{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"VICKY SMITH","gend":1,"add":"4907 E PRINCESS ANNE RD APT 24","city":"NORFOLK","state":"VA","zip":"23502-9998","dob":"1965-12-09","age":"","mstatus":"","insh":"20057750*01","cliId":"","pno":"757\/274-2343","cno":"757\/274-2343","email":"","ename":"","eno":"","pphy":"TAN, EUGENE M MD","ppno":"757\/824-2025","pcpadd":"850 KEMPSVILLE RD STE 200A","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23502,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/275-9802","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J45.41","J44.1","M06.9","Z72.0","E78.2","I10.","R35.0","J44.9","F17.200","Z20.828","D72.829","E87.2","Z71.6","D50.9","K21.9","J45.901","J45.909","J45.40","M25.611","M62.81","M25.511","M75.121","Z47.89","S92.502A","Z20.822","F17.210","Z98.890","F41.1","NO DATA","F43.21","U07.1","R05.","R06.2","M06.09","Z51.81","M75.21","F19.20","Z87.891","R52.","R20.0","M79.644","J45.50","F33.2","G60.8","E53.8","J03.80","R07.0","F33.0","K59.04","J32.1","R00.2","R06.02","R73.03","M75.41","K63.5","D50.0","J31.0","K59.00","Z01.812","Z12.11","Z86.010","K64.0","G43.909","H25.813","H18.413","D72.820","J96.91","F41.9","N39.46","R04.0","B37.2","E55.9","R73.09","Z12.2","Z12.31","H69.91","E87.1","R51.9","Z88.0","Z88.1","Z88.5","Z88.8","Z91.040","B37.0","J44.0","J20.9","F40.00","D12.2","D12.5","H02.61","H02.64","F33.1","F33.41","M79.641","Z46.4","J42.","R60.0","R11.2","R10.84","K92.2","Z74.3","L03.012","M24.111","R09.81","E87.6","D64.9","M81.0","N81.84","D72.9","Z00.00","Z23.","Z01.818","D50.8","R20.2","Z79.52","Z12.39","Z68.31","Z53.8","S92.515A","J98.8","B97.89","S92.912K","Z88.6"],"date":["2020-05-11","2022-10-08","2022-09-14","2021-08-30","2022-01-14","2022-09-14","2022-04-14","2022-09-26","2022-06-28","2020-08-12","2022-10-15","2020-08-13","2020-08-13","2021-07-15","2020-08-13","2020-08-13","2020-12-30","2020-10-04","2021-08-19","2021-08-19","2021-12-13","2021-12-13","2021-08-19","2021-08-28","2021-08-28","2022-09-26","2021-12-13","2022-05-11","2021-12-17","2022-02-22","2021-09-20","2021-09-20","2021-09-20","2022-07-18","2022-07-18","2021-12-13","2022-06-09","2022-06-09","2022-06-28","2022-06-28","2022-06-28","2022-10-20","2022-02-22","2022-04-05","2022-04-05","2022-05-25","2022-05-25","2022-08-02","2022-07-05","2022-08-02","2022-08-03","2022-08-09","2022-08-16","2021-04-06","2021-07-22","2022-01-14","2021-01-13","2021-01-19","2021-07-20","2021-07-22","2021-07-22","2021-07-22","2021-10-21","2021-10-21","2021-10-21","2022-10-08","2022-04-14","2022-08-02","2022-04-14","2022-06-30","2022-08-02","2022-01-14","2022-01-14","2022-01-14","2022-01-14","2022-03-14","2022-07-08","2022-07-08","2022-07-08","2022-07-08","2022-07-08","2022-07-08","2022-07-08","2022-08-02","2022-08-24","2022-08-24","2020-11-19","2021-07-22","2021-07-22","2022-02-01","2022-02-01","2022-06-03","2022-05-11","2022-06-28","2022-06-28","2022-07-21","2022-09-14","2022-10-15","2022-10-15","2022-10-15","2022-10-15","2020-05-18","2021-04-06","2022-10-08","2020-08-03","2020-08-03","2021-08-30","2021-01-19","2020-09-22","2020-11-04","2020-12-17","2021-04-01","2021-04-01","2021-04-10","2021-04-10","2020-02-25","2020-04-09","2020-10-13","2021-08-31","2021-06-20","2021-06-20","2021-08-30","2021-09-20"],"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":[["","60432026415","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","00781107705","ALPRAZOLAM","TAB 0.5MG","90","Select","Select",""],["","00074055402","HUMIRA","INJ 40\/0.4ML","2","Select","Select",""],["","11822002601","VITAMIN","TAB 1000UNIT","30","Select","Select",""],["","65862057490","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","31722071390","PANTOPRAZOLE","TAB 40MG","60","Select","Select",""],["","65862001230","SERTRALINE","TAB 50MG","90","Select","Select",""],["","51660007021","GUAIFENESIN","TAB 600MG ER","60","Select","Select",""],["","00904671839","MUCUS","TAB 600MG ER","60","Select","Select",""],["","59746017306","PREDNISONE","TAB 10MG","45","Select","Select",""],["","43598044774","NICOTINE","DIS 14MG\/24H","14","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","00173068220","VENTOLIN","AER ","18","Select","Select",""],["","70010016201","LORATADINE","TAB 10MG","30","Select","Select",""],["","55111079924","GG\/PSE","TAB 120\/1200","20","Select","Select",""],["","00904759080","FEROSUL","TAB 325MG","30","Select","Select",""],["","00254302802","LUBIPROSTONE","CAP 8MCG","60","Select","Select",""],["","65862037401","ESCITALOPRAM","TAB 10MG","90","Select","Select",""],["","64764008060","AMITIZA","CAP 8MCG","60","Select","Select",""],["","65862005190","SIMVASTATIN","TAB 10MG","60","Select","Select",""],["","75834015901","VERAPAMIL","TAB 240MG ER","60","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","30","Select","Select",""],["","69784018010","POLYETH","POW 3350 NF","10","Select","Select",""],["","11822010233","PAIN","TAB 500MG","60","Select","Select",""],["","00536123441","ASPIRIN","TAB 81MG EC","28","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","63824000820","MUCINEX","TAB 600MG ER","30","Select","Select",""],["","00456315467","AEROCHAMBER","MIS PLUS","1","Select","Select",""],["","64380071206","BENZONATATE","CAP 100MG","30","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","00121077516","GG\/CODEINE","SOL 100-10\/5","118","Select","Select",""],["","68180098430","BUDESONIDE","SUS 0.5MG\/2","120","Select","Select",""],["","65162062710","TRAMADOL","TAB 50MG","15","Select","Select",""],["","00228259711","INDAPAMIDE","TAB 1.25MG","90","Select","Select",""],["","00085720601","DULERA","AER 100-5MCG","13","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","59762010401","SULFASALAZIN","TAB 500MG DR","120","Select","Select",""],["","63481068447","VOLTAREN","GEL 0.01","100","Select","Select",""],["","27808011401","HYDROCO\/APAP","TAB 5-300MG","10","Select","Select",""],["","60432053716","NYSTATIN","SUS 100000","140","Select","Select",""],["","69238110005","DOXYCYCL","CAP 100MG","12","Select","Select",""],["","66993005702","HYDROXYCHLOR","TAB 200MG","14","Select","Select",""],["","67877021620","CEFUROXIME","TAB 500MG","14","Select","Select",""],["","69543025216","VIRTUSSIN","SOL 100-10\/5","240","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":""}]}]}