{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JENNIFER   G DERRING","gend":1,"add":"6601 PINEWOOD CTS","city":"VIRGINIA BEACH","state":"VA","zip":"23464-9998","dob":"1969-03-27","age":"","mstatus":"","insh":"20055305*01","cliId":"","pno":"757\/717-4485","cno":"757\/717-4485","email":"","ename":"","eno":"","pphy":"ROSSANO, WILLIAM MD","ppno":"757\/310-6413","pcpadd":"1030 LOFTIS BLVD STE 201","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":23606,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/310-6404","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K57.32","K62.89","Z98.0","M62.89","N39.0","Z46.9","F41.1","F43.23","N32.81","R39.198","R33.9","G43.709","R41.9","F41.0","N39.46","K04.7","M54.2","G89.29","R10.2","M79.7","K59.00","R32.","M32.9","M06.9","F41.9","G43.909","D68.0","J90.","L71.9","R35.0","J30.1","J30.2","J30.81","J30.89","Z01.411","B37.3","N95.2","R63.5","Z12.31","Z79.890","Z13.820","N39.3","N39.41","Z90.49","Z90.710","Z85.41","K59.09","K21.9","Z79.899","Z88.8","Z91.030","R39.15","K31.84","K29.60","R10.13","N31.2","NO DATA","C53.9","K46.9","D84.1","D69.1","N83.201","N83.202","J02.9","R10.30","R39.16","R39.14","R35.1","N30.10","H16.223","H35.52","H10.45","H57.12","M53.3","G89.4","Z51.81","M47.816","M17.0","S43.421A","D62.","E87.1","F90.9","Z91.013","Z91.048","Z83.3","Z82.61","Z83.49","Z82.1","Z84.0","Z80.9","N94.10","S63.501A","H01.021","H01.022","H01.024","H01.025","M79.661","M79.89","G89.18","M62.838","F31.81","F90.2","M54.31","M54.32","K62.0","R19.4","G45.9","I95.9","Z87.410","K57.92","M79.604","K63.5","S46.911A","K30.","R13.10","N81.10","N81.6","N95.9","M25.50","M20.10","M19.90","F51.04","R60.9","R60.0","N18.9","Z11.59","Z01.812","Z20.822","E03.9","N95.1","L70.0","L30.4","Z71.9"],"date":["2022-09-30","2020-07-08","2020-09-14","2021-02-22","2021-03-04","2020-10-12","2020-11-28","2020-11-28","2022-06-22","2020-12-03","2022-06-24","2021-04-01","2020-12-04","2021-04-01","2021-08-05","2021-06-16","2022-10-26","2021-04-01","2022-10-26","2022-06-22","2022-09-30","2021-02-10","2022-06-22","2022-06-22","2022-06-22","2021-02-10","2021-04-01","2021-02-10","2021-02-10","2022-06-22","2021-02-10","2021-02-10","2021-02-10","2021-02-10","2022-10-13","2021-09-07","2021-09-07","2021-09-07","2021-09-07","2022-10-13","2021-09-07","2022-06-22","2022-06-22","2022-06-22","2022-10-13","2022-06-22","2022-06-22","2022-06-22","2022-06-22","2022-06-22","2022-06-22","2022-06-22","2022-09-30","2022-09-30","2022-09-30","2022-09-30","2022-09-30","2022-09-30","2022-09-30","2022-09-30","2022-09-30","2020-01-15","2020-08-20","2021-04-05","2021-08-05","2021-08-05","2021-08-05","2021-08-05","2022-03-18","2021-09-15","2021-09-15","2021-09-15","2021-09-15","2022-10-26","2022-10-26","2022-10-26","2022-10-26","2022-10-26","2022-10-26","2020-01-30","2020-01-30","2020-01-30","2020-01-30","2020-01-30","2020-01-30","2020-01-30","2020-01-30","2020-01-30","2020-01-30","2020-01-30","2021-04-13","2022-08-24","2020-01-09","2020-01-09","2020-01-09","2020-01-09","2020-02-05","2020-02-05","2020-02-12","2020-02-12","2020-08-25","2021-04-01","2020-11-18","2020-11-18","2020-09-14","2020-09-14","2020-10-07","2021-05-11","2020-01-02","2020-01-30","2020-02-05","2020-09-14","2020-10-01","2021-08-25","2021-08-25","2022-03-18","2022-03-18","2020-08-20","2021-03-23","2021-03-23","2021-03-23","2021-04-01","2020-02-04","2020-02-05","2020-05-01","2020-07-06","2021-05-07","2021-05-07","2022-02-24","2020-09-18","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":[["","68180030360","CEFUROXIME","TAB 500MG","8","Select","Select",""],["","71930004712","OXYCOD\/APAP","TAB 10-325MG","20","Select","Select",""],["","00378064110","PREDNISONE","TAB 10MG","21","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","68462015713","ONDANSETRON","TAB 4MG ODT","40","Select","Select",""],["","00456120230","LINZESS","CAP 290MCG","30","Select","Select",""],["","65162099708","DOTTI","DIS 0.1MG","8","Select","Select",""],["","68180032401","ESZOPICLONE","TAB 3MG","30","Select","Select",""],["","00143314150","DOXYCYCL","CAP 50MG","30","Select","Select",""],["","58657045601","URO-MP","CAP 118MG","40","Select","Select",""],["","51660052605","ALLERGY","TAB 