{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CHRISTIE PUCKETT","gend":1,"add":"918 MODOC AVE APT A","city":"NORFOLK","state":"VA","zip":"23503-9998","dob":"1960-08-19","age":"","mstatus":"","insh":"20062328*01","cliId":"","pno":"757\/579-8779","cno":"757\/579-8779","email":"","ename":"","eno":"","pphy":"LAYNE, MICHAEL MD","ppno":"757\/446-5955","pcpadd":"825 FAIRFAX AVE SUITE 118","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23507,"pcpcounty":"","pcpid":"","pcpname":"EVMS Ghent Family Medicine","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/446-5196","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J45.901","R06.02","J96.01","M79.604","M79.605","I89.0","I10.","Z01.818","N85.02","Z92.3","R06.00","Z20.828","NO DATA","G47.33","G47.00","K43.9","Z79.811","Z86.711","Z79.01","R06.09","E11.9","J45.20","E66.01","Z68.44","Z79.899","Z79.84","Z79.51","N20.0","R05.9","J96.10","Z87.891","U07.1","N12.","N17.9","N13.2","R69.","Z01.812","Z20.822","J44.9","Z23.","J96.12","E66.2","R09.02","I26.99","I50.30","N23.","N10.","J96.91","J96.92","N39.0","N20.1","N95.0","J45.40","E66.9","R06.83","Z91.89","R60.9","Z99.81","Z88.5","Z88.8","R31.9","Z91.19","C54.1","G47.9","I87.2","J98.11","J45.909","I37.1","I26.09","R29.818","R53.83","I50.33","J96.11","F32.9","R10.9","I50.21","J44.1","R52.","G89.29","I50.9","J96.21","J96.22","I08.3","N13.30","B37.9","R11.0","Z68.45","M62.81","R26.89","I51.7","I51.89","I86.8","R06.2","I13.0","E11.22","F32.2","C54.9","Z51.5","G89.3","Z30.430","N85.4","T83.32XA","I11.0","I50.32","Z91.048","Z88.6","Z88.1","Z86.16","Z87.01","R91.8","F41.9","R00.2","N18.9","D64.1","Z83.49","Z71.89"],"date":["2022-01-14","2022-04-27","2022-01-13","2020-02-14","2020-02-14","2020-02-14","2022-07-20","2020-03-20","2021-07-23","2020-07-24","2022-09-20","2020-10-10","2022-10-24","2022-07-20","2021-07-14","2022-06-16","2021-07-23","2022-01-13","2022-06-16","2021-12-10","2022-08-10","2022-01-06","2022-09-20","2022-09-20","2021-10-21","2021-10-21","2021-10-21","2022-09-21","2021-12-20","2021-12-20","2022-01-06","2022-05-12","2022-04-05","2022-04-05","2022-06-04","2020-02-20","2021-04-12","2021-12-17","2022-10-24","2021-09-20","2022-07-20","2022-07-20","2022-10-24","2022-08-10","2022-08-10","2022-06-01","2022-06-01","2022-06-04","2022-06-04","2022-06-25","2022-06-03","2020-02-20","2020-12-03","2021-12-20","2021-04-25","2021-04-14","2021-06-10","2022-01-13","2021-12-20","2021-12-20","2022-06-25","2022-09-20","2022-08-31","2020-11-18","2020-12-08","2020-10-14","2020-08-20","2020-10-13","2022-02-17","2021-05-19","2021-05-19","2022-07-20","2022-07-20","2021-09-02","2021-12-08","2022-02-17","2022-04-27","2020-01-20","2020-02-09","2022-04-20","2022-01-14","2022-01-14","2022-05-12","2022-06-03","2022-06-25","2020-12-10","2021-04-25","2021-11-17","2021-11-17","2021-12-10","2021-12-10","2021-12-10","2021-12-15","2022-02-03","2021-12-15","2022-02-07","2022-02-07","2022-04-20","2020-02-01","2020-02-20","2020-03-31","2020-03-31","2022-01-13","2022-01-13","2022-01-06","2022-01-06","2022-01-06","2022-02-10","2022-02-10","2022-02-10","2022-02-21","2022-05-16","2022-08-10","2021-04-08","2022-01-13","2022-02-07"],"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":[["","00054429731","FUROSEMIDE","TAB 20MG","30","Select","Select",""],["","00955101510","ENOXAPARIN","INJ 150MG\/ML","60","Select","Select",""],["","00054001925","PREDNISONE","TAB 50MG","5","Select","Select",""],["","16729003410","LETROZOLE","TAB 2.5MG","90","Select","Select",""],["","00378932132","WIXELA","AER 250\/50","60","Select","Select",""],["","00054023763","MORPHINE","SOL 10MG\/5ML","500","Select","Select",""],["","50419025201","ADEMPAS","TAB 1.5MG","90","Select","Select",""],["","50111064801","FLUOXETINE","CAP 20MG","30","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","00093342505","LORAZEPAM","TAB 0.5MG","30","Select","Select",""],["","52817033010","CYCLOBENZAPR","TAB 5MG","10","Select","Select",""],["","70010049105","METFORMIN","TAB 500MG ER","180","Select","Select",""],["","00143992801","CIPROFLOXACN","TAB 500MG","8","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","27808023302","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","68382013201","TAMSULOSIN","CAP 0.4MG","14","Select","Select",""],["","00406055201","OXYCODONE","TAB 5MG","10","Select","Select",""],["","70954000520","OXYBUTYNIN","TAB 5MG","30","Select","Select",""],["","00781185220","AMOX\/K","TAB 875-125","10","Select","Select",""],["","65162062711","TRAMADOL","TAB 50MG","10","Select","Select",""],["","57237000511","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","00173069700","ADVAIR","AER 500\/50","60","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","40","Select","Select",""],["","53746051105","SPIRONOLACT","TAB 25MG","30","Select","Select",""],["","23155050105","HYDROXYZ","TAB 25MG","90","Select","Select",""],["","00225052547","AYR","GEL NASAL","28","Select","Select",""],["","65862015901","ZOLPIDEM","TAB 5MG","1","Select","Select",""],["","66993058697","FLUTIC\/SALME","AER 500\/50","60","Select","Select",""],["","10702000350","PROMETHAZINE","TAB 25MG","20","Select","Select",""],["","42806071401","BENZONATATE","CAP 100MG","30","Select","Select",""],["","00406051205","OXYCOD\/APAP","TAB 5-325MG","12","Select","Select",""],["","45802043321","DEXTROMETHOR","SUS 30MG\/5ML","89","Select","Select",""],["","00406012405","HYDROCO\/APAP","TAB 7.5-325","30","Select","Select",""],["","00378623201","CITALOPRAM","TAB 20MG","30","Select","Select",""],["","67877022201","GABAPENTIN","CAP 100MG","7","Select","Select",""],["","67877032005","IBUPROFEN","TAB 600MG","120","Select","Select",""],["","45802086802","POLYETH","POW 3350 NF","238","Select","Select",""],["","00904671980","ACETAMINOPHE","TAB 325MG","120","Select","Select",""],["","00173088210","BREO","INH 200-25","60","Select","Select",""],["","00173068220","VENTOLIN","AER ","18","Select","Select",""],["","68180098003","LISINOPRIL","TAB 10MG","90","Select","Select",""],["","57237007710","ONDANSETRON","TAB 4MG ODT","15","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":""}]}]}