{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CHRISTIE DISHAROON","gend":1,"add":"2508 HAYWOOD AVE","city":"CHESAPEAKE","state":"VA","zip":"23324-9998","dob":"1976-09-26","age":"","mstatus":"","insh":"2143981*01","cliId":"","pno":"757\/636-8966","cno":"757\/636-8966","email":"","ename":"","eno":"","pphy":"RODRIGUEZ, HIRAM J MD","ppno":"757\/547-0688","pcpadd":"705 BATTLEFIELD BOULEVARD","pcpcity":"CHESAPEAKE","pcpstate":"VA","pcpzip":23320,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/547-2902","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J84.10","R06.02","M45.0","R42.","M54.9","M50.10","F43.23","J34.89","J34.2","J34.3","G43.009","R51.9","F41.9","R20.2","M54.12","G47.00","U07.1","G43.809","L30.9","R00.0","L03.811","I10.","Z86.16","G43.701","M79.7","F32.9","S16.1XXA","M54.10","Z86.69","R51.","Z15.89","Z79.1","R00.1","I49.3","G43.709","Z20.822","J02.9","J01.00","L50.9","Z86.19","M54.2","M54.6","G47.33","R00.2","R06.00","Z20.828","M51.36","Z79.899","M25.562","G43.909","R35.0","K51.819","M79.641","K51.019","K51.90","NO DATA","N39.3","Z23."],"date":["2020-09-17","2020-11-18","2020-11-12","2020-11-12","2021-10-01","2021-12-08","2020-09-30","2020-12-03","2020-12-03","2020-12-03","2022-09-23","2020-12-17","2021-11-22","2022-09-23","2022-09-23","2022-09-23","2022-01-19","2020-12-08","2020-06-15","2020-08-03","2020-09-23","2021-11-22","2021-02-08","2021-02-08","2021-11-22","2021-02-08","2021-07-01","2021-07-01","2021-11-22","2020-07-07","2020-10-21","2020-09-28","2020-12-23","2020-12-23","2020-12-29","2022-07-06","2022-07-06","2022-07-06","2020-07-29","2020-11-18","2022-09-12","2022-09-12","2022-09-23","2020-11-18","2020-06-01","2020-10-09","2020-10-21","2020-10-21","2021-01-03","2021-11-22","2021-11-22","2021-11-22","2021-11-22","2021-11-22","2021-11-22","2021-11-22","2021-11-22","2020-11-18"],"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":[["","52817032010","BACLOFEN","TAB 10MG","30","Select","Select",""],["","68001045500","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","68382013914","TOPIRAMATE","TAB 50MG","60","Select","Select",""],["","00002237711","EMGALITY","INJ 120MG\/ML","2","Select","Select",""],["","61442010301","DICLOFENAC","TAB 75MG DR","60","Select","Select",""],["","82607066026","FLOWFLEX","KIT TEST","8","Select","Select",""],["","55111029309","SUMATRIPTAN","TAB 100MG","9","Select","Select",""],["","68645047754","METOPROL","TAB 25MG ER","90","Select","Select",""],["","50111043303","TRAZODONE","TAB 50MG","30","Select","Select",""],["","59267102504","PFIZER","INJ ADLT RTU","0","Select","Select",""],["","52817033200","CYCLOBENZAPR","TAB 10MG","15","Select","Select",""],["","00603533815","PREDNISONE","PAK 10MG","21","Select","Select",""],["","51672400201","NORTRIPTYLIN","CAP 25MG","30","Select","Select",""],["","67877026218","RIZATRIPTAN","TAB 10MG","9","Select","Select",""],["","65162010150","GABAPENTIN","CAP 100MG","90","Select","Select",""],["","00172541211","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","00143928501","AMOXICILLIN","TAB 875MG","20","Select","Select",""],["","69097067905","PREGABALIN","CAP 75MG","60","Select","Select",""],["","68071026206","MAXALT","TAB 10MG","9","Select","Select",""],["","72618300002","NURTEC","TAB 75MG ODT","8","Select","Select",""],["","67877021905","CEPHALEXIN","CAP 500MG","21","Select","Select",""],["","00406012301","HYDROCO\/APAP","TAB 5-325MG","25","Select","Select",""],["","57237007710","ONDANSETRON","TAB 4MG ODT","30","Select","Select",""],["","33342002208","LEVOFLOXACIN","TAB 500MG","10","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","29300012501","MELOXICAM","TAB 15MG","30","Select","Select",""],["","70010075401","METHOCARBAM","TAB 500MG","30","Select","Select",""],["","59762444002","METHYLPRED","TAB 4MG","21","Select","Select",""],["","65862052830","VENLAFAXINE","CAP 75MG ER","30","Select","Select",""],["","13811071910","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","00093506101","HYDROXYZ","TAB 25MG","15","Select","Select",""],["","67877025145","TRIAMCINOLON","CRE 0.001","60","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","00143980350","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","55513084301","AIMOVIG","INJ 140MG\/ML","1","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":""}]}]}