{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KIMBERLY   L FREEMAN","gend":1,"add":"955 FLORIDA AVE","city":"PORTSMOUTH","state":"VA","zip":"23707-9998","dob":"1966-03-04","age":"","mstatus":"","insh":"20045876*01","cliId":"","pno":"757\/359-4451","cno":"","email":"","ename":"","eno":"","pphy":"TAN-CAMACHO, REGINA MD","ppno":"757\/436-7888","pcpadd":"675 N BATTLEFIELD BLV","pcpcity":"CHESAPEAKE","pcpstate":"VA","pcpzip":23320,"pcpcounty":"","pcpid":"","pcpname":"Battlefield Medical Associates","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/548-5669","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["NO DATA","G24.9","G24.3","S62.024A","I10.","E11.9","E78.00","M19.90","H72.91","J32.9","K21.9","H69.83","M43.6","J30.1","H90.8","R42.","Z87.09","G89.4","M54.12","G90.529","M54.2","Z79.891","G89.29","S62.021A","M65.311","H69.82","H69.81","B37.0","M25.531","R22.32","M62.838","S62.101A","R33.9","E11.65","E53.8","E55.9","F32.9","F41.9","J01.90","N20.0","R06.02","R06.2","L65.9","V58.89","R63.5","R10.30","H90.3","H49.21","M79.673","M21.6X2","M79.672","M70.61","S43.401A","S63.501A","S39.012A","H53.2","H50.00","H25.13","M54.9","S70.01XA","H04.123","H57.9","R00.0","H61.23","Z79.4","H65.90","Z11.59","G95.9","M25.511","Z88.1","Z88.8","J45.909","Z87.442","R10.9","E78.5","K59.00","E53.9","N32.9","R35.0","B37.9","R10.11","R10.31","R11.0","M48.02","M50.30","Z79.899","G90.522","M71.332","R39.9","Z79.1","Z86.14","Z87.440","Z88.5","Z90.89"],"date":["2022-02-18","2020-10-02","2022-04-04","2020-02-25","2022-07-19","2022-10-28","2022-04-17","2020-07-23","2020-07-10","2022-07-19","2022-07-19","2020-07-10","2021-08-02","2022-01-20","2021-08-02","2021-08-02","2021-08-02","2021-02-04","2021-07-30","2021-07-30","2022-08-07","2021-07-30","2021-12-05","2020-02-25","2020-02-25","2020-06-30","2022-01-20","2021-08-02","2021-12-05","2021-12-05","2021-01-06","2020-01-07","2020-06-09","2022-07-19","2021-02-26","2021-02-26","2022-07-19","2020-11-23","2020-11-23","2020-11-23","2020-11-23","2020-11-23","2021-02-26","2021-02-26","2021-02-26","2021-02-26","2020-02-18","2019-06-04","2019-10-14","2019-08-12","2022-02-18","2019-08-12","2019-12-27","2019-12-27","2019-12-27","2019-04-09","2019-04-23","2019-04-09","2019-10-14","2019-12-27","2019-05-16","2019-04-26","2019-04-06","2019-07-12","2022-10-28","2019-07-31","2019-07-31","2019-07-31","2019-08-16","2022-04-17","2019-12-09","2022-07-19","2022-04-17","2019-07-08","2022-07-19","2022-07-19","2022-07-19","2022-07-19","2022-05-20","2022-01-20","2022-04-17","2022-04-17","2022-04-17","2022-02-18","2022-02-18","2022-04-17","2022-02-18","2022-03-21","2022-08-07","2022-04-17","2022-04-17","2022-04-17","2022-04-17","2022-04-17"],"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":[["","","LANTUS","INJ 100\/ML","","Select","Select",""],["","08627005303","DEXCOM","MIS SENSOR","9","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","90","Select","Select",""],["","00169633910","NOVOLOG","INJ FLEXPEN","9","Select","Select",""],["","64380073706","VITAMIN","CAP 50000UNT","2","Select","Select",""],["","59310057922","PROAIR","AER ","17","Select","Select",""],["","00173069600","ADVAIR","AER 250\/50","180","Select","Select",""],["","31722072890","MONTELUKAST","CHW 5MG","60","Select","Select",""],["","00378464326","ESTRADIOL","DIS 0.0375MG","8","Select","Select",""],["","55111032890","NATEGLINIDE","TAB 60MG","180","Select","Select",""],["","08489749610","PEN  NEEDLES","MIS 32GX5\/32","400","Select","Select",""],["","53885001110","ONETOUCH","MIS PLUS 30G","400","Select","Select",""],["","51672130406","TERCONAZOLE","CRE 0.004","135","Select","Select",""],["","82607066026","FLOWFLEX","KIT TEST","8","Select","Select",""],["","","POT  CHLORIDE","TAB 20MEQ ER","","Select","Select",""],["","55111039990","LANSOPRAZOLE","CAP 30MG DR","90","Select","Select",""],["","","NYSTATIN","SUS 100000","","Select","Select",""],["","","MELOXICAM","TAB 7.5MG","","Select","Select",""],["","00169517603","VAGIFEM","TAB 10MCG","8","Select","Select",""],["","00378427593","VALACYCLOVIR","TAB 500MG","60","Select","Select",""],["","08290320550","BD  PEN NEEDL","MIS 32GX5\/32","400","Select","Select",""],["","60505257909","ATORVASTATIN","TAB 20MG","30","Select","Select",""],["","","ALLERGY","TAB 10MG","","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","200","Select","Select",""],["","68462010340","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","43547035410","LISINOPRIL","TAB 