{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JENNIFER WALTERS","gend":1,"add":"1444 N BRADEN CRST APT A","city":"NORFOLK","state":"VA","zip":"23502-9998","dob":"1973-08-22","age":"","mstatus":"","insh":"20064178*01","cliId":"","pno":"757\/582-4947","cno":"757\/582-4947","email":"","ename":"","eno":"","pphy":"LAPLACE, PETER MD","ppno":"757\/623-6072","pcpadd":"426 E FREEMASON ST","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23510,"pcpcounty":"","pcpid":"","pcpname":"Associates in Primary Care, PC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/623-9748","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M21.961","M19.171","T84.84XA","M25.471","V58.89","L03.115","I10.","M25.579","G43.009","J30.1","F41.9","J45.998","F31.32","D68.69","K29.90","NO DATA","R11.2","K21.9","R10.13","R11.10","K82.8","Z87.891","Z88.6","Z91.040","Z88.5","Z88.8","Z91.018","Z91.048","Z88.3","F43.10","F39.","V62.84","M54.5","M54.16","R20.2","B35.1","L60.0","F41.1","F32.0","G47.00","R07.9","R51.9","M54.32","Z00.00","L30.8","Z01.419","Z12.11","R11.0","S93.401A","M54.2","F60.3","F31.0","F51.4","R10.9","F31.9","M25.539","J30.89","H69.82","J30.81","D72.823","N39.0","Z13.89","F43.20","U07.1","J98.01","K29.70","K44.9","R05.9","K30.","K58.8","R74.0","D53.9","M79.89","M65.9","B34.9","R31.9","R10.2","G57.31","K64.9","K63.3","E66.01","Z68.41","R19.7","Z20.822","R53.83","R53.81","R19.8","J45.20","M62.830","K29.80","R10.32","M79.674","M79.675","H69.83","H93.293","S13.4XXA","R07.89","S33.5XXA","S93.421A","M79.604","Z11.1","G89.29","M46.1","K29.60","S76.111A","S33.8XXA","M25.532","M25.531","R60.9","M79.2","R20.0","L30.9","M25.571","G44.201","K52.89","K64.8","J45.909","R06.02","G43.909","Z82.49","Z79.82","Z79.899","R05.","R50.9","Z11.9","F17.290","M65.871","M24.874","Z11.59","K52.9","M16.7","M79.645","T78.04XA"],"date":["2020-06-15","2021-05-18","2021-02-15","2021-01-11","2020-11-16","2020-07-27","2022-09-13","2020-10-07","2022-09-13","2021-05-11","2022-09-13","2022-09-13","2022-03-05","2021-10-20","2022-01-24","2022-10-11","2022-05-12","2022-08-25","2022-07-19","2022-05-06","2022-05-09","2022-05-10","2022-05-10","2022-05-10","2022-05-10","2022-05-10","2022-05-10","2022-05-10","2022-05-06","2022-11-22","2022-08-26","2022-08-25","2021-02-22","2022-10-11","2020-11-16","2021-08-10","2021-08-10","2022-11-16","2022-08-26","2021-02-18","2022-05-12","2022-05-05","2021-11-09","2022-09-13","2021-07-06","2022-09-13","2022-09-13","2022-04-29","2020-05-14","2022-10-04","2022-11-16","2022-11-16","2022-11-16","2022-05-12","2022-09-13","2022-09-13","2020-04-09","2020-04-09","2020-04-09","2020-04-30","2021-02-22","2022-03-24","2022-03-24","2022-06-06","2022-06-06","2022-06-21","2022-06-21","2022-06-28","2022-07-19","2022-07-19","2020-06-25","2020-06-25","2020-07-14","2020-07-14","2020-08-07","2020-11-18","2020-11-18","2021-04-15","2021-09-29","2022-05-17","2021-09-29","2021-09-29","2021-12-22","2021-12-22","2021-12-22","2021-12-22","2022-01-20","2022-06-21","2022-08-15","2022-01-27","2022-03-25","2020-03-06","2020-03-06","2020-04-02","2020-04-02","2020-04-27","2022-05-10","2020-04-27","2020-05-14","2021-02-15","2021-04-20","2022-05-10","2022-01-13","2022-01-24","2022-07-03","2022-08-01","2022-10-11","2022-10-11","2020-10-28","2021-01-11","2021-01-11","2021-02-18","2021-03-05","2021-07-01","2021-09-29","2021-09-29","2021-09-29","2021-09-29","2021-09-29","2021-09-29","2021-09-29","2021-09-29","2021-01-28","2020-03-16","2020-03-16","2020-03-16","2020-07-14","2020-07-14","2021-01-22","2022-05-17","2022-07-30","2022-10-18","2022-10-18"],"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":[["","59310057922","PROAIR","AER ","8","Select","Select",""],["","43199001301","HYOSCYAMINE","TAB 0.125MG","30","Select","Select",""],["","10702000709","CYCLOBENZAPR","TAB 10MG","30","Select","Select",""],["","00093100301","BUSPIRONE","TAB 15MG","45","Select","Select",""],["","50111056001","TRAZODONE","TAB 50MG","30","Select","Select",""],["","68645052354","SERTRALINE","TAB 100MG","45","Select","Select",""],["","16729017317","AMITRIPTYLIN","TAB 50MG","90","Select","Select",""],["","00005200010","PREVNAR","INJ ","0","Select","Select",""],["","29033000305","SUCRALFATE","TAB 