{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MARGIE SANCHEZ","gend":1,"add":"20 NEVILLE ST","city":"PORTSMOUTH","state":"VA","zip":"23701-9998","dob":"1958-09-01","age":"","mstatus":"","insh":"20041405*01","cliId":"","pno":"","cno":"","email":"","ename":"","eno":"","pphy":"SHAH, MEGHANA R MD","ppno":"757\/673-5890","pcpadd":"5818 HARBOUR VIEW BLVD STE 250","pcpcity":"SUFFOLK","pcpstate":"VA","pcpzip":23435,"pcpcounty":"","pcpid":"","pcpname":"HARBOUR VIEW FAMILY PRACTICE","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/484-7052","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J44.9","G47.33","I10.","R73.01","M47.816","E78.5","Z95.5","M25.562","F32.89","N39.3","E65.","F33.9","I21.4","Z72.0","M48.02","E78.1","G89.4","K21.9","R42.","R10.2","L02.92","R23.9","S83.232A","M65.88","M17.12","M46.96","M51.36","M62.838","M43.16","M54.5","S22.089A","M47.817","Z23.","Z68.30","I25.10","R73.03","M25.50","J30.9","M25.462","M25.662","G47.23","E66.01","F34.1","J30.1","J30.89","Z68.31","E55.9","R91.1","Z78.9","F17.218","F32.9","G89.29","G47.19","F06.31","I65.23","V58.89","M25.062","S83.207A","M23.322","I70.90","I73.9","H69.91","Z01.812","H90.3","G47.00","G47.30","F17.200","I65.21","G56.01","R20.0","M79.641","Z98.890","Z79.01","M21.162","I11.9","I77.9","Z68.29","Z47.89","H05.011","Z68.28","M18.11","H25.13","M47.812","R07.89","N76.0","M65.332","H10.31","H25.813","Z01.818","H25.11","M54.42","M54.41","M70.61","M70.62","Z09.","H25.12","R94.131","R20.2","M16.12","M25.552","N32.81","R35.1","M62.89","R07.9","Z12.31","M23.8X2","Z96.652","R03.0","R10.9","Z12.11","R93.89","K86.81","I25.2","J45.909","E78.00","M16.0","M19.042","M19.041","F17.210","Z53.20","M77.11","Z22.321","Z47.1","E11.9","Z79.84","Z87.440","Z74.09","E87.6","M79.89","M79.669","R10.10","R23.8","NO DATA","R82.90","N39.41","G89.18","M54.16","R21.","E66.3","M76.32","B37.2","R59.0","Z96.659"],"date":["2022-06-07","2022-09-23","2022-11-08","2022-06-07","2022-10-04","2022-06-07","2022-09-23","2022-11-18","2021-06-08","2021-06-08","2021-06-08","2022-11-08","2020-09-29","2022-06-07","2022-02-28","2022-06-07","2020-09-29","2022-11-15","2020-09-29","2022-02-07","2021-02-09","2021-02-09","2021-02-24","2021-02-24","2022-08-28","2021-07-06","2021-07-06","2021-08-25","2021-07-06","2021-07-06","2021-07-06","2022-11-08","2022-10-05","2021-05-07","2022-10-05","2022-11-08","2020-06-23","2020-01-09","2021-11-15","2020-06-12","2020-07-13","2020-07-13","2020-07-13","2020-10-05","2020-10-05","2022-11-15","2020-12-30","2020-12-30","2021-04-01","2021-04-01","2021-04-01","2021-11-15","2021-04-01","2022-01-18","2020-06-03","2021-02-24","2021-02-26","2020-01-02","2021-02-24","2021-07-23","2021-07-23","2020-10-05","2021-02-19","2020-06-04","2020-06-23","2022-02-28","2022-11-15","2020-06-23","2020-12-15","2020-12-15","2020-12-15","2020-12-15","2022-02-28","2021-12-28","2020-04-03","2020-06-03","2022-09-15","2021-07-12","2019-07-15","2022-05-19","2022-10-19","2019-04-23","2019-10-09","2022-09-23","2019-08-05","2019-08-12","2019-02-23","2019-04-12","2022-02-08","2019-06-19","2019-07-18","2019-07-18","2019-10-15","2022-09-15","2019-05-14","2019-06-05","2019-08-09","2019-08-09","2019-08-22","2019-08-22","2022-02-07","2022-02-07","2019-01-29","2019-04-20","2019-07-09","2019-12-10","2022