{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LUCY COLLINS","gend":1,"add":"APT 1 PO BOX 2175","city":"PORTSMOUTH","state":"VA","zip":"23702-9998","dob":"1973-03-02","age":"","mstatus":"","insh":"20050744*01","cliId":"","pno":"757\/515-0874","cno":"757\/515-0874","email":"","ename":"","eno":"","pphy":"MCDERMOTT, MARIE NP","ppno":"757\/278-2240","pcpadd":"155 KINGSLEY LANE STE 400","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23505,"pcpcounty":"","pcpid":"","pcpname":"DEPAUL MEDICAL ASSOCIATES","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/489-6469","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N12.","NO DATA","R15.9","M54.5","R11.2","F10.239","E87.2","Z20.822","I10.","I48.0","F43.10","F41.9","M19.90","K21.9","F32.9","G43.909","F44.9","E87.6","R94.31","D75.89","F39.","E66.9","R06.02","I48.91","R51.9","R00.0","R03.0","R53.1","M54.42","J45.20","M54.41","G89.29","J45.901","F33.2","F43.12","F10.10","R74.01","E78.5","J44.9","M54.40","M48.00","F33.9","F10.231","G93.2","F44.81","F41.1","Z91.5","Z79.899","Z88.5","Z88.8","J30.89","R06.00","R05.","V62.84","F10.129","M54.9","F05.","F10.230","E66.01","Z68.37","F31.81","S80.02XA","S49.91XA","K52.9","J06.9","R10.0","Z20.828","F32.89","G47.00","M89.49","M79.643","E55.9","E05.90","R53.83","M79.89","Z80.49","Z81.8","Z82.3","Z82.49","Z83.3","Z53.21","G56.21","R19.7","N39.0","B96.89","R11.0","E78.00","Z90.49","R07.9","R10.9","Z91.030","Z91.040","Z88.6","Z91.048","Z87.42","Z98.891","F10.929","R26.89","J45.909","Z68.41","F41.8","F32.3","F10.24","R10.31","R07.81","Z86.73","R07.1"],"date":["2020-08-06","2021-02-03","2020-09-04","2021-02-22","2022-05-02","2021-05-28","2021-05-29","2021-09-24","2022-05-02","2021-05-28","2021-05-28","2021-09-24","2021-05-28","2022-05-02","2021-05-28","2021-05-28","2021-05-28","2021-05-28","2021-05-28","2021-05-28","2021-05-28","2021-05-28","2021-09-07","2022-05-02","2022-05-02","2021-09-24","2021-09-24","2022-05-02","2021-03-22","2021-02-20","2021-03-22","2021-03-22","2021-02-17","2021-02-23","2021-03-08","2021-03-11","2021-03-08","2021-02-25","2022-05-02","2021-02-19","2021-02-24","2021-02-19","2021-03-09","2021-03-08","2021-03-12","2021-03-08","2021-03-09","2022-05-02","2021-09-24","2021-09-24","2020-09-15","2021-02-17","2021-02-17","2021-02-19","2021-02-18","2021-02-19","2021-02-19","2021-09-24","2021-03-09","2021-03-09","2021-03-12","2021-10-16","2021-10-16","2022-05-02","2020-04-06","2020-05-26","2020-07-09","2020-12-10","2020-12-03","2020-12-10","2020-12-10","2020-12-10","2020-12-10","2020-12-10","2020-12-10","2021-03-06","2021-03-06","2021-03-06","2021-03-06","2021-03-06","2022-01-10","2020-02-01","2021-09-24","2021-02-05","2021-02-05","2021-03-08","2022-05-02","2022-05-02","2021-05-28","2021-09-24","2021-09-24","2021-09-24","2021-09-24","2021-09-24","2021-09-24","2021-09-24","2021-02-19","2021-03-11","2020-02-17","2020-02-24","2021-02-15","2021-02-20","2021-02-20","2021-03-08","2021-09-07","2021-09-07","2021-09-07"],"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":[["","55111015330","ONDANSETRON","TAB 4MG","15","Select","Select",""],["","31722094101","HYDROCO\/APAP","TAB 5-325MG","10","Select","Select",""],["","00173071920","FLOVENT","AER 110MCG","12","Select","Select",""],["","11822331520","LORATADINE","TAB 10MG","30","Select","Select",""],["","69097012303","TOPIRAMATE","TAB 50MG","60","Select","Select",""],["","00378230201","PRAZOSIN","CAP 2MG","30","Select","Select",""],["","00591024005","LORAZEPAM","TAB 0.5MG","15","Select","Select",""],["","00904672080","ACETAMIN","TAB 500MG","30","Select","Select",""],["","27241009903","DULOXETINE","CAP 60MG","30","Select","Select",""],["","31722071390","PANTOPRAZOLE","TAB 40MG","90","Select","Select",""],["","65862019105","CYCLOBENZAPR","TAB 10MG","30","Select","Select",""],["","60432026415","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","42571017290","ATORVASTATIN","TAB 10MG","30","Select","Select",""],["","57237010099","METOPROL","TAB 25MG","180","Select","Select",""],["","65162027210","SMZ\/TMP","TAB 800-160","28","Select","Select",""],["","10135015851","LOPERAMIDE","TAB 2MG","12","Select","Select",""],["","16729016801","ESCITALOPRAM","TAB 5MG","30","Select","Select",""],["","11822318460","ANTI-DIARRHE","TAB 2MG","12","Select","Select",""],["","00904646420","ROBAFEN","LIQ 10-100\/5","120","Select","Select",""],["","31604001281","VITAMIN","TAB 100MG","30","Select","Select",""],["","69315012710","FOLIC","TAB 1000MCG","30","Select","Select",""],["","00904549280","THERA-M","TAB ","30","Select","Select",""],["","00555015802","CHLORDIAZEP","CAP 5MG","15","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","200","Select","Select",""],["","63481068447","VOLTAREN","GEL 0.01","200","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","39328002515","LIDOCAINE","CRE 0.05","45","Select","Select",""],["","00591079401","DICYCLOMINE","CAP 10MG","20","Select","Select",""],["","53191022701","MELATONIN","CAP 3MG","30","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","59746017506","PREDNISONE","TAB 20MG","20","Select","Select",""],["","57237000830","MIRTAZAPINE","TAB 15MG","14","Select","Select",""],["","62332002231","FLUOXETINE","CAP 10MG","30","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","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":[]}},{"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":""}]}]}