1GM","120","Select","Select",""],["","00186037020","SYMBICORT","AER 160-4.5","10","Select","Select",""],["","68382004101","PROMETHAZINE","TAB 25MG","30","Select","Select",""],["","00527411837","PROPRANOLOL","CAP 120MG ER","30","Select","Select",""],["","55111064530","OMEPRAZOLE","CAP 40MG","30","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0","Select","Select",""],["","57896044101","BISACODYL","TAB 5MG EC","2","Select","Select",""],["","62175044601","PEG","SOL ELECTROL","4000","Select","Select",""],["","69452014430","BENZONATATE","CAP 200MG","60","Select","Select",""],["","16729013616","CLONAZEPAM","TAB 0.5MG","20","Select","Select",""],["","00143122701","DICYCLOMINE","TAB 20MG","360","Select","Select",""],["","64380076921","PEG-3350\/KCL","SOL \/SODIUM","4000","Select","Select",""],["","00093220301","METOCLOPRAM","TAB 10MG","2","Select","Select",""],["","00172392660","DIAZEPAM","TAB 5MG","10","Select","Select",""],["","47781062801","BUTAL\/APAP","TAB 50-325MG","69","Select","Select",""],["","55111053301","DIVALPROEX","TAB 250MG ER","60","Select","Select",""],["","00054001829","PREDNISONE","TAB 20MG","12","Select","Select",""],["","70010077001","METHOCARBAM","TAB 750MG","25","Select","Select",""],["","29300011101","LAMOTRIGINE","TAB 25MG","60","Select","Select",""],["","00093598627","EPINEPHRINE","INJ 0.3MG","2","Select","Select",""],["","55111015430","ONDANSETRON","TAB 8MG","60","Select","Select",""],["","65862007930","TERBINAFINE","TAB 250MG","90","Select","Select",""],["","00093831118","ELETRIPTAN","TAB 40MG","18","Select","Select",""],["","29300013501","CLONIDINE","TAB 0.1MG","60","Select","Select",""],["","43547040211","FUROSEMIDE","TAB 40MG","180","Select","Select",""],["","43598065530","BUPROPN","TAB 150MG XL","30","Select","Select",""],["","62542030103","HYD","SUS 10-8\/5ML","100","Select","Select",""],["","68180044501","QUETIAPINE","TAB 25MG","60","Select","Select",""],["","00406048410","APAP\/CODEINE","TAB 300-30MG","30","Select","Select",""],["","69238110002","DOXYCYCL","CAP 100MG","14","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","68645051654","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","51672400501","CARBAMAZEPIN","TAB 200MG","60","Select","Select",""],["","45802006535","TRIAMCINOLON","CRE 0.005","30","Select","Select",""],["","67877021905","CEPHALEXIN","CAP 500MG","14","Select","Select",""],["","51672127406","BETAMETH","CRE 0.0005","45","Select","Select",""],["","13107007501","BUT\/APAP\/CAF","CAP ","30","Select","Select",""],["","55111017915","TIZANIDINE","TAB 2MG","60","Select","Select",""],["","68462029201","VERAPAMIL","TAB 120MG ER","90","Select","Select",""],["","45802041926","AMMONIUM","LOT 0.12","400","Select","Select",""],["","72618300002","NURTEC","TAB 75MG ODT","15","Select","Select",""],["","65162019011","NAPROXEN","TAB 500MG","60","Select","Select",""],["","00002143611","EMGALITY","INJ 120MG\/ML","1","Select","Select",""],["","67877026118","RIZATRIPTAN","TAB 5MG","12","Select","Select",""],["","00023650110","UBRELVY","TAB 100MG","10","Select","Select",""],["","68645056354","IBUPROFEN","TAB 800MG","90","Select","Select",""],["","55513084301","AIMOVIG","INJ 140MG\/ML","1","Select","Select",""],["","00049234045","RELPAX","TAB 40MG","18","Select","Select",""],["","49348089392","SM","POW ","510","Select","Select",""],["","45802014167","CICLOPIROX","SOL 0.08","7","Select","Select",""],["","00310737020","BUDES\/FORMOT","AER 160-4.5","10","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","58657064550","CARISOPRODOL","TAB 350MG","30","Select","Select",""],["","50111078751","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","67877022210","GABAPENTIN","CAP 100MG","270","Select","Select",""],["","31722054201","INDOMETHACIN","CAP 25MG","30","Select","Select",""],["","00406012305","HYDROCO\/APAP","TAB 5-325MG","28","Select","Select",""],["","29300012510","MELOXICAM","TAB 15MG","30","Select","Select",""],["","00406051205","OXYCOD\/APAP","TAB 5-325MG","28","Select","Select",""],["","31722070190","LOSARTAN","TAB 50MG","30","Select","Select",""],["","16714069211","FLUCONAZOLE","TAB 150MG","2","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":""}]}]}