-28","2019-03-28","2019-03-28","2019-07-11","2019-08-22","2019-08-22","2019-03-28","2019-08-22","2019-08-22","2019-12-30","2019-03-19"],"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":[["","","ALBUTEROL"," ALBUTEROL ","8","Select","Select",""],["","","OXYCOD\/APAP","TAB 5-325MG","","Select","Select",""],["","63824000832","MUCINEX","TAB 600MG ER","20","Select","Select",""],["","","CLONAZEPAM"," CLONAZEPAM ","30","Select","Select",""],["","","PROAIR"," PROAIR ","8","Select","Select",""],["","","ONDANSETRON"," ONDANSETRON ","30","Select","Select",""],["","68001041408","DULOXETINE","CAP 30MG","30","Select","Select",""],["","","METHYLPRED"," METHYLPRED ","21","Select","Select",""],["","","METOPROL"," METOPROL ","30","Select","Select",""],["","51672416403","METRONIDAZOL","GEL 0.01","60","Select","Select",""],["","65162062711","TRAMADOL","TAB 50MG","12","Select","Select",""],["","","VENTOLIN"," VENTOLIN ","18","Select","Select",""],["","57664023388","NITROFUR","CAP 100MG","14","Select","Select",""],["","","DOXYCYC"," DOXYCYC ","20","Select","Select",""],["","","BENZONATATE","CAP 200MG","","Select","Select",""],["","68382013814","TOPIRAMATE","TAB 25MG","30","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","","MELOXICAM","TAB 15MG","","Select","Select",""],["","","DOXYCYCL","CAP 100MG","","Select","Select",""],["","","HYDROCHLOROT","CAP 12.5MG","","Select","Select",""],["","","CIPROFLOXACN","TAB 250MG","","Select","Select",""],["","","AZITHROMYCIN","TAB 250MG","","Select","Select",""],["","","PREDNISONE","TAB 20MG","","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":""}]}]}