{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MICHAEL REID","gend":0,"add":"1210 COLONIAL AVE APT 303","city":"NORFOLK","state":"VA","zip":"23517-9998","dob":"1962-03-23","age":"","mstatus":"","insh":"20038605*01","cliId":"","pno":"757\/773-9682","cno":"","email":"","ename":"","eno":"","pphy":"LATIMER, KELLY M 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":["G47.33","J45.991","K21.9","I10.","E66.01","F39.","Z68.41","F43.23","F34.1","M54.40","G89.29","M79.609","F33.42","F90.2","F43.10","E11.3213","H35.033","H25.13","H43.812","I42.9","I77.810","E78.2","Z99.89","Z68.39","H40.053","H04.123","Z76.0","NO DATA","F41.9","E11.9","G47.30","Z86.73","Z79.899","Z79.82","Z79.4","E10.40","L20.89","G57.52","I11.0","I50.31","M54.5","E10.9","M20.10","M20.40","E11.65","M25.561","M79.606","M54.30","E11.42","E10.51","R11.2","N17.9","K59.00","I73.9","F33.0","R06.00","Z78.9","F33.1","R13.10","K44.9","H40.1134","R10.826","J45.909","K62.5","J06.9","B97.89","M17.10","M17.11","Z23.","R05.","I15.8","M99.05","J45.901","E11.40","F31.81","F33.9","Z68.38","K61.0","L08.9"],"date":["2022-05-11","2020-01-17","2021-12-30","2022-06-10","2022-05-11","2020-01-17","2020-12-10","2021-01-04","2021-11-18","2022-04-08","2022-04-08","2021-12-01","2021-09-30","2021-09-30","2021-09-30","2022-09-22","2022-09-22","2021-01-13","2022-03-14","2022-05-11","2022-05-11","2022-05-11","2022-05-11","2021-10-20","2022-06-06","2022-06-06","2021-12-30","2021-12-30","2022-06-10","2021-12-30","2021-12-30","2021-12-30","2021-12-30","2021-12-30","2021-12-30","2022-05-18","2020-09-21","2020-09-21","2021-10-08","2021-10-08","2020-08-18","2020-03-16","2020-03-16","2020-03-16","2022-06-10","2021-12-30","2021-12-01","2020-08-18","2020-10-12","2021-10-21","2019-02-27","2019-03-05","2019-07-10","2019-05-22","2019-07-16","2019-09-17","2019-09-17","2019-05-28","2019-07-10","2019-04-24","2019-01-21","2019-02-21","2019-02-21","2019-02-27","2019-03-05","2019-03-05","2022-06-10","2019-05-22","2019-06-07","2019-02-22","2019-09-17","2019-01-31","2019-02-13","2022-07-21","2022-11-21","2022-04-06","2022-05-11","2022-08-17","2022-08-17"],"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":[["","53885024510","ONETOUCH","TES ULTRA BL","100","Select","Select",""],["","59746021601","SPIRONOLACT","TAB 25MG","30","Select","Select",""],["","00781279010","OMEPRAZOLE","CAP 20MG","30","Select","Select",""],["","00078091112","XIIDRA","DRO 0.05","60","Select","Select",""],["","50111032701","HYDRALAZINE","TAB 25MG","90","Select","Select",""],["","68382009501","CARVEDILOL","TAB 25MG","60","Select","Select",""],["","00456112030","VIIBRYD","TAB 20MG","30","Select","Select",""],["","","ATORVASTATIN","TAB 40MG","","Select","Select",""],["","11822300240","RA","TAB 325MG EC","30","Select","Select",""],["","08290320109","BD  PEN NEEDL","MIS 31GX8MM","30","Select","Select",""],["","65862020390","LOSARTAN","TAB 100MG","30","Select","Select",""],["","29300012810","HYDROCHLOROT","TAB 25MG","30","Select","Select",""],["","00169413212","OZEMPIC","INJ 2\/1.5ML","2","Select","Select",""],["","00597015230","JARDIANCE","TAB 10MG","30","Select","Select",""],["","62332023330","VILAZODONE","TAB 20MG","30","Select","Select",""],["","69238110005","DOXYCYCL","CAP 100MG","14","Select","Select",""],["","00093342501","LORAZEPAM","TAB 0.5MG","30","Select","Select",""],["","","DICLOFENAC","GEL 0.03","","Select","Select",""],["","","METFORMIN","TAB 500MG ER","","Select","Select",""],["","","SHINGRIX","INJ 50\/0.5ML","","Select","Select",""],["","65862052890","VENLAFAXINE","CAP 75MG ER","30","Select","Select",""],["","","HYDROXYZ","TAB 50MG","","Select","Select",""],["","","OMEGA-3-ACID","CAP 1GM","","Select","Select",""],["","00006483703","PNEUMOVAX","INJ 25\/0.5","0","Select","Select",""],["","57237002801","AMOXICILLIN","TAB 500MG","30","Select","Select",""],["","65162011510","HYDROCO\/APAP","TAB 7.5-325","15","Select","Select",""],["","00088221905","LANTUS","INJ 100\/ML","15","Select","Select",""],["","65162046650","IBUPROFEN","TAB 800MG","21","Select","Select",""],["","65862018601","CLINDAMYCIN","CAP 300MG","21","Select","Select",""],["","00378905593","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","","NAPROXEN","TAB 500MG","","Select","Select",""],["","","AMMONIUM","CRE 0.12","","Select","Select",""],["","","CALCIPOTRIEN","OIN 0.00005","","Select","Select",""],["","58160089652","FLUARIX","INJ 2019-20","0","Select","Select",""],["","","FREESTY","KIT 2 SENSOR","","Select","Select",""],["","68180051701","LISINOPRIL","TAB 40MG","30","Select","Select",""],["","00173069600","ADVAIR","AER 250\/50","60","Select","Select",""],["","00378932132","WIXELA","AER 250\/50","60","Select","Select",""],["","11822061283","ARTHRTS","TAB 650MG","30","Select","Select",""],["","50383066730","LIDO\/PRILOCN","CRE 2.5-2.5%","30","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","00054001829","PREDNISONE","TAB 20MG","10","Select","Select",""],["","11822022527","MUCUS","TAB 600MG","20","Select","Select",""],["","60432026415","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","69452014420","BENZONATATE","CAP 200MG","30","Select","Select",""],["","49348090547","SM","TAB 600MG","14","Select","Select",""],["","63824000886","MUCINEX","TAB 600MG ER","14","Select","Select",""],["","00603015032","DOCQLACE","CAP 100MG","30","Select","Select",""],["","66993058597","FLUTIC\/SALME","AER 250\/50","60","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":""}]}]}