{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"EDWARD   M VINCENT","gend":0,"add":"675 HOLLOMON DR","city":"HAMPTON","state":"VA","zip":"23666-9998","dob":"1960-04-08","age":"","mstatus":"","insh":"2277119*01","cliId":"","pno":"757\/768-4038","cno":"757\/768-4038","email":"","ename":"","eno":"","pphy":"HERBERT, DWIGHT C MD","ppno":"757\/594-4431","pcpadd":"12420 WARWICK BLVD BLDG 4 SUITE 4A","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":23606,"pcpcounty":"","pcpid":"","pcpname":"Riverside Primary Care - Hidenwood","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/594-2936","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I10.","C18.7","D12.3","D12.2","K63.5","K57.30","K64.1","Z86.010","N17.9","I50.22","E87.2","K21.9","E78.5","I11.0","F17.210","I95.9","F10.10","R06.02","R06.09","E86.0","D50.9","Z20.828","Z95.810","Z79.899","R06.00","I50.9","R63.4","R74.8","R19.5","F10.288","Z80.0","Z85.038","I42.0","NO DATA","R94.5","Z20.822","Z87.891","H25.13","H40.023","R06.89","I42.8","F10.20","I44.7","I71.4","Z95.818","Z95.0","R94.31","I50.32","I12.9","M46.47","K62.5","Z86.2","H57.13","I51.7","D50.0","R68.89","Z12.5","N52.9","M79.641","M79.642","R35.0","E78.6","E78.1","Z98.890","Z85.09","Z45.02","H43.391","H53.19","I44.0","I25.5","T82.190A","G47.30","F17.200","R07.9","Z12.11","D12.5","K63.89","K64.4","R11.0","Z23.","N40.1","E55.9","Z88.1","Z88.8","I49.9","I51.89","K20.9","K57.90","K64.8","H53.9","F17.209","D64.9","N28.9","R79.0","R79.89","R51.","R10.9","R93.2","D69.6","Z85.030","H11.30","R39.12","R35.1","N13.8","E83.42","G47.00","N40.0","I25.10","R63.0","T82.838A","F10.21","R44.8","E66.3","Z00.00","R73.03","Z28.21","Z91.14","Z09.","R06.83","R53.83","R42.","R74.0","I95.89","D72.819","I42.9","E87.8","E83.52","Z82.49","Z80.9","R03.0","D12.6","G47.31","I50.21","R09.02","N17.0","I13.0","F10.239","I50.20","F10.229","N18.9","R55.","F12.90","E80.7","R17."],"date":["2022-10-17","2020-06-09","2020-05-19","2021-06-15","2021-06-15","2021-06-15","2020-05-19","2022-05-24","2022-05-17","2022-09-12","2020-08-10","2022-05-17","2022-09-09","2022-09-09","2020-08-25","2020-08-25","2022-04-27","2022-09-07","2020-08-10","2022-04-27","2020-11-30","2021-01-08","2022-09-09","2022-05-17","2020-08-11","2022-08-29","2020-09-17","2021-12-01","2020-08-12","2020-08-12","2022-04-18","2022-10-17","2022-10-17","2022-09-26","2021-08-26","2021-01-08","2022-09-26","2022-01-19","2021-10-19","2021-03-16","2022-09-01","2022-10-17","2022-05-17","2022-09-01","2022-07-26","2022-08-29","2022-08-29","2022-09-09","2022-09-26","2020-03-09","2020-04-07","2020-04-07","2020-07-16","2020-08-11","2021-01-11","2020-10-08","2022-04-18","2021-04-19","2020-11-30","2020-11-30","2022-02-14","2020-11-30","2020-11-30","2021-08-26","2021-08-26","2021-11-02","2022-01-19","2022-01-19","2022-04-27","2022-05-12","2022-05-12","2020-04-24","2020-04-27","2021-12-02","2021-06-15","2021-06-15","2021-06-15","2021-06-15","2021-11-11","2021-12-14","2022-09-19","2022-10-17","2022-05-17","2022-05-17","2022-05-17","2022-08-29","2020-03-11","2020-03-11","2021-06-15","2020-03-11","2020-05-19","2022-10-17","2020-09-09","2020-09-09","2022-05-24","2020-09-13","2021-04-09","2021-04-09","2021-04-09","2021-04-09","2021-05-07","2022-09-19","2022-09-19","2022-09-19","2022-10-17","2022-04-27","2022-04-27","2022-04-27","2022-04-27","2020-05-23","2021-02-09","2021-10-11","2021-10-11","2022-04-18","2022-05-24","2022-04-18","2022-04-18","2022-05-24","2020-07-08","2020-07-10","2020-08-25","2020-08-10","2020-08-25","2021-01-11","2022-09-01","2022-09-01","2022-09-01","2020-02-06","2020-02-06","2020-02-06","2020-05-19","2020-06-13","2020-06-16","2020-08-14","2020-08-25","2020-08-25","2020-08-25","2020-08-25","2020-08-25","2020-08-25","2020-08-25","2020-08-25","2022-04-27","2022-10-17"],"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":[["","45963070911","METOPROL","TAB 25MG ER","30","Select","Select",""],["","00078065920","ENTRESTO","TAB 24-26MG","60","Select","Select",""],["","55111012305","ATORVASTATIN","TAB 40MG","90","Select","Select",""],["","00054429731","FUROSEMIDE","TAB 20MG","20","Select","Select",""],["","53746051105","SPIRONOLACT","TAB 25MG","30","Select","Select",""],["","68382013201","TAMSULOSIN","CAP 0.4MG","90","Select","Select",""],["","69452015120","VITAMIN","CAP 50000UNT","4","Select","Select",""],["","31722052530","FINASTERIDE","TAB 5MG","90","Select","Select",""],["","65162062711","TRAMADOL","TAB 50MG","20","Select","Select",""],["","00406055201","OXYCODONE","TAB 5MG","30","Select","Select",""],["","64980033912","MAGNESIUM-OX","TAB 400MG","30","Select","Select",""],["","60258017101","MAG","TAB 400MG","30","Select","Select",""],["","68382056928","ACAMPRO","TAB 333MG","180","Select","Select",""],["","42806071501","BENZONATATE","CAP 200MG","15","Select","Select",""],["","00781808926","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","20","Select","Select",""],["","65862020299","LOSARTAN","TAB 50MG","30","Select","Select",""],["","00904759080","FEROSUL","TAB 325MG","30","Select","Select",""],["","00093301856","TADALAFIL","TAB 10MG","12","Select","Select",""],["","68462015713","ONDANSETRON","TAB 4MG ODT","20","Select","Select",""],["","68180098201","LISINOPRIL","TAB 30MG","30","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","26","Select","Select",""],["","68462016505","CARVEDILOL","TAB 25MG","180","Select","Select",""],["","68180072003","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","00406012305","HYDROCO\/APAP","TAB 5-325MG","12","Select","Select",""],["","60432012608","MEGESTROL","SUS 40MG\/ML","150","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","00223172101","SODIUM","TAB 650MG","15","Select","Select",""],["","62175011843","OMEPRAZOLE","CAP 20MG","30","Select","Select",""],["","00378668999","PANTOPRAZOLE","TAB 40MG","90","Select","Select",""],["","60258016201","RENAL","CAP ","30","Select","Select",""],["","00406048410","APAP\/CODEINE","TAB 300-30MG","21","Select","Select",""],["","60258016001","RENA-VITE","TAB ","30","Select","Select",""],["","69097052444","DICLOFENAC","GEL 0.01","100","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":""}]}]}