{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SHIRLEY   A DAVIS","gend":1,"add":"68 HUXLEY PL","city":"NEWPORT NEWS","state":"VA","zip":"23606-9998","dob":"1957-09-17","age":"","mstatus":"","insh":"20029360*01","cliId":"","pno":"757\/977-6331","cno":"","email":"","ename":"","eno":"","pphy":"PATEL, SHRADDHA R MD","ppno":"757\/234-4285","pcpadd":"12652 JEFFERSON AVE","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":23602,"pcpcounty":"","pcpid":"","pcpname":"RIVERSIDE PHYSICIAN SERVICES INC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/234-4260","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.9","I10.","E78.5","G20.","E55.9","C44.90","K21.9","M17.0","F41.9","L30.9","R60.9","N39.41","M62.81","E66.9","N64.4","M54.2","R20.8","D48.5","Z79.4","G31.84","M76.61","M72.2","L60.3","M20.5X2","M20.5X1","M24.572","M24.571","M79.671","N95.0","N85.00","L90.5","L85.3","R31.0","R31.29","L60.2","E11.51","R60.0","Z71.89","Z83.3","E66.01","Z68.42","R06.83","G47.30","G47.10","Z87.09","E11.69","E11.59","M89.9","L98.9","N60.02","E11.29","R80.9","D50.0","H61.23","Z01.419","I73.9","C44.529","E11.8","G47.33","R07.9","R07.89","R31.9","M19.019","M20.21","M20.22","M25.571","M19.90","Z79.899","Z12.11","R06.09","M20.11","M20.12","L21.9","M76.821","R26.89","R53.1"],"date":["2022-03-31","2022-01-28","2022-01-28","2021-01-20","2021-08-10","2020-09-18","2021-08-10","2021-11-26","2021-11-26","2021-11-26","2022-04-11","2022-10-25","2022-10-25","2022-10-25","2020-12-31","2020-10-14","2020-12-14","2020-12-14","2022-01-28","2021-08-10","2022-07-21","2021-12-23","2022-02-08","2022-03-31","2022-03-31","2021-12-23","2022-07-21","2022-01-28","2021-09-20","2021-09-20","2021-04-30","2021-04-30","2020-01-29","2020-02-10","2020-09-09","2020-09-09","2021-01-20","2020-09-09","2020-09-09","2021-11-26","2021-11-26","2021-01-20","2021-01-20","2021-01-20","2021-01-20","2020-10-30","2020-09-10","2020-09-10","2020-12-11","2020-12-31","2022-01-28","2022-01-28","2021-11-26","2021-12-09","2021-02-24","2020-03-10","2020-09-03","2021-01-20","2021-03-19","2020-01-21","2020-01-29","2020-01-29","2020-01-29","2021-01-19","2021-01-19","2021-11-09","2021-11-09","2021-11-09","2019-07-11","2019-12-20","2019-04-08","2019-04-08","2022-01-28","2022-03-29","2022-03-29","2022-03-29"],"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":[["","00002879759","HUMALOG","INJ 75\/25KWP","15","Select","Select",""],["","69097052444","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","45802046564","KETOCONAZOLE","SHA 0.02","120","Select","Select",""],["","45802006435","TRIAMCINOLON","CRE 0.001","45","Select","Select",""],["","","LOSARTAN","TAB 25MG","","Select","Select",""],["","00904759080","FEROSUL","TAB 325MG","30","Select","Select",""],["","69097084805","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","57896070310","IRON","TAB 325MG","30","Select","Select",""],["","","METOPRL\/HCTZ","TAB 50-25MG","","Select","Select",""],["","11917009215","FERROUS","TAB 325MG","90","Select","Select",""],["","68382059716","DILTIAZEM","CAP 240MG ER","30","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","60","Select","Select",""],["","55111012390","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","","INSULIN","INJ PROTAMIN","","Select","Select",""],["","29300012810","HYDROCHLOROT","TAB 25MG","30","Select","Select",""],["","08290320109","BD  PEN NEEDL","MIS 31GX8MM","100","Select","Select",""],["","","CLONIDINE","TAB 0.1MG","","Select","Select",""],["","59651000205","OMEPRAZOLE","CAP 20MG","30","Select","Select",""],["","54629006901","VITAMIN","TAB 250MG","90","Select","Select",""],["","42806040021","METHYLPRED","TAB 4MG","21","Select","Select",""],["","00813001206","FERRETTS","TAB 325MG","30","Select","Select",""],["","53885024510","ONETOUCH","TES ULTRA BL","100","Select","Select",""],["","","CYCLOBENZAPR","TAB 10MG","","Select","Select",""],["","","LIDOCAINE","PAD 0.05","","Select","Select",""],["","62037059990","CARTIA","CAP 240\/24HR","90","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","","MUPIROCIN","OIN 0.02","","Select","Select",""],["","68180051703","LISINOPRIL","TAB 40MG","30","Select","Select",""],["","37000045503","PRILOSEC","TAB 20MG","28","Select","Select",""],["","57599000101","FREESTYLE    KIT SENSOR","KIT SENSOR","1","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":""}]}]}