20MG","45","Select","Select",""],["","65862019105","CYCLOBENZAPR","TAB 10MG","60","Select","Select",""],["","00023114501","BOTOX","INJ 100UNIT","1","Select","Select",""],["","55111078430","FEXOFENADINE","TAB 180MG","30","Select","Select",""],["","08627002011","G4","MIS RECEIVER","1","Select","Select",""],["","00172572960","FAMOTIDINE","TAB 40MG","60","Select","Select",""],["","66993058597","FLUTIC\/SALME","AER 250\/50","180","Select","Select",""],["","00591079501","DICYCLOMINE","TAB 20MG","28","Select","Select",""],["","11822489250","FAST","SUP 10MG","10","Select","Select",""],["","57896044312","BISACODYL","SUP 10MG","10","Select","Select",""],["","81421002101","DULCOLAX","SUP 10MG","10","Select","Select",""],["","70010077001","METHOCARBAM","TAB 750MG","90","Select","Select",""],["","","RA","LIQ 100-10\/5","","Select","Select",""],["","76204020025","ALBUTEROL","NEB 0.00083","75","Select","Select",""],["","43598032675","CIPRO\/DEXA","SUS 0.3-0.1%","8","Select","Select",""],["","00143924920","AMOX\/K","TAB 875-125","20","Select","Select",""],["","68462034690","LEVOCETIRIZI","TAB 5MG","30","Select","Select",""],["","24208041010","OFLOXACIN","DRO 0.3%OTIC","10","Select","Select",""],["","58657045601","URO-MP","CAP 118MG","180","Select","Select",""],["","00185012201","NITROFURANTN","CAP 100MG","28","Select","Select",""],["","00093310905","AMOXICILLIN","CAP 500MG","30","Select","Select",""],["","","KETOROLAC","TAB 10MG","","Select","Select",""],["","58160089652","FLUARIX","INJ 2019-20","0","Select","Select",""],["","","HYDROXYZ","TAB 25MG","","Select","Select",""],["","00378905593","LIDOCAINE","PAD 0.05","90","Select","Select",""],["","60432026415","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","00406052201","OXYCOD\/APAP","TAB 7.5-325","60","Select","Select",""],["","65162022621","YUVAFEM","TAB 10MCG","8","Select","Select",""],["","65162027210","SMZ\/TMP","TAB 800-160","20","Select","Select",""],["","","CEFUROXIME","TAB 500MG","","Select","Select",""],["","00574010770","CLOTRIMAZOLE","LOZ 10MG","70","Select","Select",""],["","51672411606","METRONIDAZOL","GEL 0.0075","45","Select","Select",""],["","","DOTTI","DIS 0.0375MG","","Select","Select",""],["","45802063732","CLOBETASOL","AER 0.0005","50","Select","Select",""],["","16729016801","ESCITALOPRAM","TAB 5MG","30","Select","Select",""],["","","WIXELA","AER 250\/50","","Select","Select",""],["","00002771559","BASAGLAR","INJ 100UNIT","45","Select","Select",""],["","00591234101","METAXALONE","TAB 800MG","90","Select","Select",""],["","43538018245","ROSADAN","GEL 0.0075","45","Select","Select",""],["","00173068220","VENTOLIN","AER ","54","Select","Select",""],["","45802006435","TRIAMCINOLON","CRE 0.001","30","Select","Select",""],["","45802086803","POLYETH","POW 3350 NF","1530","Select","Select",""],["","31722071390","PANTOPRAZOLE","TAB 40MG","60","Select","Select",""],["","67877021901","CEPHALEXIN","CAP 500MG","30","Select","Select",""],["","55111018015","TIZANIDINE","TAB 4MG","120","Select","Select",""],["","00591024005","LORAZEPAM","TAB 0.5MG","60","Select","Select",""],["","00024586903","TOUJEO","INJ 300IU\/ML","4","Select","Select",""],["","57599000101","FREESTYLE    KIT SENSOR","KIT SENSOR","2","Select","Select",""],["","","CLARITHROMYC","TAB 500MG","","Select","Select",""],["","","DIAZEPAM","TAB 5MG","","Select","Select",""],["","","TAMSULOSIN","CAP 0.4MG","","Select","Select",""],["","","OMEPRAZOLE","CAP 40MG","","Select","Select",""],["","00832532511","POT  CL MICRO","TAB 20MEQ ER","90","Select","Select",""],["","","ROPINIROLE","TAB 0.25MG","","Select","Select",""],["","","VILAMIT","CAP 118MG","","Select","Select",""],["","","CHLORHEX","SOL 0.0012","","Select","Select",""],["","","PREDNISONE","TAB 10MG","","Select","Select",""],["","","BENZONATATE","CAP 100MG","","Select","Select",""],["","","AZITHROMYCIN","TAB 250MG","","Select","Select",""],["","65162025403","RANITIDINE","TAB 300MG","30","Select","Select",""],["","63481068447","VOLTAREN","GEL 0.01","200","Select","Select",""],["","00245088130","DIVIGEL","GEL 0.5MG","30","Select","Select",""],["","56151146001","TRUE","TES GLUCOSE","400","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","56151014401","TRUPLUS","MIS 30G","100","Select","Select",""],["","00169706515","GLUCAGEN","INJ HYPOKIT","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":""}]}]}