{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"AMY DANIELS","gend":1,"add":"109 BRADY DR APT 8","city":"WILLIAMSBURG","state":"VA","zip":"23188-9998","dob":"1981-07-07","age":"","mstatus":"","insh":"20058199*01","cliId":"","pno":"757\/966-8194","cno":"757\/966-8194","email":"","ename":"","eno":"","pphy":"DOEREN, BRIAN MD","ppno":"757\/941-5600","pcpadd":"263 MCLAWS CIRCLE SUITE 105","pcpcity":"WILLIAMSBURG","pcpstate":"VA","pcpzip":23185,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/564-0557","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.65","R52.","R10.9","R11.2","R10.32","E11.42","I11.0","I50.32","E11.43","K31.84","I25.10","D86.0","D86.86","D86.87","NO DATA","J44.9","G40.909","E24.9","F41.1","F33.41","J96.11","M51.36","L03.311","R10.13","E11.69","E10.65","R73.9","E10.43","Z90.49","E66.01","Z68.43","Z71.3","I50.9","Z83.3","G47.30","Z87.891","Z79.899","Z79.4","Z88.5","I10.","R21.","M79.7","D86.89","Z86.711","Z86.14","Z90.2","M25.461","K86.1","D86.9","K86.89","R74.02","R79.89","R74.8","G89.29","H40.20X0","F41.9","K86.81","J45.909","J96.21","U09.9","R91.8","R07.81","R06.02","R00.0","J96.10","K21.9","R11.10","R13.10","E66.3","F32.9","B83.9","G89.4","Z51.81","J20.9","J18.9","R68.84","K08.89","E86.0","L03.90","K58.0","E11.9","E78.5","Z86.718","Z79.51","R11.0","K59.00","R35.0","R42.","Z91.048","Z88.8","Z91.040","Z88.0","Z86.16","U07.1","R07.89","K29.50","R06.00","K02.9","K04.7","K05.322","R74.0","D72.829","J84.9","K58.9","F42.9","E66.9","T50.905A","Z68.42","K76.0","Z20.822","R05.9","R60.0","Z86.018","M51.37","M51.26","R10.84","E16.1","E16.2","R50.9","D86.85","M85.80","Z79.52","R06.9","R53.81","A41.9","R55.","R74.01","R19.7","J45.998","Z98.890","R10.11","R10.12","E10.10","M54.9","G52.2","Z87.19","Z86.19","Z86.2","E87.2","D64.9","A41.89","D84.9","E66.2","E24.2","R16.2","J45.40","R50.81","M25.50","T40.416A","V58.69","R63.8","R26.2","M25.40","M25.561","Z91.013","Z91.018","Z99.89","Z91.19","Z88.6","R07.9","G47.33","E11.49","K22.4","R06.09","R22.0","R51.","R06.01","R89.9","K64.9","R09.02","R06.89","H40.9","H10.31","K04.01","L53.9","V58.89","M81.8","Z78.9","Z00.00","E55.9","M54.16","I45.81","M47.816","M19.90","D68.9","R06.2","K08.9","T38.0X5A","Z87.11","L68.0","R14.0","R16.0","Z79.891","Z86.39","Z87.442","L30.4","J30.2","J30.89","I51.9","H69.93","H92.03","H91.91","H93.13","Z23.","F41.8","F17.210","G47.00","B37.0","Z53.29","M54.41","Z76.5","Z99.81","M54.42","J12.89","Z51.5","B34.9","F11.90","G99.0","E11.52","I96.","M87.052","M87.051","E11.39","H40.10X0","H42.","M96.1","M54.5","T50.A95A","K21.0","V72.85","R10.31","E10.9","F11.20","F41.0","Z87.01"],"date":["2022-10-24","2022-09-15","2022-10-24","2022-10-25","2022-03-14","2022-09-09","2022-09-23","2022-10-24","2022-09-23","2022-09-23","2022-09-16","2022-09-16","2022-05-02","2022-05-02","2022-10-22","2022-09-13","2022-08-30","2022-06-07","2022-09-09","2022-09-09","2022-10-22","2022-05-02","2022-10-25","2022-07-29","2022-07-29","2022-05-26","2022-09-16","2022-05-26","2022-08-28","2022-10-24","2022-09-09","2022-05-26","2022-09-23","2022-06-07","2022-09-15","2022-08-28","2022-08-13","2022-10-22","2022-06-27","2022-08-11","2022-06-07","2022-06-07","2022-10-24","2022-06-27","2022-06-07","2022-06-07","2022-07-14","2022-08-15","2022-10-22","2022-07-28","2022-07-28","2022-10-25","2022-07-28","2022-09-15","2022-09-23","2022-07-30","2022-07-28","2022-08-30","2022-09-09","2022-08-22","2022-08-22","2022-08-22","2022-09-16","2022-09-04","2022-10-24","2022-10-22","2022-01-20","2020-01-20","2020-01-20","2022-07-08","2020-01-25","2022-10-22","2020-03-30","2020-02-07","2022-08-21","2020-03-25","2022-05-09","2022-09-23","2021-12-22","2022-07-08","2022-10-22","2022-09-09","2022-09-16","2022-08-19","2021-12-22","2021-12-28","2021-12-28","2021-12-28","2022-06-27","2022-05-09","2022-06-27","2022-06-27","2022-09-16","2022-08-31","2022-09-16","2020-01-20","2022-01-03","2022-05-09","2020-03-21","2020-03-24","2020-03-24","2020-03-24","2022-09-16","2022-04-23","2022-07-08","2022-08-13","2021-12-18","2021-12-24","2022