{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MICHAEL HOPSON","gend":0,"add":"100 MARTHA LEE DR APT 76","city":"HAMPTON","state":"VA","zip":"23666-9998","dob":"1957-03-27","age":"","mstatus":"","insh":"20062207*01","cliId":"","pno":"757\/930-7203","cno":"","email":"","ename":"","eno":"","pphy":"WILS-OWENS, MELISSA PA","ppno":"804\/828-4360","pcpadd":"1300 E MARSHALL STREET","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":23298,"pcpcounty":"","pcpid":"","pcpname":"MCV ASSOCIATED PHYSICIANS","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/828-7825","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["L02.419","L02.416","F11.20","Z48.00","E11.9","I10.","Z79.4","M25.512","M75.52","C79.51","Z51.0","C34.12","R60.9","C90.00","C90.30","Z78.9","C90.01","R22.43","Z79.899","Z94.84","D64.81","D70.1","T45.1X5A","R79.89","E83.42","Z95.828","D69.59","G89.29","M54.9","E11.40","D70.9","E83.39","D69.6","Z87.891","Z79.01","Z90.49","Z86.718","L03.116","R91.8","R60.0","K12.31","Z79.2","Z08.","Z85.79","I49.8","R53.83","Z71.89","K12.30","R19.7","E87.5","N17.9","I82.C11","E11.29","Z72.0","V58.89","Z51.11","Z51.12","R25.2","M84.58XA","R06.02","Z45.2","D61.810","K92.81","I11.9","R62.7","E83.51","E87.6","R94.4","T38.0X5A","G62.9","N47.1","Z11.3","M19.012","N47.8","E11.69","N40.0","R35.1","N52.1","M75.02","E78.5","B18.2","N18.9","Z12.5","Z23.","M48.54XA","G89.3","K59.00","C80.1","Z86.19","Z82.49","K08.89","T82.9XXA","F17.210","Z94.81","Z88.8","Z79.891","L53.9","C34.11","R53.1","H53.8","M79.662","M79.661","E09.65","I82.C21","G62.0","M67.912","M79.652","M79.651","M79.604","M79.605","D64.9","R03.0","T14.8XXA","V87.7XXA","R52.","C79.9","I95.9","E86.1","I43.","L02.91","S70.361A","R21.","B95.0","B95.4","Z83.3","G89.4","M79.89","Z92.21","E87.8","E11.42","Z52.011","M79.606","E83.89","R00.0","R76.8"],"date":["2020-07-16","2020-08-25","2021-02-08","2020-08-25","2022-05-27","2022-05-19","2022-05-19","2020-10-20","2020-10-20","2022-10-05","2021-04-05","2022-10-05","2022-05-19","2022-10-05","2022-10-05","2022-02-22","2022-10-06","2022-04-04","2022-06-17","2022-07-07","2022-06-17","2022-06-17","2022-06-17","2022-06-17","2022-05-27","2022-04-22","2022-06-17","2022-05-27","2022-05-27","2022-05-19","2022-05-19","2022-05-19","2022-05-19","2022-05-19","2022-05-19","2022-05-19","2022-05-19","2020-07-13","2021-02-12","2022-09-28","2022-04-11","2022-04-06","2022-04-08","2022-04-08","2022-03-14","2022-03-23","2022-06-17","2022-03-29","2022-03-29","2022-04-06","2022-05-19","2022-05-02","2021-05-12","2020-07-29","2020-07-27","2021-05-20","2021-05-10","2021-03-21","2021-04-05","2022-01-10","2022-03-09","2022-03-14","2022-03-21","2022-03-14","2022-03-14","2022-03-14","2022-04-01","2022-03-14","2022-03-22","2022-05-12","2020-09-09","2020-07-06","2020-10-20","2020-09-09","2020-09-09","2020-09-09","2020-09-09","2020-09-09","2020-10-20","2021-05-12","2020-10-28","2020-10-28","2020-10-28","2022-10-06","2021-02-09","2022-05-27","2021-02-09","2021-02-09","2021-03-01","2021-02-09","2022-02-02","2022-02-22","2022-02-22","2022-02-22","2022-02-22","2022-03-22","2022-02-22","2021-03-01","2021-05-23","2021-05-23","2021-05-23","2022-03-14","2022-03-22","2022-04-27","2022-05-27","2020-08-20","2021-03-21","2021-03-21","2021-05-20","2021-05-20","2022-03-14","2021-05-20","2020-06-29","2020-06-29","2021-02-04","2021-02-13","2021-06-28","2021-05-23","2021-06-02","2022-01-15","2022-01-15","2022-01-15","2020-07-13","2020-07-13","2020-07-13","2021-02-12","2022-09-25","2022-05-19","2022-04-11","2022-04-27","2022-04-27","2021-05-28","2022-04-01","2022-04-14","2022-04-14"],"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":[["","00406012305","HYDROCO\/APAP","TAB 