{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"RODERICK HANEY","gend":0,"add":"1025 COLLEGE PARK BLVD APT 116","city":"VIRGINIA BEACH","state":"VA","zip":"23464-9998","dob":"1965-12-11","age":"","mstatus":"","insh":"20038511*01","cliId":"","pno":"718\/640-7653","cno":"","email":"","ename":"","eno":"","pphy":"GUZMAN-LEE, JOJO-ANNE MD","ppno":"757\/955-2828","pcpadd":"885 KEMPSVILLE RD SUITE 320","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23502,"pcpcounty":"","pcpid":"","pcpname":"AMELIA MEDICAL ASSOCIATES","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/955-2829","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F84.0","F31.81","F31.12","F33.0","D72.823","F91.3","F31.4","E11.9","I10.","E78.5","M17.0","F31.2","E11.40","R53.83","R15.9","F31.9","E66.9","Z79.4","Z68.31","M25.561","M25.562","M17.10","R55.","Z13.828","E11.65","E55.9","H04.202","H92.02","E66.3","Z68.29","M17.11","M17.12","Z23.","Z68.30","M54.16","M25.511","NO DATA","D72.829","R91.1","N18.3","G25.81","M75.02","G89.29","L57.0","Z71.9","E11.21","R05.","J45.909","H25.13","R35.0","I12.9","N18.9","K21.9","E53.8","E11.3293","K59.00","L98.9","K59.09","R80.9","R05.9"],"date":["2020-05-04","2021-01-07","2022-10-17","2022-10-17","2021-12-06","2020-02-24","2020-10-27","2021-11-30","2022-09-19","2022-01-10","2020-04-07","2020-03-06","2021-03-17","2019-03-21","2019-03-21","2022-09-19","2019-06-25","2021-10-06","2019-09-05","2019-09-05","2019-09-05","2019-08-19","2019-08-19","2020-01-06","2021-10-06","2020-10-08","2020-02-05","2020-02-05","2022-01-27","2020-02-05","2020-01-06","2020-01-06","2021-10-06","2021-10-06","2022-01-10","2021-10-06","2022-09-19","2019-06-25","2022-09-19","2019-06-25","2021-05-28","2019-02-25","2019-09-05","2021-04-20","2021-04-20","2022-09-19","2021-09-21","2022-09-19","2021-11-30","2020-10-08","2020-10-08","2020-10-08","2022-01-10","2020-10-08","2020-07-07","2021-03-17","2021-03-17","2022-01-10","2022-09-19","2022-01-27"],"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":[["","","FARXIGA"," FARXIGA ","30","Select","Select",""],["","70370106001","INGREZZA","CAP 60MG","30","Select","Select",""],["","","HYDROCHLOROT"," HYDROCHLOROT ","30","Select","Select",""],["","64764024060","AMITIZA","CAP 24MCG","60","Select","Select",""],["","","SERTRALINE"," SERTRALINE ","60","Select","Select",""],["","","LAMOTRIGINE"," LAMOTRIGINE ","30","Select","Select",""],["","00002223680","TRULICITY","INJ 3\/0.5","2","Select","Select",""],["","","LANTUS"," LANTUS ","15","Select","Select",""],["","","BUSPIRONE"," BUSPIRONE ","60","Select","Select",""],["","","LISINOPRIL"," LISINOPRIL ","30","Select","Select",""],["","00378351501","MIRTAZAPINE","TAB 15MG","30","Select","Select",""],["","","ROSUVASTATIN"," ROSUVASTATIN ","30","Select","Select",""],["","","LOXAPINE"," LOXAPINE ","90","Select","Select",""],["","51672130301","ECONAZOLE","CRE 0.01","90","Select","Select",""],["","","TRAZODONE"," TRAZODONE ","30","Select","Select",""],["","31722070190","LOSARTAN","TAB 50MG","30","Select","Select",""],["","00093310905","AMOXICILLIN","CAP 500MG","30","Select","Select",""],["","","FAMOTIDINE","TAB 20MG","","Select","Select",""],["","80777027398","MODERNA","INJ COVID-19","0","Select","Select",""],["","62332025118","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","","NOVOTWIST"," NOVOTWIST ","100","Select","Select",""],["","11822365670","ACETAMIN","TAB 500MG","21","Select","Select",""],["","00093342201","CYCLOBENZAPR","TAB 10MG","30","Select","Select",""],["","00254302802","LUBIPROSTONE","CAP 8MCG","60","Select","Select",""],["","00955172805","INSULIN","INJ 100U\/ML","15","Select","Select",""],["","59267030402","PFIZER","INJ BA4\/BA5","0","Select","Select",""],["","58160089052","FLUARIX","INJ 2022-23","0","Select","Select",""],["","53885027210","ONETOUCH","TES VERIO","100","Select","Select",""],["","00006008061","JANUMET","TAB 50-1000","60","Select","Select",""],["","10006073036","VITAMIN","TAB 500MCG","30","Select","Select",""],["","","NOVOFINE","MIS 32GX6MM","","Select","Select",""],["","47335071186","TOPIRAMATE","TAB 100MG","90","Select","Select",""],["","43547027210","ROPINIROLE","TAB 3MG","30","Select","Select",""],["","16714097601","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","63481068447","VOLTAREN","GEL 0.01","100","Select","Select",""],["","16714008310","HYDROXYZ","TAB 50MG","90","Select","Select",""],["","","LINZESS","CAP 145MCG","","Select","Select",""],["","","QUETIAPINE","TAB 100MG","","Select","Select",""],["","","FLUCLVX","INJ 2020-21","","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":{"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":""}]}]}