{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DAVID   R SMITH","gend":0,"add":"2409 HAYWOOD AVE","city":"CHESAPEAKE","state":"VA","zip":"23324-9998","dob":"1970-12-08","age":"","mstatus":"","insh":"20054377*01","cliId":"","pno":"757\/965-9677","cno":"","email":"","ename":"","eno":"","pphy":"MUSSELMANI, ZATTAM MD","ppno":"757\/543-3557","pcpadd":"1422 POINDEXTER ST","pcpcity":"CHESAPEAKE","pcpstate":"VA","pcpzip":23324,"pcpcounty":"","pcpid":"","pcpname":"ZATTAM MUSSELMANI","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/543-0053","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["C83.03","F31.73","A41.9","J18.1","R65.10","R50.9","R79.89","J91.8","N17.9","E87.6","L81.0","L40.0","L85.3","A40.9","J18.9","J86.9","J90.","F41.9","F31.9","K74.60","E55.9","E66.01","K21.9","M10.9","N18.9","Z20.822","L40.9","R16.1","Z83.3","Z82.0","Z85.6","R78.81","D84.9","A49.1","C83.00","C91.10","D61.818","B19.20","Z86.59","R00.0","F31.4","Z91.14","C91.11","K76.6","D70.9","B00.1","R50.81","F14.10","Z79.899","Z92.21","Z87.442","E86.0","I85.10","J91.0","Z68.41","B18.2","R11.2","R19.7","B97.89","I86.4","Z20.828","I49.1","R05.","F31.32","F43.12","F60.2","Z01.812","R93.3","Z01.818","Z45.2","NO DATA","M54.9","R07.9","I51.7","A40.3","I85.00","K57.30","M19.90","M54.31","M54.32","K59.00","J43.9","Z86.19","D69.6","F31.81","M54.42","S30.0XXA","R79.9","J93.9","R18.8","E66.9","C85.90","R06.02","C91.90","Z46.82","E44.0","Z68.38","Z51.11","M62.81","D64.81","K70.31","Z51.12","F31.11","D70.1","R07.81","D64.9","K76.9","T81.82XA","R10.84","R07.89","D69.59","D63.0","Z68.35","E87.1","J98.11","J98.2","I10.","R06.00","R60.0","J94.2","D68.4","L03.313","R16.2","Z68.34","R53.83","R10.9","R11.0","F32.9","K72.90","K74.69","R94.5","J94.1","C91.00","R59.1","Z87.09","T45.1X5A","Z80.9","R10.817","D61.810","F33.1","F41.1","E83.39","R03.0","K40.90","N44.2","Z68.37","N20.0","N43.3","N50.89","S21.109A","S76.112A","L21.8","Z08.","Z85.72","M25.562","M79.652","F14.90","M25.462","Z91.048","M25.569"],"date":["2022-09-23","2020-09-02","2021-11-06","2020-11-12","2020-11-12","2020-11-12","2020-11-12","2020-11-12","2020-11-12","2020-11-12","2021-10-05","2022-08-31","2021-09-09","2021-10-26","2021-11-08","2021-11-05","2021-11-06","2021-10-26","2022-11-09","2021-10-26","2021-10-26","2021-10-26","2021-10-26","2021-10-26","2021-10-26","2021-10-26","2022-04-15","2021-10-26","2021-10-26","2021-10-26","2021-10-29","2021-11-05","2021-11-05","2021-11-05","2021-03-24","2020-03-15","2020-11-07","2021-03-24","2022-04-15","2021-10-25","2021-04-08","2021-04-08","2020-11-11","2020-11-07","2020-03-08","2020-03-08","2020-03-08","2020-03-08","2020-03-08","2022-02-09","2020-03-08","2020-05-01","2020-11-07","2020-11-07","2020-11-07","2020-11-07","2020-11-07","2020-11-07","2020-11-07","2020-11-07","2021-10-26","2020-11-07","2020-11-07","2020-01-17","2020-01-17","2020-01-17","2021-04-20","2021-04-27","2021-04-20","2021-05-14","2021-10-17","2021-10-17","2021-10-25","2021-10-29","2021-10-29","2021-04-27","2021-04-27","2021-04-27","2021-10-18","2021-10-18","2021-10-18","2021-11-01","2020-03-13","2020-11-10","2022-09-14","2021-10-09","2021-10-13","2021-10-27","2021-10-30","2019-06-18","2019-05-15","2022-04-15","2019-04-24","2019-07-08","2019-05-01","2019-05-01","2019-05-01","