{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ELADIA FIGUEROA","gend":1,"add":"3052 KINGS ROW CT","city":"VIRGINIA BEACH","state":"VA","zip":"23452-9998","dob":"1960-11-16","age":"","mstatus":"","insh":"20062701*01","cliId":"","pno":"848\/212-1008","cno":"","email":"","ename":"","eno":"","pphy":"GRAHAM, TAMARA N PA","ppno":"757\/446-8920","pcpadd":"825 FAIRFAX AVE SUITE 445","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23507,"pcpcounty":"","pcpid":"","pcpname":"EVMS Internal Medicine","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/446-5242","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["B20.","Z11.3","Z11.1","Z11.59","Z20.822","H61.91","D48.5","H15.101","Z72.0","J15.9","J44.0","J20.9","R05.","C44.212","Z20.828","K21.9","R68.83","C69.10","B02.39","R73.9","E78.5","J30.9","J45.909","F41.9","NO DATA","Z76.0","Z03.818","H40.1113","Z00.00","I10.","F32.9","F41.0","E55.9","S29.019A","M54.6","H00.032","H00.031","R03.0","Z13.1","Z23.","F17.210","Z88.1","H16.141","H04.121","H40.003","H40.1132","K08.9","H02.051","H25.12","R21.","B02.9","H40.1112","M54.9","K08.89","Z97.2"],"date":["2021-09-16","2021-09-16","2020-06-17","2020-08-20","2021-02-17","2021-10-11","2021-10-11","2020-10-03","2021-09-16","2021-04-15","2021-04-15","2021-04-15","2021-04-26","2021-10-29","2021-05-24","2020-12-02","2021-02-08","2021-10-21","2021-10-21","2021-10-21","2021-10-21","2021-10-21","2021-10-21","2021-10-21","2021-10-21","2020-04-17","2020-08-20","2020-10-05","2020-04-22","2020-04-22","2020-05-06","2020-04-22","2020-05-06","2020-06-09","2020-06-09","2020-12-14","2020-12-14","2021-09-16","2021-09-16","2021-09-16","2020-06-09","2020-06-09","2020-07-10","2020-07-10","2021-11-01","2021-04-21","2021-09-16","2021-11-01","2021-11-01","2020-06-18","2020-06-18","2021-04-07","2021-04-26","2020-10-23","2020-10-23"],"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":[["","","SIMBRINZA","SUS 1-0.2%","","Select","Select",""],["","","OFLOXACIN","DRO 0.3% OP","","Select","Select",""],["","","NYSTATIN","SUS 100000","","Select","Select",""],["","","DAILY-VITE","TAB ","","Select","Select",""],["","00363035926","WAL-TUSSIN","LIQ DM","118","Select","Select",""],["","","TIVICAY","TAB 50MG","","Select","Select",""],["","","DESCOVY","TAB 200\/25","","Select","Select",""],["","","WIXELA","AER 250\/50","","Select","Select",""],["","","ALPHAGAN","SOL 0.001","","Select","Select",""],["","","ALPRAZOLAM","TAB 0.25MG","","Select","Select",""],["","","FLUTICASONE","SPR 50MCG","","Select","Select",""],["","31722072690","MONTELUKAST","TAB 10MG","90","Select","Select",""],["","","METOPROL","TAB 25MG ER","","Select","Select",""],["","00173068220","VENTOLIN","AER ","18","Select","Select",""],["","","ALBUTEROL","AER HFA","","Select","Select",""],["","59762033302","LATANOPROST","SOL 0.00005","10","Select","Select",""],["","","NAPROXEN","TAB 500MG","","Select","Select",""],["","","CYCLOBENZAPR","TAB 10MG","","Select","Select",""],["","00023320505","LUMIGAN","SOL 0.0001","5","Select","Select",""],["","","OMEPRAZOLE","CAP 40MG","","Select","Select",""],["","31722088390","ROSUVASTATIN","TAB 10MG","90","Select","Select",""],["","80681002000","MULTIVITAMIN","TAB ","90","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","42806031250","DOXYCYCL","TAB 100MG","14","Select","Select",""],["","51672126401","FLUOCINONIDE","OIN 0.0005","30","Select","Select",""],["","","ESCITALOPRAM","TAB 10MG","","Select","Select",""],["","","BENZONATATE","CAP 200MG","","Select","Select",""],["","00031875912","ROBIT","LIQ 20-200SF","1500","Select","Select",""],["","24208048510","DORZOLAMIDE","SOL 2% OP","10","Select","Select",""],["","64380080707","IBUPROFEN","TAB 800MG","90","Select","Select",""],["","59267100002","PFIZER","INJ COVID-19","0","Select","Select",""],["","","LIDOCAINE","SOL 2% VISC","","Select","Select",""],["","","FENOFIBRATE","CAP 134MG","","Select","Select",""],["","","PANTOPRAZOLE","TAB 40MG","","Select","Select",""],["","45802005536","TRIAMCINOLON","OIN 0.001","80","Select","Select",""],["","","LORATADINE","TAB 10MG","","Select","Select",""],["","70074040701","ENSURE","LIQ CHOCOLAT","11376","Select","Select",""],["","","VITAMIN","TAB 50000UNI","","Select","Select",""],["","96295013575",""," ","30","Select","Select",""],["","00904053913","THERA","TAB ","90","Select","Select",""],["","24208079535","NEO\/POLY\/DEX","OIN 0.1% OP","4","Select","Select",""],["","96295012832","ONE","TAB MULTIVIT","30","Select","Select",""],["","00904053060","TAB-A-VITE","TAB ","30","Select","Select",""],["","00904548652","CERTAVITE","TAB SENIOR","30","Select","Select",""],["","","AZITHROMYCIN","TAB 250MG","","Select","Select",""],["","","CETIRIZINE","TAB 10MG","","Select","Select",""],["","","CEPHALEXIN","CAP 500MG","","Select","Select",""],["","","ERYTHROMYCIN","OIN 5MG\/GM","","Select","Select",""],["","","ZYRTEC","TAB 10MG","","Select","Select",""],["","","VALACYCLOVIR","TAB 1GM","","Select","Select",""],["","","LORAZEPAM","TAB 1MG","","Select","Select",""],["","","MIRTAZAPINE","TAB 7.5MG","","Select","Select",""],["","","LOSARTAN","TAB 25MG","","Select","Select",""],["","","RESTASIS","EMU 0.0005","","Select","Select",""],["","","CHLORHEX","SOL 0.0012","","Select","Select",""],["","","LOTEMAX","GEL 0.005","","Select","Select",""],["","","PROAIR","AER ","","Select","Select",""],["","","AFLURIA","INJ 2020-21","","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":""}]}]}