-09-16","2022-02-09","2022-08-13","2021-12-24","2022-02-26","2022-07-30","2021-12-24","2022-04-23","2021-12-28","2021-12-28","2022-09-23","2022-03-17","2022-03-17","2022-08-18","2022-08-01","2022-08-01","2022-09-07","2022-01-03","2022-09-07","2022-09-23","2022-01-22","2022-01-22","2022-03-06","2022-07-27","2022-04-01","2022-04-01","2022-04-01","2022-07-29","2022-05-29","2022-05-29","2022-08-30","2022-08-04","2022-08-04","2022-09-09","2022-10-22","2022-08-15","2022-08-15","2022-08-19","2022-09-04","2022-10-25","2022-09-15","2022-09-15","2022-09-15","2022-09-15","2022-09-15","2022-06-27","2022-06-27","2022-06-27","2022-07-29","2022-08-19","2022-07-29","2022-09-16","2022-08-19","2022-08-23","2020-01-20","2020-03-12","2020-03-21","2020-03-21","2021-12-01","2021-12-04","2021-12-09","2022-01-02","2022-01-02","2022-03-31","2022-02-17","2022-02-17","2022-02-17","2022-02-21","2022-09-09","2022-08-11","2022-05-10","2022-07-08","2022-07-08","2022-08-15","2022-09-09","2020-03-04","2020-03-08","2022-09-23","2020-03-19","2021-12-06","2022-06-21","2022-03-07","2021-12-14","2021-12-14","2022-05-29","2022-03-06","2022-03-14","2022-09-06","2020-01-15","2020-01-15","2020-01-15","2020-01-15","2020-01-15","2020-01-15","2020-01-15","2020-02-21","2020-02-21","2020-02-21","2021-12-16","2021-12-21","2022-01-29","2022-08-11","2022-08-11","2022-09-16","2022-08-11","2022-08-13","2022-09-06","2020-01-08","2020-02-24","2022-02-24","2022-09-23","2022-09-23","2022-09-23","2022-09-23","2022-09-23","2022-09-23","2022-09-23","2020-01-02","2020-01-02","2020-02-21","2020-02-25","2020-02-25","2021-12-06","2021-12-28","2022-08-30","2022-08-30","2022-09-16"],"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":[["","00032301613","CREON","CAP 36000UNT","250","Select","Select",""],["","13107008401","LORAZEPAM","TAB 1MG","30","Select","Select",""],["","00054001825","PREDNISONE","TAB 20MG","15","Select","Select",""],["","67877056105","METFORMIN","TAB 500MG","180","Select","Select",""],["","68382004101","PROMETHAZINE","TAB 25MG","25","Select","Select",""],["","65862019430","FLUOXETINE","CAP 40MG","90","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","15","Select","Select",""],["","00143962125","CYANOCOBALAM","INJ 1000MCG","1","Select","Select",""],["","00169643810","LEVEMIR","INJ FLEXTOUC","30","Select","Select",""],["","60505265401","TRAZODONE","TAB 100MG","180","Select","Select",""],["","50383070016","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","64380073706","VITAMIN","CAP 50000UNT","4","Select","Select",""],["","47781042647","FENTANYL","DIS 50MCG\/HR","10","Select","Select",""],["","27241009903","DULOXETINE","CAP 60MG","30","Select","Select",""],["","65862057490","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","00173068220","VENTOLIN","AER ","18","Select","Select",""],["","00173069700","ADVAIR","AER 500\/50","180","Select","Select",""],["","62542030104","HYD","SUS 10-8\/5ML","100","Select","Select",""],["","64380071206","BENZONATATE","CAP 100MG","30","Select","Select",""],["","65162036110","FOLIC","TAB 1MG","30","Select","Select",""],["","50228017701","GABAPENTIN","TAB 600MG","90","Select","Select",""],["","08290309623","1ML","MIS 27GX1\/2\"","4","Select","Select",""],["","00169255013","TRESIBA","INJ 200UNIT","15","Select","Select",""],["","59148003713","REXULTI","TAB 1MG","30","Select","Select",""],["","00093220305","METOCLOPRAM","TAB 10MG","20","Select","Select",""],["","65862018601","CLINDAMYCIN","CAP 300MG","40","Select","Select",""],["","82607066026","FLOWFLEX","KIT TEST","8","Select","Select",""],["","08290320109","BD  PEN NEEDL","MIS 31GX8MM","100","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","20","Select","Select",""],["","53885092701","ONETOUCH","KIT VERIO RE","1","Select","Select",""],["","00597016061","SPIRIVA","AER 1.25MCG","4","Select","Select",""],["","53885004401","ONE","KIT VERIO FL","1","Select","Select",""],["","00088221905","LANTUS","INJ 100\/ML","45","Select","Select",""],["","61314063006","NEO\/POLY\/DEX","SUS 