{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"RICHARD   L PAYTON","gend":0,"add":"2608 KELLER AVE 1948 LANDSTOWN CENTRE WAY","city":"NORFOLK","state":"VA","zip":"23509-9998","dob":"1964-04-25","age":"","mstatus":"","insh":"20069298*01","cliId":"","pno":"757\/621-1120","cno":"757\/621-1120","email":"","ename":"","eno":"","pphy":"NEWBY, JAMES E MD","ppno":"757\/627-6892","pcpadd":"STE 220 930 MAJESTIC AVE","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23504,"pcpcounty":"","pcpid":"","pcpname":"Primary Care Specialists","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/627-5809","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R69.","R68.89","H40.053","H40.043","E11.8","Z79.4","H35.033","E11.3313","E11.65","Z68.26","I10.","H20.043","H40.042","I25.10","R53.1","R07.9","M25.522","M25.422","G62.9","I51.7","H25.813","E11.3393","E11.3312","I49.3","E11.9","Z95.5","Z86.73","E11.3311","M25.572","E78.5","K59.00","H43.812","Z96.1","R55.","I25.2","Z79.899","Z91.09","D64.9","E55.9","R42.","I73.9","L97.509","I70.209","R27.0","R29.898","M47.812","M48.02","I65.03","R26.2","G46.4","I67.9","M62.81","E04.1","H81.10","R53.81","I63.9","M54.12","H25.811","H40.023","H25.812","E11.43","I95.1","E11.42","Z99.3","I25.118","Z68.27","N17.9","R26.9","Z68.25","I63.50","E78.00","R01.1","R60.9","R94.31","M19.90","F32.9","E11.3299","Z68.21","H20.042","I69.393","H26.491","I25.119","H26.9","Z68.28"],"date":["2022-07-30","2022-10-17","2022-09-22","2022-09-22","2022-03-09","2021-03-12","2022-04-14","2022-08-15","2022-10-04","2022-04-06","2022-04-06","2022-02-25","2022-02-25","2022-04-18","2021-02-18","2021-02-28","2021-02-23","2021-02-23","2021-10-12","2022-04-18","2021-04-09","2021-04-09","2022-01-05","2021-02-17","2022-05-21","2022-05-21","2021-02-17","2022-01-05","2020-10-26","2022-04-06","2021-04-27","2021-12-29","2022-06-01","2022-05-21","2022-05-21","2022-05-21","2022-05-21","2022-05-21","2022-05-21","2022-05-21","2022-10-11","2022-10-11","2022-10-11","2020-11-17","2020-10-01","2020-10-01","2020-10-01","2020-10-01","2020-10-01","2021-02-16","2020-10-01","2020-10-01","2020-10-01","2020-10-01","2020-10-01","2021-10-12","2020-12-10","2021-07-16","2021-08-13","2021-08-20","2021-12-17","2020-11-17","2021-01-26","2021-01-26","2021-02-17","2022-03-09","2022-05-21","2021-10-12","2021-10-12","2022-04-18","2022-04-18","2022-04-18","2022-04-18","2022-04-18","2022-04-18","2020-10-19","2020-10-19","2020-10-19","2021-11-04","2021-12-17","2022-06-01","2021-02-16","2021-08-09","2021-08-09"],"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":[["","60505622500","BRIMO\/TIMOLO","SOL 0.2\/0.5%","5","Select","Select",""],["","00002773701","INSULIN","INJ 100\/ML","30","Select","Select",""],["","61314063710","PREDNISOLONE","SUS 1% OP","10","Select","Select",""],["","08508200005","OMNIPOD","MIS 5 PACK","15","Select","Select",""],["","17478071510","BRIMONIDINE","SOL 0.2% OP","5","Select","Select",""],["","00002143380","TRULICITY","INJ 0.75\/0.5","2","Select","Select",""],["","60505267108","ATORVASTATIN","TAB 80MG","30","Select","Select",""],["","13107000130","MIRTAZAPINE","TAB 7.5MG","30","Select","Select",""],["","59746012206","MECLIZINE","TAB 12.5MG","90","Select","Select",""],["","72065012012","GVOKE","INJ .5\/.1ML","0","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","40","Select","Select",""],["","16729021816","CLOPIDOGREL","TAB 75MG","30","Select","Select",""],["","00002751001","HUMALOG","INJ 100\/ML","30","Select","Select",""],["","08627001601","DEXCOM","MIS TRANSMIT","1","Select","Select",""],["","00378108601","COLCHICINE","TAB 0.6MG","11","Select","Select",""],["","61314012605","KETOROLAC","SOL 0.005","15","Select","Select",""],["","70069013101","TOBRAMYCIN","SOL 0.3% OP","5","Select","Select",""],["","61314035502","TROPICAMIDE","SOL 1% OP","15","Select","Select",""],["","68180035109","SERTRALINE","TAB 25MG","27","Select","Select",""],["","65862001005","METFORMIN","TAB 1000MG","60","Select","Select",""],["","52817031910","BACLOFEN","TAB 5MG","90","Select","Select",""],["","00254101196","SUCRALFATE","SUS 1GM\/10ML","420","Select","Select",""],["","50458057760","XARELTO","TAB 2.5MG","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":""}]}]}