{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"NANCY MILLER","gend":1,"add":"1542 MALIBU PL","city":"NEWPORT NEWS","state":"VA","zip":"23608-9998","dob":"1958-10-18","age":"","mstatus":"","insh":"20068585*01","cliId":"","pno":"757\/968-5328","cno":"757\/968-5328","email":"","ename":"","eno":"","pphy":"VERNON, SANDRIA T MD","ppno":"757\/930-0091","pcpadd":"12715 WARWICK BLVD STE O","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":23606,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/269-4406","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.9","B35.1","G57.61","M72.2","M24.571","M20.42","M20.41","E78.5","Z82.49","F33.1","E11.3311","H43.823","E11.3312","U07.1","J96.01","R06.02","G47.33","M20.40","L84.","M06.4","E55.9","G51.0","E11.3313","Z23.","E11.3319","E11.59","E11.69","Z79.4","I15.2","M15.9","Z79.899","M17.0","J32.9","Z20.822","I08.3","I63.9","R29.810","R29.898","F41.9","I10.","E03.9","E66.01","R25.1","R07.9","I05.8","M25.871","R78.81","B95.7","NO DATA","L20.84","Z09.","Z87.2","L82.0","L53.8","R07.89","G47.30","R91.1","Z78.9","R00.0","R06.82","R73.09","W19.XXXA","R60.0","Z86.73","Z79.82","R74.01","E87.6","E83.51","R09.89","E11.65","I08.0","I49.9","I70.213","Z68.42","V58.69","M13.80","D72.829","T38.0X5A","E11.649","E78.00","I26.99","E11.8","R41.3","R10.13","R63.4","R14.2","K59.09","Z86.010","Z91.14","F41.1","B30.9","J00.","D48.5","I45.81","R94.31","I82.4Y3","R79.89","Z79.84","Z96.1","H52.13","H52.223","H52.4","L65.0","L57.0","R53.1","H43.811","H02.206","L82.1","D22.5","Z71.89","Z91.040","Z88.1","Z88.7","Z88.2","Z88.8","Z91.014","Z91.013","R09.81","U09.9","D84.9","I82.432","Z68.41","E66.9","Z79.01","R06.89","M62.81","R51.","G81.94","R27.8","D64.9","G43.909","F32.9","N30.00","L30.9","R10.10","K59.00","Z12.11","K59.04","Z53.09","Z86.16","Z86.711","Z86.718","F32.89","Z63.6"],"date":["2022-10-12","2022-10-12","2021-10-15","2021-10-15","2021-10-15","2022-09-29","2022-09-29","2022-09-28","2022-01-22","2022-02-10","2021-11-19","2021-11-19","2021-11-19","2022-03-04","2022-03-04","2022-02-09","2022-07-13","2022-05-04","2022-10-12","2022-07-14","2022-07-14","2021-03-29","2022-09-28","2021-10-22","2021-10-22","2022-09-28","2022-09-28","2022-09-28","2022-09-28","2021-12-09","2022-06-28","2021-12-09","2022-01-22","2022-02-07","2022-02-08","2020-08-14","2020-08-14","2020-08-14","2022-09-16","2022-06-28","2022-06-28","2022-06-02","2021-03-29","2021-04-18","2021-04-18","2021-10-15","2022-02-03","2022-02-03","2022-02-07","2021-02-16","2021-11-04","2021-11-04","2021-02-16","2020-08-12","2021-04-17","2022-06-28","2021-04-17","2022-09-28","2022-01-28","2022-01-28","2022-01-28","2022-01-28","2022-02-01","2022-02-03","2022-02-03","2022-02-03","2022-02-03","2022-02-03","2020-08-13","2022-09-20","2020-08-14","2021-04-19","2021-04-23","2022-01-28","2022-01-28","2022-01-28","2022-02-07","2022-01-28","2022-01-28","2022-06-28","2022-02-07","2022-09-15","2022-10-06","2022-09-20","2022-09-20","2022-09-20","2022-09-20","2022-09-20","2022-09-20","2022-10-25","2020-09-14","2020-09-14","2021-11-04","2022-02-07","2022-02-07","2022-02-07","2022-02-07","2022-06-28","2022-04-07","2022-04-07","2022-04-07","2022-04-07","2022-05-05","2022-05-05","2020-08-13","2020-08-17","2020-08-17","2021-11-04","2021-11-04","2021-11-04","2022-01-22","2022-06-28","2022-06-28","2022-01-22","2022-01-22","2022-01-22","2022-01-22","2022-01-22","2022-02-07","2022-02-07","2022-02-07","2022-06-02","2022-02-07","2022-06-28","2022-02-07","2020-08-13","2020-08-14","2020-08-14","2020-08-14","2020-08-14","2020-08-14","2020-08-14","2022-03-01","2022-03-01","2022-06-20","2022-06-20","2022-06-28","2022-06-28","2022-06-28","2022-06-28","2022-06-28","2022-06-28","2022-09-16","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":[["","72511076002","REPATHA","INJ 