10MG","30","Select","Select",""],["","16729017317","AMITRIPTYLIN","TAB 50MG","30","Select","Select",""],["","49483060450","IBUPROFEN","TAB 800MG","90","Select","Select",""],["","65162055310","METAXALONE","TAB 800MG","90","Select","Select",""],["","64980014612","FLORANEX","GRA ","60","Select","Select",""],["","41167005840","ASPERCREME","PAD LIDO 4%","30","Select","Select",""],["","65162052111","PROMETHAZINE","TAB 25MG","28","Select","Select",""],["","65862052305","GABAPENTIN","TAB 600MG","90","Select","Select",""],["","00187516445","RETIN-A","CRE 0.001","45","Select","Select",""],["","49100040007","CULTURELLE","CAP ","40","Select","Select",""],["","51672139509","TRETINOIN","CRE 0.001","45","Select","Select",""],["","62175013643","OMEPRAZOLE","CAP 40MG","30","Select","Select",""],["","00168009960","KETOCONAZOLE","CRE 0.02","60","Select","Select",""],["","00591352530","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","69097084615","CYCLOBENZAPR","TAB 10MG","30","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","65862007701","CIPROFLOXACN","TAB 500MG","8","Select","Select",""],["","00178074001","URIBEL","CAP 118MG","40","Select","Select",""],["","00093535301","PROGESTERONE","CAP 100MG","30","Select","Select",""],["","51862088603","ERRIN","TAB 0.35MG","84","Select","Select",""],["","55111053305","DIVALPROEX","TAB 250MG ER","30","Select","Select",""],["","00093747243","RIZATRIPTAN","TAB 10MG","9","Select","Select",""],["","08290236850","LACTINEX","CHW ","120","Select","Select",""],["","24510005010","NUCYNTA","TAB 50MG","90","Select","Select",""],["","63044015005","PRENATAL","TAB LOW IRON","90","Select","Select",""],["","00781716783","ESTRADIOL","DIS 0.1MG","8","Select","Select",""],["","43547040611","CLONAZEPAM","TAB 0.5MG","90","Select","Select",""],["","00781261305","AMOXICILLIN","CAP 500MG","14","Select","Select",""],["","70010075405","METHOCARBAM","TAB 500MG","40","Select","Select",""],["","00228207750","TEMAZEPAM","CAP 30MG","30","Select","Select",""],["","57237000511","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","00093100301","BUSPIRONE","TAB 15MG","45","Select","Select",""],["","10702005601","OXYCODONE","TAB 10MG","15","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","20","Select","Select",""],["","00093227434","AMOX\/K","TAB 500-125","14","Select","Select",""],["","00046087221","PREMARIN","CRE 0.625MG","30","Select","Select",""],["","00536130840","OLOPATADINE","DRO 0.001","5","Select","Select",""],["","00078091112","XIIDRA","DRO 0.05","60","Select","Select",""],["","69097015815","MELOXICAM","TAB 7.5MG","30","Select","Select",""],["","57664050318","TIZANIDINE","TAB 4MG","21","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","20","Select","Select",""],["","46122017081","ARTHRTS","TAB 650MG","30","Select","Select",""],["","00172409680","BACLOFEN","TAB 10MG","90","Select","Select",""],["","39822031005","NEOMYCIN","TAB 500MG","4","Select","Select",""],["","65862014836","SUMATRIPTAN","TAB 100MG","6","Select","Select",""],["","00574416035","NEO\/POLY\/DEX","OIN 0.1% OP","4","Select","Select",""],["","63481068447","VOLTAREN","GEL 0.01","100","Select","Select",""],["","00406012301","HYDROCO\/APAP","TAB 5-325MG","8","Select","Select",""],["","29300022705","METRONIDAZOL","TAB 500MG","4","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","00591079501","DICYCLOMINE","TAB 20MG","120","Select","Select",""],["","50111043403","TRAZODONE","TAB 100MG","60","Select","Select",""],["","00065427325","PAZEO","DRO 0.007","2","Select","Select",""],["","70756081115","NYSTAT\/TRIAM","OIN ","15","Select","Select",""],["","51224045020","NIVATOPIC","CRE PLUS","450","Select","Select",""],["","00172392780","DIAZEPAM","TAB 10MG","10","Select","Select",""],["","67877021905","CEPHALEXIN","CAP 500MG","6","Select","Select",""],["","55111028050","LEVOFLOXACIN","TAB 500MG","7","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","12","Select","Select",""],["","57664037718","TRAMADOL","TAB 50MG","20","Select","Select",""],["","68382013814","TOPIRAMATE","TAB 25MG","120","Select","Select",""],["","65862017760","CEFDINIR","CAP 300MG","8","Select","Select",""],["","00713052612","PROMETHEGAN","SUP 25MG","12","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":""}]}]}