{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LILLIAN   A JOHNSON","gend":1,"add":"65 GRAND ST","city":"PORTSMOUTH","state":"VA","zip":"23701-9998","dob":"1963-03-09","age":"","mstatus":"","insh":"20030056*01","cliId":"","pno":"757\/392-6243","cno":"","email":"","ename":"","eno":"","pphy":"GRANT JR, THOMAS R MD","ppno":"757\/446-5955","pcpadd":"825 FAIRFAX AVE STE 118","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23507,"pcpcounty":"","pcpid":"","pcpname":"EVMS Ghent Family Medicine","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/446-5196","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.2","T84.029A","Z96.641","E87.6","F14.90","Z96.649","V58.89","I10.","F41.9","F32.9","I25.10","I25.2","F14.10","F11.10","K21.9","Z79.891","Z79.01","Z96.651","Z96.642","Z86.73","Z91.81","S01.81XA","S51.811A","Y04.0XXA","J45.21","B34.9","Z20.828","NO DATA","F17.210","F29.","M25.561","M16.11","K59.00","R10.13","E83.42","J20.9","Z72.0","M54.16","M43.16","M62.81","R26.89","R03.0","W19.XXXA","R06.09","N90.89","M17.11","T14.90XA","R51.9","K12.0","J06.9","J45.909","V62.84","K52.9","M54.5","G89.29","R06.2","S99.919A","R25.2","B36.0","L20.9","F31.9","Z23.","J30.9","Z01.811","Z47.1","T84.020A","R10.9","H33.321","H25.813","R19.7","Z01.818","M25.551","R60.9","M54.2","R94.31","R41.3","G45.9","E87.1","Z79.82","J45.20","E83.51","Z79.899","Z88.1","Z88.0","Z88.8","Z96.643","Z90.711","M54.32","M17.12","Z88.2","R29.898","M25.511","F17.200","M79.631","H53.8","Z87.891","N95.2","N75.0","M25.661","J45.901","R05.","M87.052","M16.12","M25.552","M47.816","R11.2","Q04.8","S99.921A","S00.93XA","J45.41","R22.0","T50.905A","R60.0","E53.8","L03.211","J01.90","G44.89","F33.0","L60.0","R63.4","M20.41","M20.11","M19.071","Z03.818","R07.9","R06.02","R44.1","E66.3","M26.621","G24.01","K57.30","K22.10","K44.9","F14.20","F20.9","F10.20","K08.89","M19.90","R10.84","Z88.5","R10.10"],"date":["2022-08-16","2021-08-17","2021-08-13","2021-11-23","2021-08-17","2021-08-17","2021-09-14","2022-10-31","2022-05-13","2021-09-14","2022-05-13","2021-10-07","2022-09-30","2021-09-14","2022-09-21","2021-09-14","2021-09-14","2021-10-07","2021-09-14","2021-10-07","2021-09-14","2020-03-25","2020-03-25","2020-03-25","2020-07-14","2020-07-14","2020-07-14","2022-07-21","2022-10-31","2022-08-18","2020-12-08","2021-07-20","2022-10-24","2021-11-22","2021-11-22","2020-03-18","2021-10-07","2020-10-26","2020-10-26","2020-10-26","2021-07-20","2022-08-18","2020-11-16","2021-05-21","2021-06-03","2021-07-20","2021-08-12","2022-08-18","2020-02-11","2020-02-11","2022-10-31","2022-07-21","2020-10-07","2020-09-15","2020-09-15","2020-09-15","2020-11-16","2021-07-12","2020-01-27","2020-01-27","2022-05-13","2020-10-07","2021-07-15","2021-05-21","2021-08-03","2021-08-15","2022-08-18","2021-02-08","2021-02-08","2022-03-31","2021-07-15","2021-10-07","2021-07-12","2021-08-14","2022-08-18","2022-03-31","2022-05-13","2021-07-16","2022-10-31","2021-07-16","2021-07-16","2022-10-31","2022-10-24","2022-10-24","2021-08-12","2021-10-07","2021-08-12","2020-09-01","2020-09-01","2022-10-24","2021-10-07","2020-01-09","2020-01-09","2020-03-25","2021-10-13","2021-10-13","2019-07-25","2019-07-25","2019-03-14","2019-02-21","2019-04-11","2019-09-03","2019-09-03","2019-09-03","2019-07-20","2019-02-19","2019-11-19","2019-09-03","2019-09-03","2019-03-28","2022-10-31","2019-05-11","2019-05-11","2022-09-09","2022-07-12","2022-07-12","2022-08-18","2022-11-26","2022-05-03","2022-09-21","2022-02-02","2022-02-02","2022-02-02","2022-07-19","2022-08-18","2022-08-18","2022-08-18","2022-03-31","2022-04-20","2022-04-20","2022-05-13","2022-05-13","2022-05-13","2022-08-19","2022-09-15","2022-09-30","2022-10-31","2022-10-31","2022-10-24","2022-10-24","2022-10-24"],"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":[["","","MONTELUKAST","TAB 10MG","","Select","Select",""],["","","WIXELA"," WIXELA ","60","Select","Select",""],["","","CETIRIZINE"," CETIRIZINE ","30","Select","Select",""],["","70436015301","POT  CHLORIDE","TAB 20MEQ ER","30","Select","Select",""],["","","DULOXETINE"," DULOXETINE ","30","Select","Select",""],["","45802048678","DOCUSATE","CAP 100MG","60","Select","Select",""],["","45802065087","LORATADINE","TAB 10MG","30","Select","Select",""],["","","ADVAIR"," ADVAIR ","60","Select","Select",""],["","50111064801","FLUOXETINE","CAP 20MG","30","Select","Select",""],["","","CLINDAMYCIN"," CLINDAMYCIN ","21","Select","Select",""],["","43386035701","HYDROCO\/APAP","TAB 7.5-325","14","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","50383023310","DORZOL\/TIMOL","SOL 22.3-6.8","10","Select","Select",""],["","","PROAIR"," PROAIR ","8","Select","Select",""],["","","OMEPRAZOLE"," OMEPRAZOLE ","90","Select","Select",""],["","","ASPIRIN"," ASPIRIN ","108","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","30","Select","Select",""],["","","LIDOCAINE"," LIDOCAINE ","30","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","3","Select","Select",""],["","","FLUTICASONE"," FLUTICASONE ","16","Select","Select",""],["","","OLANZAPINE"," OLANZAPINE ","30","Select","Select",""],["","65162019050","NAPROXEN","TAB 500MG","20","Select","Select",""],["","59762305102","AZITHROMYCIN","POW 1GM PAK","1","Select","Select",""],["","","LISINOPRIL"," LISINOPRIL ","30","Select","Select",""],["","","MELOXICAM","TAB 7.5MG","","Select","Select",""],["","64380080707","IBUPROFEN","TAB 800MG","20","Select","Select",""],["","24658031205","DOXYCYCL","TAB 100MG","20","Select","Select",""],["","00527296237","CHLORPROMAZ","TAB 25MG","30","Select","Select",""],["","35046001130","B-12","SUB 1000MCG","30","Select","Select",""],["","69315013601","BENZTROPINE","TAB 0.5MG","30","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","00378064205","PREDNISONE","TAB 20MG","12","Select","Select",""],["","","BENZONATATE","CAP 200MG","","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","30","Select","Select",""],["","","METHYLPRED","TAB 4MG","","Select","Select",""],["","59779030603","CVS","POW ","510","Select","Select",""],["","12843013105","BAYER","CHW 81MG","30","Select","Select",""],["","00406051205","OXYCOD\/APAP","TAB 5-325MG","16","Select","Select",""],["","00116200116","CHLORHEX","SOL 0.0012","473","Select","Select",""],["","62559049001","DIPHEN\/ATROP","TAB 2.5MG","30","Select","Select",""],["","80777027315","MODERNA","INJ COVID-19","0","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","64980033912","MAGNESIUM-OX","TAB 400MG","7","Select","Select",""],["","50458058030","XARELTO","TAB 10MG","31","Select","Select",""],["","10006070049","MAGNESIUM","TAB 420MG","20","Select","Select",""],["","00766074052","TUMS","CHW 500MG","20","Select","Select",""],["","","GABAPENTIN","CAP 300MG","","Select","Select",""],["","65628005004","FIRST-MOUTHW","SUS BLM","119","Select","Select",""],["","71351001250","LACTOBACILLU","TAB ","30","Select","Select",""],["","00603020922","MAG","TAB 400MG","3","Select","Select",""],["","43386031214","GAVILAX","POW ","510","Select","Select",""],["","37000074078","METAMUCIL","POW 28.3%ORG","575","Select","Select",""],["","00363023820","STOOL","CAP 100MG","30","Select","Select",""],["","38779028901","PEG","POW ","527","Select","Select",""],["","00536589588","NICOTINE","DIS 14MG\/24H","14","Select","Select",""],["","00173068220","VENTOLIN","AER ","18","Select","Select",""],["","49884093547","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","68382097001","CHLORTHALID","TAB 25MG","15","Select","Select",""],["","45802046564","KETOCONAZOLE","SHA 0.02","120","Select","Select",""],["","","HYD","SUS 10-8\/5ML","","Select","Select",""],["","","DESONIDE","OIN 0.0005","","Select","Select",""],["","","LATUDA","TAB 20MG","","Select","Select",""],["","","MOMETASONE","SPR 50MCG","","Select","Select",""],["","","METOCLOPRAM","TAB 10MG","","Select","Select",""],["","","FLUTIC\/SALME","AER 500\/50","","Select","Select",""],["","","SUCRALFATE","TAB 1GM","","Select","Select",""],["","","METHOCARBAM","TAB 500MG","","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":""}]}]}