{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SHARON   A COLE","gend":1,"add":"103 HEATH LN","city":"WILLIAMSBURG","state":"VA","zip":"23188-9998","dob":"1963-11-10","age":"","mstatus":"","insh":"20055840*01","cliId":"","pno":"757\/345-6183","cno":"","email":"","ename":"","eno":"","pphy":"ROSSANO, WILLIAM MD","ppno":"757\/310-6413","pcpadd":"739 THIMBLE SHOALS BLVD SUITE 1008","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":23606,"pcpcounty":"","pcpid":"","pcpname":"INVICTUS HEALTH LLC","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":["R50.9","N75.0","J10.1","F17.210","H65.21","V58.89","M25.521","R29.898","M79.641","Z02.83","M77.11","J43.2","R91.1","E55.9","Z72.0","R05.","K52.9","R19.7","K92.2","Z87.09","D72.829","I95.9","R10.9","K62.5","R93.3","I10.","M51.36","M53.3","G89.4","M47.817","NO DATA","Z12.39","J44.9","R42.","I25.10","M54.6","Z01.419","E03.9","E78.2","R73.9","Z09.","H61.22","J44.1","Z79.891","J06.9","Z20.828","M47.816","M75.42","D48.5","L98.9","Z71.9","T14.8XXA","D23.9","N73.9","R10.2","M43.07","K55.039","Z79.51","Z79.82","Z79.890","Z79.899","D72.828","Z88.2","Z88.8","E78.00","Z01.818","S61.206A","F33.1","K21.9","K44.9","Z23.","J02.9","R21.","H65.23","M46.1","R93.89","R51.","R09.82","K08.89","M54.9","M54.5","K04.7","M16.9","F17.200","E66.3","R11.10","K59.00","R13.10","Z68.31","K21.0","M50.30","Z88.1"],"date":["2020-02-22","2020-02-22","2020-02-22","2020-04-26","2021-11-01","2020-09-10","2021-05-14","2020-11-13","2020-11-13","2020-11-13","2021-03-10","2021-11-23","2021-04-05","2021-05-14","2021-11-23","2021-04-05","2020-05-13","2020-12-22","2020-04-26","2020-04-26","2020-04-28","2020-04-26","2020-04-27","2020-04-28","2020-04-27","2021-05-14","2021-05-14","2021-03-02","2021-12-15","2020-01-28","2020-01-21","2020-01-21","2020-06-18","2020-02-28","2020-07-23","2020-02-28","2020-03-03","2021-11-23","2020-03-03","2020-03-03","2020-05-01","2020-07-06","2020-05-19","2020-11-13","2020-12-22","2020-12-22","2021-12-15","2021-12-15","2021-11-02","2021-11-02","2021-12-14","2021-12-14","2021-12-14","2020-02-10","2020-02-10","2020-02-10","2020-04-26","2020-04-26","2020-04-26","2020-04-26","2020-04-26","2020-04-26","2020-04-26","2020-04-26","2020-04-26","2020-07-02","2021-01-14","2021-11-23","2020-07-23","2020-09-10","2021-05-29","2021-05-06","2021-11-23","2020-07-06","2021-11-23","2020-05-13","2020-06-18","2020-06-18","2020-01-13","2019-08-07","2019-08-07","2019-12-23","2019-04-23","2019-04-10","2019-04-10","2019-04-10","2019-04-10","2019-03-11","2019-03-11","2019-03-11","2019-12-23","2019-12-23"],"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":[["","65862052305","GABAPENTIN","TAB 600MG","30","Select","Select",""],["","","ALBUTEROL","NEB 0.00083","","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","","FLUTIC\/SALME","AER 250\/50","","Select","Select",""],["","16714029904","AMOXICILLIN","CAP 500MG","30","Select","Select",""],["","42858000101","OXYCODONE","TAB 5MG","84","Select","Select",""],["","49348004534","ALLERGY","LIQ 12.5\/5ML","118","Select","Select",""],["","68645055554","LISINOPRIL","TAB 40MG","30","Select","Select",""],["","00054001729","PREDNISONE","TAB 10MG","43","Select","Select",""],["","00781518592","LEVOTHYROXIN","TAB 112MCG","30","Select","Select",""],["","","PANTOPRAZOLE","TAB 20MG","","Select","Select",""],["","","ROSUVASTATIN","TAB 5MG","","Select","Select",""],["","00173069600","ADVAIR","AER 250\/50","60","Select","Select",""],["","31722053301","METHOCARBAM","TAB 500MG","270","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","20","Select","Select",""],["","67877021905","CEPHALEXIN","CAP 500MG","28","Select","Select",""],["","","DULOXETINE","CAP 30MG","","Select","Select",""],["","68462018022","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","52565012215","LIDOCAINE","CRE 0.04","15","Select","Select",""],["","","PROAIR","AER ","","Select","Select",""],["","23155013525","DOXYCYC","TAB 100MG","60","Select","Select",""],["","31722070590","VALACYCLOVIR","TAB 1GM","30","Select","Select",""],["","29300012401","MELOXICAM","TAB 7.5MG","30","Select","Select",""],["","80777027399","MODERNA","INJ COVID-19","0","Select","Select",""],["","55111017915","TIZANIDINE","TAB 2MG","21","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","00172392670","DIAZEPAM","TAB 5MG","6","Select","Select",""],["","00781286810","OMEPRAZOLE","CAP 20MG DR","30","Select","Select",""],["","","OXYCOD\/APAP","TAB 7.5-325","","Select","Select",""],["","","CLINDAMYCIN","CAP 300MG","","Select","Select",""],["","62332014131","CELECOXIB","CAP 100MG","30","Select","Select",""],["","","FLUCONAZOLE","TAB 150MG","","Select","Select",""],["","","DOXYCYCL","CAP 100MG","","Select","Select",""],["","","HYD","SUS 10-8\/5ML","","Select","Select",""],["","","VOLTAREN","GEL 0.01","","Select","Select",""],["","","METRONIDAZOL","TAB 500MG","","Select","Select",""],["","","BREO","INH 100-25","","Select","Select",""],["","","BACLOFEN","TAB 5MG","","Select","Select",""],["","","FAMOTIDINE","TAB 20MG","","Select","Select",""],["","","NICOTINE","GUM 4MG MINT","","Select","Select",""],["","","NICODERM","DIS 21MG\/24H","","Select","Select",""],["","","MUCINEX","TAB 30-600ER","","Select","Select",""],["","","OSELTAMIVIR","SUS 6MG\/ML","","Select","Select",""],["","","VENTOLIN","AER ","","Select","Select",""],["","","AMOX\/K","TAB 875-125","","Select","Select",""],["","","LEVOFLOXACIN","TAB 750MG","","Select","Select",""],["","","CIPROFLOXACN","TAB 500MG","","Select","Select",""],["","69543025216","VIRTUSSIN","SOL 100-10\/5","100","Select","Select",""],["","64764017530","DEXILANT","CAP 60MG DR","30","Select","Select",""],["","00406012301","HYDROCO\/APAP","TAB 5-325MG","21","Select","Select",""],["","45802086803","POLYETH","POW 3350 NF","510","Select","Select",""],["","66869020490","LIVALO","TAB 2MG","30","Select","Select",""],["","00116200116","CHLORHEX","SOL 0.0012","473","Select","Select",""],["","50111078751","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","69452014320","BENZONATATE","CAP 100MG","20","Select","Select",""],["","37000045504","PRILOSEC","TAB 20MG","84","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","16714023501","PENICILLN","TAB 500MG","40","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":""}]}]}