{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LARA   A NITTINGER","gend":1,"add":"1608 KING WILLIAM ROAD","city":"VIRGINIA BEACH","state":"VA","zip":"23455-9998","dob":"1967-08-20","age":"","mstatus":"","insh":"20041593*01","cliId":"","pno":"757\/274-2106","cno":"","email":"","ename":"","eno":"","pphy":"SAMUELS, GARFIELD HUE MD","ppno":"757\/518-8823","pcpadd":"4452 CORPORATION LN STE 300","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":23462,"pcpcounty":"","pcpid":"","pcpname":"PRIMECARE INTERNAL MEDICINE PC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/518-8832","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N39.490","R31.9","G47.33","R06.83","F31.62","R00.2","R42.","J32.9","J45.901","I10.","E78.5","F31.9","F32.9","F41.0","N76.4","N39.9","M54.2","Z04.9","R22.42","M67.02","M72.2","M79.2","J44.9","Z87.891","Z86.73","M79.7","K21.9","Z79.82","S83.242A","M25.562","M75.82","M19.072","G54.0","M25.561","E61.1","R00.0","R06.00","R53.83","Z98.84","E55.9","E66.9","Z68.27","M62.838","R10.13","B18.2","Z80.0","M17.0","R68.89","Z68.33","S93.401A","S80.12XA","M79.605","M65.9","M25.571","F90.9","M75.22","N75.1","N30.01","L03.116","J01.90","W19.XXXA","S46.001A","Z68.28","L98.7","M79.601","T78.40XA","Z68.36","Z68.29","F34.1","J45.909","B37.2","M79.3","M77.32","S52.122A","S60.211A","Y99.8","M22.42","E66.01","Z68.35","R05.","Z01.812","Z20.828","M25.572","R51.9","R11.0","R07.89","R20.2","Z01.810","M75.00","R74.8","K28.9","F43.21","M79.672","M47.812","M54.5","N36.8","S60.222A","S40.012A","S20.212A","S90.02XA","G54.2","G43.909","S62.90XA","M25.532","M62.830","S52.502A","Z01.818","R94.31","Z20.822","Z09.","M17.12","Z13.828"],"date":["2020-11-16","2020-11-16","2020-12-16","2020-12-16","2022-02-23","2019-10-23","2019-10-23","2020-01-02","2019-10-23","2022-05-24","2021-03-11","2020-04-29","2022-02-22","2020-04-29","2021-04-16","2020-07-08","2021-08-03","2021-07-29","2021-10-08","2021-08-27","2021-08-27","2021-08-27","2021-10-08","2021-10-08","2021-10-08","2021-10-08","2022-05-24","2021-10-08","2019-01-24","2019-01-24","2020-07-22","2019-08-01","2022-02-22","2019-02-22","2019-02-25","2019-02-25","2019-02-25","2019-02-25","2020-11-06","2020-04-28","2020-04-28","2020-04-28","2020-07-17","2020-11-06","2020-10-26","2020-10-26","2022-05-24","2020-02-04","2019-07-15","2019-07-15","2019-07-15","2019-07-15","2019-08-01","2019-08-01","2022-10-06","2020-07-22","2021-03-28","2021-06-01","2021-08-31","2021-08-31","2019-07-15","2019-11-01","2020-02-04","2022-03-25","2021-08-03","2021-10-08","2019-01-31","2019-10-15","2020-11-11","2020-12-11","2021-08-19","2022-09-09","2021-08-19","2021-12-25","2021-12-25","2021-12-25","2019-01-29","2019-03-19","2019-03-19","2020-01-02","2022-04-07","2020-12-11","2021-07-09","2021-07-29","2021-07-29","2021-09-16","2021-09-16","2022-04-07","2019-01-02","2019-02-21","2020-10-17","2019-06-06","2019-06-17","2019-07-08","2020-09-23","2021-03-22","2021-05-10","2021-05-10","2021-05-10","2021-05-10","2021-07-22","2021-07-22","2021-12-30","2021-12-30","2022-05-24","2022-03-09","2022-04-07","2022-04-07","2022-04-07","2022-08-09","2022-06-30","2022-06-30"],"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":[["","65162062711","TRAMADOL","TAB 50MG","21","Select","Select",""],["","","ALPRAZOLAM"," ALPRAZOLAM ","90","Select","Select",""],["","29300012810","HYDROCHLOROT","TAB 25MG","30","Select","Select",""],["","","GABAPENTIN"," GABAPENTIN ","90","Select","Select",""],["","","ARIPIPRAZOLE"," ARIPIPRAZOLE ","30","Select","Select",""],["","","MIRTAZAPINE"," MIRTAZAPINE ","30","Select","Select",""],["","","PANTOPRAZOLE","TAB 40MG","","Select","Select",""],["","","VITAMIN"," VITAMIN ","4","Select","Select",""],["","","ESZOPICLONE"," ESZOPICLONE ","30","Select","Select",""],["","70010077001","METHOCARBAM","TAB 750MG","90","Select","Select",""],["","50742062101","NIFEDIPINE","TAB 60MG ER","30","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","64380080707","IBUPROFEN","TAB 800MG","9","Select","Select",""],["","65862020299","LOSARTAN","TAB 50MG","30","Select","Select",""],["","","SHINGRIX","INJ 50\/0.5ML","","Select","Select",""],["","68382005105","MELOXICAM","TAB 15MG","30","Select","Select",""],["","","DICYCLOMINE","SOL 10MG\/5ML","","Select","Select",""],["","","AMPHET\/DEXTR"," AMPHET\/DEXTR ","60","Select","Select",""],["","68462034690","LEVOCETIRIZI","TAB 5MG","3","Select","Select",""],["","","HALOPERIDOL"," HALOPERIDOL ","60","Select","Select",""],["","","OXYCOD\/APAP","TAB 5-325MG","","Select","Select",""],["","","DICLOFENAC"," DICLOFENAC ","500","Select","Select",""],["","","B-12","LOZ 3000MCG","","Select","Select",""],["","11917020834","PAIN","PAD LIDOCAIN","170","Select","Select",""],["","10631001130","KAPSPARGO","CAP 200MG","30","Select","Select",""],["","","DESVENLAFAX"," DESVENLAFAX ","30","Select","Select",""],["","72140063382","EUCERIN","CRE INT REPA","156","Select","Select",""],["","00472016630","NYSTATIN","OIN 100000","30","Select","Select",""],["","","ADDERALL","TAB 20MG","","Select","Select",""],["","","CHLORZOXAZON","TAB 500MG","","Select","Select",""],["","","METRONIDAZOL","TAB 500MG","","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","21","Select","Select",""],["","","CYCLOBENZAPR"," CYCLOBENZAPR ","90","Select","Select",""],["","","METOPROL"," METOPROL ","60","Select","Select",""],["","59267100002","PFIZER","INJ COVID-19","0","Select","Select",""],["","00904759080","FEROSUL","TAB 325MG","30","Select","Select",""],["","11917017126","IRON","TAB 325MG","90","Select","Select",""],["","","AZITHROMYCIN","SUS 200\/5ML","","Select","Select",""],["","58160084252","BOOSTRIX","INJ ","0","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","00085461001","DULERA","AER 200-5MCG","13","Select","Select",""],["","","SUCRALFATE","SUS 1GM\/10ML","","Select","Select",""],["","","METOPROLOL","TAB 50MG ER","","Select","Select",""],["","","MYRBETRIQ","TAB 25MG","","Select","Select",""],["","33342009441","RIZATRIPTAN","TAB 10MG ODT","12","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","68134020116","NAPROXEN","SUS 125\/5ML","400","Select","Select",""],["","","METOCLOPRAM","TAB 5MG","","Select","Select",""],["","65862053820","LEVOFLOXACIN","TAB 750MG","5","Select","Select",""],["","00591352530","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","20","Select","Select",""],["","00093227434","AMOX\/K","TAB 500-125","20","Select","Select",""],["","00074455290","SYNTHROID","TAB 50MCG","90","Select","Select",""],["","00527169505","BUT\/APAP\/CAF","TAB ","20","Select","Select",""],["","","PROMETHAZINE","TAB 12.5MG","","Select","Select",""],["","65862001501","AMOXICILLIN","TAB 875MG","10","Select","Select",""],["","00185012201","NITROFURANTN","CAP 100MG","10","Select","Select",""],["","00280210032","ASPIRIN","TAB 81MG EC","60","Select","Select",""],["","57237007710","ONDANSETRON","TAB 4MG ODT","15","Select","Select",""],["","","HYD","SUS 10-8\/5ML","","Select","Select",""],["","00597016061","SPIRIVA","AER 1.25MCG","4","Select","Select",""],["","62175011843","OMEPRAZOLE","CAP 20MG","60","Select","Select",""],["","00069046956","CHANTIX","TAB 1MG","60","Select","Select",""],["","08290309582","3ML","MIS 25GX1.5\"","3","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","","LOPERAMIDE","CAP 2MG","","Select","Select",""],["","","DOXYCYCL","TAB 100MG DR","","Select","Select",""],["","","UBRELVY","TAB 50MG","","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":""}]}]}