0.1% OP","5","Select","Select",""],["","67877021901","CEPHALEXIN","CAP 500MG","40","Select","Select",""],["","08489830910","PEN  NEEDLES","MIS 31GX8MM","200","Select","Select",""],["","00002879959","HUMALOG","INJ 100\/ML","33","Select","Select",""],["","66993058597","FLUTIC\/SALME","AER 250\/50","60","Select","Select",""],["","51991081403","AZELASTINE","SPR 0.001","30","Select","Select",""],["","42858000401","OXYCODONE","TAB 20MG","60","Select","Select",""],["","51672128402","TRIAMCINOLON","OIN 0.001","30","Select","Select",""],["","50383077504","LIDOCAINE","SOL 2% VISC","200","Select","Select",""],["","60505081301","BUTORPHANOL","SOL 10MG\/ML","2","Select","Select",""],["","63304061650","DOXYCYC","CAP 100MG","10","Select","Select",""],["","63824000815","MUCINEX","TAB 600MG ER","28","Select","Select",""],["","08290236850","LACTINEX","CHW ","30","Select","Select",""],["","16729053308","DODEX","INJ ","1","Select","Select",""],["","67877054360","CEFDINIR","CAP 300MG","10","Select","Select",""],["","16714069101","FLUCONAZOLE","TAB 100MG","7","Select","Select",""],["","00378456177","POT  CHLORIDE","TAB 10MEQ ER","15","Select","Select",""],["","00054418625","DEXAMETHASON","TAB 6MG","6","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","00832046515","NYAMYC","POW 100000","30","Select","Select",""],["","31722072250","LEVOFLOXACIN","TAB 500MG","3","Select","Select",""],["","60432053716","NYSTATIN","SUS 100000","140","Select","Select",""],["","98302014059","COMFORT","MIS 32GX4MM","500","Select","Select",""],["","00093216568","NALOXONE","SPR 4MG","2","Select","Select",""],["","98302000105","ALCOHOL","PAD ","500","Select","Select",""],["","00121058104","HALOPERIDOL","CON 2MG\/ML","15","Select","Select",""],["","51672127506","CLOTRIMAZOLE","CRE 0.01","45","Select","Select",""],["","57237023305","SMZ-TMP","TAB 800-160","14","Select","Select",""],["","62135098505","DOXYCYCL","CAP 100MG","14","Select","Select",""],["","00406577101","METHADONE","TAB 10MG","22","Select","Select",""],["","65162027250","SMZ\/TMP","TAB 800-160","12","Select","Select",""],["","69367024324","HYDROCORT","SUP 25MG","12","Select","Select",""],["","69238149001","BUMETANIDE","TAB 1MG","30","Select","Select",""],["","00527128201","DICYCLOMINE","TAB 20MG","20","Select","Select",""],["","65162062710","TRAMADOL","TAB 50MG","12","Select","Select",""],["","41167431004","ALLEGRA-D","TAB 12 HOUR","20","Select","Select",""],["","13733087641","ALLRGY","TAB 5-120MG","20","Select","Select",""],["","65162003310","APAP\/CODEINE","TAB 300-30MG","20","Select","Select",""],["","00904645760","DOK","CAP 100MG","60","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","61703035038","METHOTREXATE","INJ 25MG\/ML","8","Select","Select",""],["","65862064163","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","11822512670","STOOL","CAP 100MG","60","Select","Select",""],["","11822775350","RA","LIQ 100-10\/5","237","Select","Select",""],["","31722063231","OSELTAMIVIR","CAP 75MG","10","Select","Select",""],["","11822619080","ALLERGY\/CONG","TAB 5-120MG","20","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","50383008716","GUAIATUSS","SYP 100-10\/5","70","Select","Select",""],["","11523716202","CLARITIN-D","TAB 5-120MG","20","Select","Select",""],["","00574722612","COMPRO","SUP 25MG","10","Select","Select",""],["","70000041502","CLEARLAX","POW ","238","Select","Select",""],["","50111033401","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","43598044774","NICOTINE","DIS 14MG\/24H","28","Select","Select",""],["","42806064801","DIPHENHYDRAM","CAP 25MG","30","Select","Select",""],["","00065853302","CIPRODEX","SUS 0.3-0.1%","8","Select","Select",""],["","11822041250","ACETAMIN","TAB 500MG","30","Select","Select",""],["","00116200116","CHLORHEX","SOL 0.0012","473","Select","Select",""],["","54838020940","SILTUSSIN-DM","SYP ALC FREE","300","Select","Select",""],["","00143924920","AMOX\/K","TAB 875-125","14","Select","Select",""],["","00591299239","PHENADOZ","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":""}]}]}