{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"EDDIE HOWARD","gend":0,"add":"4701 WINDERMERE CT APT 103","city":"VIRGINIA BEACH","state":"VA","zip":"23455-9998","dob":"1964-05-31","age":"","mstatus":"","insh":"20057075*01","cliId":"","pno":"757\/920-4343","cno":"","email":"","ename":"","eno":"","pphy":"SAMUELS, GARFIELD HUE MD","ppno":"757\/518-8823","pcpadd":"4452 CORPORATION LN STE 300","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":23462,"pcpcounty":"","pcpid":"","pcpname":"PRIMECARE INTERNAL MEDICINE PC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/518-8832","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M62.838","M06.9","G89.29","H54.7","F17.200","Z71.6","Z76.0","S46.812A","S39.012A","R25.2","I10.","E55.9","M06.89","M54.2","M54.5","M54.9","M79.606","H54.8","Z96.653","F17.210","M54.6","H40.9","R05.","L85.3","R21.","G89.4","M17.9","M50.122","V49.10XD","K51.90","Z01.810","H25.9","R94.31","M17.0","G89.18","M25.562","L29.9","T40.605A","G62.9","M17.11","D63.8","M96.1","M25.561","M51.36","M17.12","H40.60X0","I97.3","T38.0X5A","M21.262","Z79.52","Z79.1","Z79.899","Z88.6","Z91.030","Z87.19","Z47.1","H40.1133","H25.813","H25.049","H43.02","Z96.1","Z98.1","Z01.818","V58.89","Z04.1","G25.81","L60.3","Z96.652","R26.81","Z20.822","V49.10XA","Y92.488","R26.2","L60.8"],"date":["2020-02-20","2021-11-29","2020-05-05","2020-04-03","2020-03-24","2020-03-24","2020-04-04","2020-10-04","2020-10-04","2020-09-04","2020-11-02","2020-11-02","2021-11-29","2021-11-29","2021-08-26","2020-02-26","2020-02-26","2020-04-04","2020-04-04","2020-04-04","2020-02-20","2020-02-20","2020-02-20","2020-05-05","2020-05-05","2020-05-06","2021-02-03","2020-01-03","2020-01-03","2020-04-03","2019-11-11","2019-06-28","2019-06-28","2019-12-11","2019-11-14","2019-12-18","2019-07-26","2019-07-25","2019-11-19","2019-12-11","2019-12-11","2019-12-18","2019-12-18","2019-06-27","2019-11-11","2019-11-14","2019-07-11","2019-11-14","2019-07-11","2019-11-14","2019-07-11","2019-11-14","2019-07-11","2019-07-11","2019-07-11","2019-08-09","2019-06-20","2019-05-17","2019-06-19","2019-06-20","2019-06-20","2019-11-14","2019-07-08","2019-07-26","2019-11-09","2019-11-14","2019-11-14","2019-11-14","2021-05-26","2021-05-26","2019-12-02","2019-12-02","2019-07-31","2019-11-18"],"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":[["","00378699152","ALBUTEROL","NEB 0.63MG\/3","75","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","00023932110","ALPHAGAN","SOL 0.001","10","Select","Select",""],["","10702005601","OXYCODONE","TAB 10MG","28","Select","Select",""],["","00378064010","PREDNISONE","TAB 5MG","60","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","50383023310","DORZOL\/TIMOL","SOL 22.3-6.8","10","Select","Select",""],["","65862090801","CELECOXIB","CAP 100MG","60","Select","Select",""],["","65162046510","IBUPROFEN","TAB 600MG","28","Select","Select",""],["","65162062710","TRAMADOL","TAB 50MG","90","Select","Select",""],["","16571020210","DICLOFENAC","TAB 50MG DR","20","Select","Select",""],["","42858010401","OXYCOD\/APAP","TAB 10-325MG","40","Select","Select",""],["","68462012601","GABAPENTIN","TAB 600MG","30","Select","Select",""],["","41167005842","ASPERCREME","PAD LIDO 4%","7","Select","Select",""],["","46122045021","GNP","PAD 0.04","7","Select","Select",""],["","65862015901","ZOLPIDEM","TAB 5MG","10","Select","Select",""],["","11822300930","SENNA","TAB 8.6-50MG","60","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","64380073706","VITAMIN","CAP 50000UNT","12","Select","Select",""],["","00781713593","MOXIFLOXACIN","SOL HCL 0.5%","3","Select","Select",""],["","60758077305","KETOROLAC","SOL 0.004","5","Select","Select",""],["","61314063136","NEO\/POLY\/DEX","OIN 0.1% OP","4","Select","Select",""],["","11822989470","RA","TAB 81MG EC","60","Select","Select",""],["","65862019105","CYCLOBENZAPR","TAB 10MG","30","Select","Select",""],["","00378905593","LIDOCAINE","PAD 0.05","7","Select","Select",""],["","68462019001","NAPROXEN","TAB 500MG","14","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":""}]}]}