{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CHERYL   L MICKENS","gend":1,"add":"16 HARDWOOD DR","city":"HAMPTON","state":"VA","zip":"23666-9998","dob":"1965-11-20","age":"","mstatus":"","insh":"20032050*01","cliId":"","pno":"757\/715-3335","cno":"","email":"","ename":"","eno":"","pphy":"ROBESON, THOMAS N MD","ppno":"757\/873-2000","pcpadd":"STE 700 704 THIMBLE SHOALS","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":23606,"pcpcounty":"","pcpid":"","pcpname":"Oyster Point Family Practice","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/873-2003","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G89.4","M54.5","F90.0","G56.00","M15.0","M25.569","M47.819","M51.36","Z79.891","M25.561","M25.562","M46.96","R20.8","M25.50","M51.16","M47.816","Z71.89","R60.9","J45.909","Z01.419","L21.8","L20.89","J06.9","J45.40","J30.9","F90.9","G89.29","U07.1","M54.9","F98.8","Z20.828","R03.0","E66.3","Z68.28","R35.0","NO DATA","F41.9","M25.519","M54.2","M47.811","E55.9","Z12.4","Z11.3","Z12.31","Z12.11","N60.02","F31.9","Z79.899","M17.0","N60.11","N64.4","R92.2","M25.512","Z23.","R41.840","M51.26","Z00.00","F41.1","M25.511","M45.0","S05.01XA","F39."],"date":["2020-07-16","2020-12-08","2020-07-16","2020-07-16","2020-07-16","2020-07-16","2020-04-23","2020-07-16","2021-03-09","2020-11-12","2020-11-12","2019-08-29","2019-08-29","2020-12-08","2021-08-31","2021-08-31","2021-08-31","2020-03-17","2021-12-23","2021-06-14","2021-11-15","2021-11-15","2019-02-11","2021-09-30","2021-09-30","2021-12-10","2021-01-25","2021-09-30","2021-12-23","2021-12-23","2021-08-20","2021-08-31","2021-08-31","2021-08-31","2019-06-27","2019-06-27","2021-06-11","2019-03-05","2019-03-05","2021-06-11","2021-06-11","2021-06-14","2021-06-14","2021-06-14","2021-06-14","2019-06-25","2021-12-23","2021-06-10","2019-05-10","2019-08-09","2019-08-09","2019-08-09","2019-08-26","2020-11-19","2021-01-25","2021-01-25","2021-12-23","2020-09-08","2019-08-05","2020-02-11","2020-11-19","2021-12-10"],"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":[["","","OXYCODONE"," OXYCODONE ","210","Select","Select",""],["","","GLYDO"," GLYDO ","120","Select","Select",""],["","","PREDNISONE"," PREDNISONE ","21","Select","Select",""],["","","AMITIZA"," AMITIZA ","60","Select","Select",""],["","","AMPHET\/DEXTR"," AMPHET\/DEXTR ","60","Select","Select",""],["","","DIAZEPAM"," DIAZEPAM ","60","Select","Select",""],["","","ALLERGY"," ALLERGY ","30","Select","Select",""],["","","ADVAIR"," ADVAIR ","60","Select","Select",""],["","","ROBIT"," ROBIT ","120","Select","Select",""],["","","ALBUTEROL"," ALBUTEROL ","180","Select","Select",""],["","","SPIRIVA"," SPIRIVA ","4","Select","Select",""],["","","FLUTIC\/SALME"," FLUTIC\/SALME ","60","Select","Select",""],["","","SYMBICORT"," SYMBICORT ","10","Select","Select",""],["","","VENTOLIN"," VENTOLIN ","18","Select","Select",""],["","","PROAIR"," PROAIR ","8","Select","Select",""],["","","WIXELA"," WIXELA ","60","Select","Select",""],["","","ZTLIDO"," ZTLIDO ","30","Select","Select",""],["","","SYMPROIC"," SYMPROIC ","30","Select","Select",""],["","","BENZONATATE"," BENZONATATE ","30","Select","Select",""],["","","VOLTAREN"," VOLTAREN ","100","Select","Select",""],["","","LORATADINE"," LORATADINE ","30","Select","Select",""],["","","NARCAN"," NARCAN ","2","Select","Select",""],["","","FLUOCIN"," FLUOCIN ","118","Select","Select",""],["","","DICLOFENAC"," DICLOFENAC ","100","Select","Select",""],["","","ELIDEL"," ELIDEL ","100","Select","Select",""],["","","KETOCONAZOLE"," KETOCONAZOLE ","120","Select","Select",""],["","","ADDERALL"," ADDERALL ","60","Select","Select",""],["","","METHADONE","TAB 10MG","","Select","Select",""],["","","LIDOCAINE","OIN 0.05","","Select","Select",""],["","","FLUTICASONE","SPR 50MCG","","Select","Select",""],["","","MONTELUKAST","TAB 10MG","","Select","Select",""],["","","FLUCONAZOLE","TAB 150MG","","Select","Select",""],["","","IBUPROFEN","TAB 600MG","","Select","Select",""],["","","AZITHROMYCIN","TAB 250MG","","Select","Select",""],["","","ERYTHROMYCIN","OIN 5MG\/GM","","Select","Select",""],["","","PIMECROLIMUS","CRE 0.01","","Select","Select",""],["","","SULINDAC","TAB 200MG","","Select","Select",""],["","","HYDROCO\/APAP","TAB 5-325MG","","Select","Select",""],["","","CLINDAMYCIN","CAP 300MG","","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":""}]}]}