{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SHERRY   B EASLEY - DANIEL","gend":1,"add":"423 MARINERS WAY APT B","city":"NORFOLK","state":"VA","zip":"23502-9998","dob":"1984-07-22","age":"","mstatus":"","insh":"20055860*01","cliId":"","pno":"757\/575-0197","cno":"757\/575-0197","email":"","ename":"","eno":"","pphy":"VANHORN, MARILYN MD","ppno":"757\/627-6220","pcpadd":"SUITE 100 400 W BRAMBLETON AVE","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23510,"pcpcounty":"","pcpid":"","pcpname":"Hague Medical Associates","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/627-0200","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N64.4","I10.","J45.909","F31.9","L40.0","B37.2","M25.551","L65.9","K04.90","Z88.5","K08.89","R10.9","K92.0","R07.89","R10.84","M54.5","N94.6","N76.0","NO DATA","Z30.42","L40.9","M25.50","L91.0","L29.8","L50.3","J31.0","R09.89","Z71.9","Z30.09","Z32.02","L30.4","Z01.411","Z11.3","R82.90","R89.5","Z11.51","L30.8","K62.5","N92.1","Z23.","Z00.00","M79.89"],"date":["2022-07-07","2022-07-07","2020-06-30","2022-07-07","2022-03-14","2021-12-20","2022-07-07","2021-12-20","2022-01-04","2022-01-04","2022-01-04","2020-05-27","2020-05-27","2020-05-27","2022-07-07","2021-08-30","2022-07-07","2022-07-07","2022-07-07","2022-05-12","2022-03-08","2022-03-08","2022-03-08","2022-09-28","2022-09-28","2022-09-28","2022-09-28","2021-12-06","2022-04-19","2022-04-19","2021-07-08","2021-09-01","2021-09-01","2021-09-01","2021-09-01","2021-09-01","2021-10-20","2021-10-25","2022-05-12","2022-09-28","2020-06-30","2021-12-20"],"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":[["","68462015713","ONDANSETRON","TAB 4MG ODT","12","Select","Select",""],["","68645057154","CITALOPRAM","TAB 40MG","90","Select","Select",""],["","65862007930","TERBINAFINE","TAB 250MG","10","Select","Select",""],["","10702000709","CYCLOBENZAPR","TAB 10MG","90","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","21","Select","Select",""],["","00074055402","HUMIRA","INJ 40\/0.4ML","2","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","16","Select","Select",""],["","68645055854","LISINOP\/HCTZ","TAB 20-25MG","30","Select","Select",""],["","53329016979","ANTIFUNGAL","POW 0.02","85","Select","Select",""],["","57237004101","PENICILLN","TAB 500MG","28","Select","Select",""],["","71093013502","QUETIAPINE","TAB 50MG ER","30","Select","Select",""],["","57237001830","DULOXETINE","CAP 30MG","90","Select","Select",""],["","69097014260","ALBUTEROL","AER HFA","7","Select","Select",""],["","29300046801","CLONIDINE","TAB 0.1MG","90","Select","Select",""],["","51672129303","CLOBETASOL","SOL 0.0005","50","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","45802000402","HYDROCORT","CRE 0.025","20","Select","Select",""],["","68462029817","CLOTRIM\/BETA","CRE DIPROP","45","Select","Select",""],["","68645051054","HYDROCHLOROT","TAB 25MG","30","Select","Select",""],["","49035045875","ALLERGY","TAB 10MG","30","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","00006003330","BELSOMRA","TAB 10MG","30","Select","Select",""],["","70010016305","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","80681017400","VITAMIN","CAP 50000UNT","4","Select","Select",""],["","00555073302","TRAZODONE","TAB 300MG","15","Select","Select",""],["","66993058497","FLUTIC\/SALME","AER 100\/50","60","Select","Select",""],["","68382005005","MELOXICAM","TAB 7.5MG","30","Select","Select",""],["","70069009101","AZELASTINE","DRO 0.0005","6","Select","Select",""],["","00173069500","ADVAIR","AER 100\/50","60","Select","Select",""],["","00781261305","AMOXICILLIN","CAP 500MG","21","Select","Select",""],["","49035007860","EQ","CAP SOFTENER","60","Select","Select",""],["","68645056259","IBUPROFEN","TAB 600MG","20","Select","Select",""],["","55111014512","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0","Select","Select",""],["","65162047810","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","51672130200","TERCONAZOLE","CRE 0.008","40","Select","Select",""],["","16714008210","HYDROXYZ","TAB 25MG","90","Select","Select",""],["","65197010305","MICATIN","CRE 0.02","42","Select","Select",""],["","00054001925","PREDNISONE","TAB 50MG","5","Select","Select",""],["","61874011530","VRAYLAR","CAP 1.5MG","30","Select","Select",""],["","00093005805","TRAMADOL","TAB 50MG","16","Select","Select",""],["","59762501002","CLINDAMYCIN","CAP 300MG","28","Select","Select",""],["","00116200116","CHLORHEX","SOL 0.0012","473","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","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":""}]}]}