{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KRISTIN   M ARMSTRONG","gend":1,"add":"5603 PARISH LN","city":"PORTSMOUTH","state":"VA","zip":"23703-9998","dob":"1984-09-04","age":"","mstatus":"","insh":"1961092*01","cliId":"","pno":"757\/402-2263","cno":"","email":"","ename":"","eno":"","pphy":"TORRY, CHE DO","ppno":"757\/310-6413","pcpadd":"739 THIMBLE SHOALS BLVD SUITE 1008","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":23606,"pcpcounty":"","pcpid":"","pcpname":"INVICTUS HEALTH LLC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/310-6404","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R10.9","R11.2","R63.4","Z34.90","O24.913","O99.013","V23.5","Z3A.34","Z3A.36","D50.8","R07.9","R53.83","Z30.42","M54.16","F41.1","O26.891","R10.2","Z3A.01","O34.42","Z36.83","Z3A.22","M19.90","G89.4","M47.816","M53.3","V23.9","D50.9","Z98.84","Z3A.35","Z39.1","Z23.","Z30.41","M62.838","Z30.2","Z87.42","L98.9","Z87.891","L72.9","R10.30","O36.8330","Z37.0","Z3A.37","O99.513","O34.219","O99.844","O99.344","O99.613","F43.10","O26.893","F41.8","K58.9","L50.8","J45.909","Z79.899","O80.","D64.9","Z98.890","E28.2","V23.82","Z3A.08","O24.419","Z71.3","O09.523","O34.43","N93.9","O34.211","B37.9","Z30.9"],"date":["2019-07-05","2020-08-25","2019-07-05","2019-07-05","2019-09-20","2019-09-20","2019-09-20","2019-09-04","2019-09-17","2021-04-21","2021-12-23","2020-12-16","2021-05-24","2021-12-09","2021-12-15","2019-02-19","2019-02-19","2019-02-19","2019-06-07","2019-06-07","2019-06-07","2021-08-06","2021-12-09","2021-12-09","2021-12-30","2019-08-12","2019-02-11","2020-08-25","2019-09-13","2019-09-20","2021-10-28","2020-07-15","2021-08-04","2021-09-03","2021-09-03","2021-12-10","2021-12-10","2021-12-10","2019-02-19","2019-09-20","2019-09-20","2019-09-20","2019-09-20","2019-09-20","2019-09-20","2019-09-20","2019-09-20","2019-09-20","2019-09-20","2019-09-20","2019-09-20","2019-09-20","2021-07-09","2019-09-20","2019-09-20","2020-08-25","2020-08-25","2021-11-04","2019-03-04","2019-03-04","2019-08-12","2019-08-12","2019-09-20","2019-09-17","2021-10-25","2019-09-20","2020-10-16","2020-10-16"],"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":[["","","METHYLPHENID","TAB 20MG","","Select","Select",""],["","","DULOXETINE","CAP 30MG","","Select","Select",""],["","13668001105","CITALOPRAM","TAB 40MG","30","Select","Select",""],["","","ONDANSETRON"," ONDANSETRON ","30","Select","Select",""],["","16729013616","CLONAZEPAM","TAB 0.5MG","90","Select","Select",""],["","13107005801","APAP\/CODEINE","TAB 300-15MG","10","Select","Select",""],["","27241005303","ARIPIPRAZOLE","TAB 10MG","30","Select","Select",""],["","00115180301","HYDROXYZ","CAP 25MG","60","Select","Select",""],["","70010077005","METHOCARBAM","TAB 750MG","18","Select","Select",""],["","71093015604","ZOLPIDEM","TAB 10MG","30","Select","Select",""],["","","PROCHLORPER"," PROCHLORPER ","30","Select","Select",""],["","00143122701","DICYCLOMINE","TAB 20MG","15","Select","Select",""],["","00172392770","DIAZEPAM","TAB 10MG","1","Select","Select",""],["","65862000899","METFORMIN","TAB 500MG","60","Select","Select",""],["","59267100002","PFIZER","INJ COVID-19","0","Select","Select",""],["","51991075933","LETROZOLE","TAB 2.5MG","5","Select","Select",""],["","00555077902","MEDROXYPR","TAB 10MG","10","Select","Select",""],["","55111018010","TIZANIDINE","TAB 4MG","21","Select","Select",""],["","00603548232","PROPRANOLOL","TAB 10MG","90","Select","Select",""],["","76204020060","ALBUTEROL","NEB 0.00083","180","Select","Select",""],["","08373996900","INNOSPIRE","MIS NEBULIZE","1","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","51672131200","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","31722070530","VALACYCLOVIR","TAB 1GM","42","Select","Select",""],["","","LORATADINE","TAB 10MG","","Select","Select",""],["","","JUNEL","TAB 43831","","Select","Select",""],["","","LARIN","TAB 43831","","Select","Select",""],["","","SMZ\/TMP","TAB 800-160","","Select","Select",""],["","","SPRINTEC","TAB 28 DAY","","Select","Select",""],["","","EPINEPHRINE","INJ 0.3MG","","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":""}]}]}