2019-12-12","2019-06-21","2019-06-21","2019-06-21","2019-12-12","2019-08-30","2019-09-26","2019-03-15","2019-06-18","2019-04-03","2019-03-29","2019-02-22","2019-03-09","2019-06-18","2019-03-21","2019-04-11","2019-03-21","2019-03-21","2019-04-09","2019-06-18","2019-04-09","2019-04-15","2019-04-18","2019-05-15","2019-05-15","2019-05-15","2019-05-15","2019-06-20","2019-02-23","2019-02-23","2019-03-11","2019-03-13","2019-03-13","2019-03-13","2019-03-25","2019-04-17","2019-05-23","2019-06-20","2019-06-18","2019-06-18","2019-02-22","2019-03-28","2019-08-05","2019-08-05","2019-02-22","2019-02-22","2019-04-18","2019-04-11","2019-04-09","2019-04-09","2019-04-16","2022-09-06","2019-04-29","2022-04-21","2022-08-31","2022-02-09","2022-02-09","2022-03-29","2022-04-15","2022-08-09","2022-04-15","2022-04-15","2022-04-15"],"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":[["","00378064110","PREDNISONE","TAB 10MG","30","Select","Select",""],["","42858010301","OXYCOD\/APAP","TAB 7.5-325","15","Select","Select",""],["","60258018601","POLY-IRON","CAP 150 FORT","30","Select","Select",""],["","50111064701","FLUOXETINE","CAP 10MG","30","Select","Select",""],["","45802000403","HYDROCORT","CRE 0.025","28","Select","Select",""],["","50383004248","PREDNISOLONE","SOL 15MG\/5ML","375","Select","Select",""],["","66993068030","OLANZAPINE","TAB 2.5MG","30","Select","Select",""],["","63402030830","LATUDA","TAB 80MG","30","Select","Select",""],["","67877025145","TRIAMCINOLON","CRE 0.001","454","Select","Select",""],["","45802046564","KETOCONAZOLE","SHA 0.02","120","Select","Select",""],["","00172392570","DIAZEPAM","TAB 2MG","15","Select","Select",""],["","10572010001","PEG-3350","SOL ELECTROL","4000","Select","Select",""],["","69097086707","NADOLOL","TAB 20MG","180","Select","Select",""],["","49884025111","OLANZA\/FLUOX","CAP 6-50MG","30","Select","Select",""],["","55513013760","OTEZLA","TAB 30MG","180","Select","Select",""],["","59267100003","PFIZER","INJ COVID-19","0","Select","Select",""],["","68180095604","CLOBETASOL","CRE 0.0005","120","Select","Select",""],["","69452015120","VITAMIN","CAP 50000UNT","12","Select","Select",""],["","50428016183","CVS","CAP 2000UNIT","90","Select","Select",""],["","00406012301","HYDROCO\/APAP","TAB 5-325MG","10","Select","Select",""],["","65162027250","SMZ\/TMP","TAB 800-160","14","Select","Select",""],["","67877032105","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","00781185220","AMOX\/K","TAB 875-125","28","Select","Select",""],["","69584061250","METHOCARBAM","TAB 750MG","20","Select","Select",""],["","63304069205","CLINDAMYCIN","CAP 150MG","56","Select","Select",""],["","","ZIPRASIDONE","CAP 20MG","","Select","Select",""],["","","LEVOFLOXACIN","TAB 750MG","","Select","Select",""],["","","METHYLPRED","TAB 4MG","","Select","Select",""],["","","PROBIOTIC","CAP 250MG","","Select","Select",""],["","00074262528","MAVYRET","TAB 100-40MG","84","Select","Select",""],["","68180016613","VANCOMYCIN","CAP 125MG","48","Select","Select",""],["","68462010530","ONDANSETRON","TAB 4MG","30","Select","Select",""],["","50383066730","LIDO\/PRILOCN","CRE 2.5-2.5%","30","Select","Select",""],["","00093117210","PENICILLN","TAB 250MG","20","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":""}]}]}