140MG\/ML","2","Select","Select",""],["","00378180377","LEVOTHYROXIN","TAB 50MCG","30","Select","Select",""],["","00169413212","OZEMPIC","INJ 2\/1.5ML","2","Select","Select",""],["","68382005101","MELOXICAM","TAB 15MG","30","Select","Select",""],["","65862050320","AMOX\/K","TAB 875-125","20","Select","Select",""],["","51224002218","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","16729021715","SERTRALINE","TAB 100MG","30","Select","Select",""],["","50458057930","XARELTO","TAB 20MG","30","Select","Select",""],["","64980033912","MAGNESIUM-OX","TAB 400MG","60","Select","Select",""],["","00185012201","NITROFURANTN","CAP 100MG","10","Select","Select",""],["","51672128202","TRIAMCINOLON","CRE 0.001","30","Select","Select",""],["","67877041305","METFORMIN","TAB 500MG ER","120","Select","Select",""],["","00597015230","JARDIANCE","TAB 10MG","30","Select","Select",""],["","00169633910","NOVOLOG","INJ FLEXPEN","15","Select","Select",""],["","65162010250","GABAPENTIN","CAP 300MG","60","Select","Select",""],["","72733590102","PRALUENT","INJ 75MG\/ML","2","Select","Select",""],["","31722070090","LOSARTAN","TAB 25MG","30","Select","Select",""],["","73070010315","INSULIN","INJ FLEXPEN","15","Select","Select",""],["","00002143480","TRULICITY","INJ 1.5\/0.5","2","Select","Select",""],["","29300012810","HYDROCHLOROT","TAB 25MG","30","Select","Select",""],["","00088221905","LANTUS","INJ 100\/ML","15","Select","Select",""],["","45802065078","LORATADINE","TAB 10MG","30","Select","Select",""],["","00591079601","SULFASALAZIN","TAB 500MG","120","Select","Select",""],["","57237007810","ONDANSETRON","TAB 8MG ODT","12","Select","Select",""],["","00172572860","FAMOTIDINE","TAB 20MG","60","Select","Select",""],["","62037099901","POT  CL MICRO","TAB 20MEQ ER","30","Select","Select",""],["","60258017101","MAG","TAB 400MG","60","Select","Select",""],["","57599080000","FREESTY","KIT 2 SENSOR","2","Select","Select",""],["","64380080707","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","00781261305","AMOXICILLIN","CAP 500MG","21","Select","Select",""],["","69618001501","ASPIRIN","TAB 325MG EC","30","Select","Select",""],["","68382039801","POT  CHLORIDE","TAB 20MEQ ER","30","Select","Select",""],["","00310653004","BYDUREON","INJ 2MG","4","Select","Select",""],["","08290320122","BD  PEN NEEDL","MIS 32GX4MM","100","Select","Select",""],["","00169185550","NOVOFINE","MIS 32GX4MM","100","Select","Select",""],["","00169406012","VICTOZA","INJ 18MG\/3ML","6","Select","Select",""],["","00245531990","KLOR-CON","TAB 20MEQ ER","30","Select","Select",""],["","49348081845","SM","TAB 10MG","30","Select","Select",""],["","54629089309","OMEGA-3","CAP 1000MG","60","Select","Select",""],["","68382080501","TRAZODONE","TAB 50MG","30","Select","Select",""],["","00378064110","PREDNISONE","TAB 10MG","39","Select","Select",""],["","00591371330","EZETIMIBE","TAB 10MG","30","Select","Select",""],["","16729028415","ROSUVASTATIN","TAB 5MG","30","Select","Select",""],["","55111046701","METOPROL","TAB 50MG ER","30","Select","Select",""],["","00093768432","OLOPATADINE","SOL 0.002","2","Select","Select",""],["","55111078430","FEXOFENADINE","TAB 180MG","30","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","53885027210","ONETOUCH","TES VERIO","100","Select","Select",""],["","45802091939","CETIRIZINE","TAB 10MG","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":""}]}]}