5-325MG","15","Select","Select",""],["","68462042121","ATOVAQUONE","SUS 750\/5ML","210","Select","Select",""],["","59572042521","REVLIMID","CAP 25MG","14","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","53489011905","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","00169633910","NOVOLOG","INJ FLEXPEN","9","Select","Select",""],["","65862039110","ONDANSETRON","TAB 8MG ODT","30","Select","Select",""],["","43547040111","FUROSEMIDE","TAB 20MG","10","Select","Select",""],["","00088221905","LANTUS","INJ 100\/ML","15","Select","Select",""],["","00169185189","NOVOFINE","MIS 32GX6MM","300","Select","Select",""],["","53885027150","ONETOUCH","TES VERIO","100","Select","Select",""],["","55111012205","ATORVASTATIN","TAB 20MG","30","Select","Select",""],["","69097094312","GABAPENTIN","CAP 300MG","90","Select","Select",""],["","59746011506","PROCHLORPER","TAB 10MG","60","Select","Select",""],["","27241009706","DULOXETINE","CAP 20MG","30","Select","Select",""],["","73070010315","INSULIN","INJ FLEXPEN","15","Select","Select",""],["","62332002891","LOSARTAN","TAB 50MG","30","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","60","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","12","Select","Select",""],["","68382079101","ACYCLOVIR","TAB 400MG","60","Select","Select",""],["","00003089421","ELIQUIS","TAB 5MG","60","Select","Select",""],["","07610032024","MAG","TAB 400MG","30","Select","Select",""],["","62332004890","LOSARTAN\/HCT","TAB 50-12.5","30","Select","Select",""],["","63304045101","MORPHINE","TAB 30MG ER","60","Select","Select",""],["","08290320122","BD  PEN NEEDL","MIS 32GX4MM","100","Select","Select",""],["","00173068220","VENTOLIN","AER ","18","Select","Select",""],["","50428029464","CVS","TAB 8.6-50MG","60","Select","Select",""],["","59746017506","PREDNISONE","TAB 20MG","15","Select","Select",""],["","00054418425","DEXAMETHASON","TAB 4MG","120","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","18","Select","Select",""],["","59779058401","STOOL","TAB 8.6-50MG","60","Select","Select",""],["","65162019011","NAPROXEN","TAB 500MG","30","Select","Select",""],["","64380080707","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","91237000128","ALCOHOL","PAD ","400","Select","Select",""],["","50111033401","METRONIDAZOL","TAB 500MG","30","Select","Select",""],["","50428085942","PREP","PAD ","100","Select","Select",""],["","68645055654","LISINOP\/HCTZ","TAB 10-12.5","30","Select","Select",""],["","50484001030","SANTYL","OIN 250\/GM","30","Select","Select",""],["","16714047802","AMOX\/K","TAB 875-125","20","Select","Select",""],["","70377000215","SIMVASTATIN","TAB 10MG","30","Select","Select",""],["","45802005911","NYSTATIN","CRE 100000","60","Select","Select",""],["","68462018022","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","67877041984","LINEZOLID","TAB 600MG","20","Select","Select",""],["","10702000709","CYCLOBENZAPR","TAB 10MG","20","Select","Select",""],["","43547035411","LISINOPRIL","TAB 20MG","30","Select","Select",""],["","16714069301","FLUCONAZOLE","TAB 200MG","10","Select","Select",""],["","65862018601","CLINDAMYCIN","CAP 300MG","28","Select","Select",""],["","00904645780","DOK","CAP 100MG","30","Select","Select",""],["","00002879959","HUMALOG","INJ 100\/ML","15","Select","Select",""],["","00363058714","ASPIRIN","TAB 81MG EC","30","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":""}]}]}