-09-15","2022-10-05","2022-11-15","2022-10-13","2022-05-19","2022-11-15","2022-09-23","2022-09-23","2022-09-23","2022-09-23","2022-09-23","2022-09-23","2022-09-23","2022-09-23","2022-02-01","2022-02-08","2022-08-11","2022-02-28","2022-02-28","2022-02-28","2022-02-18","2022-02-21","2022-02-21","2022-02-21","2022-06-07","2022-06-07","2022-10-04","2022-01-31","2022-01-31","2022-02-14","2022-10-04","2022-11-08","2022-09-15","2022-09-15","2022-11-08","2022-11-08","2022-11-18"],"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":[["","42858000101","OXYCODONE","TAB 5MG","40","Select","Select",""],["","55111015330","ONDANSETRON","TAB 4MG","40","Select","Select",""],["","68645059459","FAMOTIDINE","TAB 20MG","60","Select","Select",""],["","","HYDROCHLOROT"," HYDROCHLOROT ","30","Select","Select",""],["","","SMZ\/TMP","TAB 800-160","","Select","Select",""],["","","DULOXETINE"," DULOXETINE ","30","Select","Select",""],["","","METOPROL"," METOPROL ","30","Select","Select",""],["","","SOLIFENACIN"," SOLIFENACIN ","30","Select","Select",""],["","57664037713","TRAMADOL","TAB 50MG","50","Select","Select",""],["","00006027731","JANUVIA","TAB 100MG","90","Select","Select",""],["","","CLOPIDOGREL"," CLOPIDOGREL ","30","Select","Select",""],["","51672131201","MUPIROCIN","OIN 0.02","15","Select","Select",""],["","","EQ","DIS 14MG\/24H","","Select","Select",""],["","49035000206","STOOL","TAB 8.6-50MG","60","Select","Select",""],["","00832532511","POT  CL MICRO","TAB 20MEQ ER","6","Select","Select",""],["","00032301613","CREON","CAP 36000UNT","210","Select","Select",""],["","","ATORVASTATIN"," ATORVASTATIN ","30","Select","Select",""],["","50458058030","XARELTO","TAB 10MG","14","Select","Select",""],["","68382032010","POT  CHLORIDE","TAB 10MEQ ER","7","Select","Select",""],["","65162010211","GABAPENTIN","CAP 300MG","90","Select","Select",""],["","68462029855","CLOTRIM\/BETA","CRE DIPROP","45","Select","Select",""],["","70156010501","HYOSCYAMINE","SUB 0.125MG","50","Select","Select",""],["","80777027398","MODERNA","INJ COVID-19","0","Select","Select",""],["","68047025301","OSCIMIN","SUB 0.125MG","50","Select","Select",""],["","00085113204","PROVENTIL","AER HFA","7","Select","Select",""],["","66993058497","FLUTIC\/SALME","AER 100\/50","180","Select","Select",""],["","00173068220","VENTOLIN","AER ","18","Select","Select",""],["","","FLUTICASONE","SPR 50MCG","","Select","Select",""],["","49884065909","CANDESARTAN","TAB 8MG","30","Select","Select",""],["","31722099601","HYDROCO\/APAP","TAB 5-325MG","28","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","500","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","00173069500","ADVAIR","AER 100\/50","60","Select","Select",""],["","68645058259","METFORMIN","TAB 500MG","90","Select","Select",""],["","00096070760","DRYSOL","SOL 0.2","60","Select","Select",""],["","51248015001","VESICARE","TAB 5MG","30","Select","Select",""],["","","CEPHALEXIN","CAP 500MG","","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","","MECLIZINE","TAB 25MG","","Select","Select",""],["","","SM","DIS 14MG\/24H","","Select","Select",""],["","","CEFDINIR","CAP 300MG","","Select","Select",""],["","55111014512","FLUCONAZOLE","TAB 150MG","1","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":""}]}]}