{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ELIZABETH   A WALKER","gend":1,"add":"1421 COMMERCE AVE","city":"CHESAPEAKE","state":"VA","zip":"23324-9998","dob":"1959-10-30","age":"","mstatus":"","insh":"20036780*01","cliId":"","pno":"757\/667-0662","cno":"757\/217-8721","email":"","ename":"","eno":"","pphy":"MUSSELMANI, ZATTAM MD","ppno":"757\/543-3557","pcpadd":"1422 POINDEXTER ST","pcpcity":"CHESAPEAKE","pcpstate":"VA","pcpzip":23324,"pcpcounty":"","pcpid":"","pcpname":"ZATTAM MUSSELMANI","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/543-0053","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M62.81","M54.5","E11.40","E11.9","S93.602A","H43.813","M25.551","R29.6","E66.9","I10.","M15.9","B00.0","F33.1","F43.10","R26.89","F43.21","E08.620","E55.9","Z00.01","Z13.5","Z12.11","Z13.820","Z12.4","H40.013","H25.13","H18.893","S39.012A","E11.8","M16.11","S13.8XXA","S16.1XXA","M70.61","L23.9","R21.","T14.8XXD","T14.8XXA","M54.9","L23.1","S05.02XA","R07.9","K59.00","M15.0","E08.649","M70.62","J30.9","L23.7","L03.115","M79.661","V58.89","H18.59","M47.816","L25.9","R11.0","K31.84","H53.9","Z96.651","Z96.652","Z96.653","M54.31","S93.601A","M54.30","E11.319","H53.123","R23.3","R53.1","R26.2","E11.620","Z12.31","S83.91XA","H16.143","E87.70","Z13.31","S93.401A","M25.571","H81.10","H53.459","H25.013","H52.03","H52.223","H52.4","S80.01XA","S70.01XA"],"date":["2019-04-26","2019-06-19","2020-09-30","2021-09-30","2019-08-29","2021-06-11","2021-02-23","2020-02-07","2021-10-19","2021-10-19","2020-12-16","2020-10-27","2020-02-19","2020-02-19","2020-07-23","2021-12-15","2020-10-28","2021-03-03","2021-05-20","2021-05-20","2021-10-19","2021-05-20","2021-05-20","2021-06-11","2021-06-11","2021-06-11","2021-07-07","2021-10-19","2021-10-19","2019-03-26","2019-10-16","2021-05-25","2020-03-17","2020-06-29","2021-03-22","2019-04-03","2019-10-16","2021-09-30","2019-01-09","2019-08-01","2019-08-01","2020-03-25","2020-03-25","2020-06-03","2020-06-30","2020-06-30","2020-01-06","2020-06-18","2019-01-10","2019-01-10","2019-03-06","2019-10-15","2020-07-15","2020-07-15","2020-08-03","2021-02-09","2021-02-09","2020-08-14","2021-05-25","2019-01-30","2019-06-19","2020-08-03","2020-08-03","2020-10-28","2021-02-23","2021-02-23","2021-08-30","2021-08-30","2019-02-21","2019-05-06","2019-06-04","2019-06-04","2019-08-14","2019-08-14","2020-01-15","2020-08-03","2020-12-11","2020-12-11","2020-12-11","2020-12-11","2021-03-09","2021-03-09"],"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":[]},{"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":[["","00597014030","TRADJENTA","TAB 5MG","30","Select","Select",""],["","00713063415","MOMETASONE","CRE 0.001","60","Select","Select",""],["","53885024510","ONETOUCH","TES ULTRA BL","100","Select","Select",""],["","68382005001","MELOXICAM","TAB 7.5MG","30","Select","Select",""],["","31722071390","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","00093834401","GLYBURIDE","TAB 5MG","30","Select","Select",""],["","68382091634","METHYLPRED","TAB 4MG","21","Select","Select",""],["","64380073706","VITAMIN","CAP 50000UNT","4","Select","Select",""],["","64679092502","ENALAPRIL","TAB 10MG","90","Select","Select",""],["","65862005390","SIMVASTATIN","TAB 40MG","30","Select","Select",""],["","56151014260","TRUPLUS","MIS 28G","100","Select","Select",""],["","10370083011","DILTIAZEM","CAP 180MG ER","30","Select","Select",""],["","00254101196","SUCRALFATE","SUS 1GM\/10ML","1200","Select","Select",""],["","00378905593","LIDOCAINE","PAD 0.05","15","Select","Select",""],["","00054429931","FUROSEMIDE","TAB 40MG","30","Select","Select",""],["","00006483703","PNEUMOVAX","INJ 25\/0.5","0","Select","Select",""],["","00005197102","PREVNAR","INJ ","0","Select","Select",""],["","00472040060","CLOBETASOL","CRE 0.0005","60","Select","Select",""],["","58160084252","BOOSTRIX","INJ ","0","Select","Select",""],["","80777027399","MODERNA","INJ COVID-19","0","Select","Select",""],["","62037059890","CARTIA","CAP 180\/24HR","30","Select","Select",""],["","58160089652","FLUARIX","INJ 2019-20","0","Select","Select",""],["","60505004101","ETODOLAC","TAB 400MG","60","Select","Select",""],["","65162044210","MECLIZINE","TAB 25MG","40","Select","Select",""],["","00023916360","RESTASIS","EMU 0.0005","60","Select","Select",""],["","65162046510","IBUPROFEN","TAB 600MG","20","Select","Select",""],["","16714049401","AMOX\/K","TAB 500-125","14","Select","Select",""],["","45802006436","TRIAMCINOLON","CRE 0.001","320","Select","Select",""],["","55111015330","ONDANSETRON","TAB 4MG","30","Select","Select",""],["","65162062710","TRAMADOL","TAB 50MG","15","Select","Select",""],["","69097081307","GABAPENTIN","CAP 100MG","90","Select","Select",""],["","00071101368","LYRICA","CAP 50MG","60","Select","Select",""],["","00781152601","POT  CHLORIDE","TAB 10MEQ CR","30","Select","Select",""],["","00456120330","LINZESS","CAP 72MCG","30","Select","Select",""],["","42167000554","LANCET","MIS THIN 30G","300","Select","Select",""],["","58160081912","SHINGRIX","INJ 50MCG","1","Select","Select",""],["","70010075401","METHOCARBAM","TAB 500MG","20","Select","Select",""],["","58914017014","CARAFATE","SUS 1GM\/10ML","1260","Select","Select",""],["","11822039970","RA","TAB 5MG EC","20","Select","Select",""],["","00009005604","MEDROL","TAB 4MG","21","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":""}]}]}