{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SANDRA   J JOHNSON","gend":1,"add":"4029 FOXGLOVE CT APT 304","city":"CHESAPEAKE","state":"VA","zip":"23321-9998","dob":"1969-12-29","age":"","mstatus":"","insh":"2495015*01","cliId":"","pno":"757\/944-8522","cno":"757\/944-8522","email":"","ename":"","eno":"","pphy":"SAAND, MARIAM R MD","ppno":"757\/738-1225","pcpadd":"3537 AIRLINE BLVD STE 1","pcpcity":"PORTSMOUTH","pcpstate":"VA","pcpzip":23701,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/488-1037","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.9","Z79.84","H40.013","H40.053","H52.01","H52.223","H52.4","J30.9","E11.65","N18.9","I13.0","D50.9","D63.1","H25.13","H52.13","B34.9","G47.33","R09.89","K21.9","J30.1","J34.3","J34.89","J02.9","G47.19","E11.42","M20.11","R60.0","M20.12","D64.9","B35.4","R81.","N76.0","Z11.3","Z11.4","A60.04","R91.8","R06.83","E11.40","K59.00","G47.30","I10.","E78.5","Z20.828","NO DATA","N17.2","D57.3","E66.3","J31.0","H93.293","R06.00","Z68.34","R35.0","E11.21","R63.4","F43.0","Z12.31","Z68.29","L65.9","Z71.9","S16.1XXA","S39.012A","S29.019A","V49.50XA","Z68.33","C54.1","R68.83","J01.00","S39.92XA","G44.309","K14.6","E61.1","Z79.899","R94.31","R06.02","L21.0","R05.","E66.9","Z68.32","N28.1","Z87.448","E11.69","L21.8","Z48.02","E78.1","Z68.31","M54.31","M54.32","R82.90","R06.2","R05.9","N30.01","J45.20","R31.0","Z87.442","R10.32","I12.9","E55.9","Z13.29","K76.0","E78.2","H69.83","R06.81","R53.82","B35.1","L85.3","T38.3X5A","Z79.4","N08.","K59.01","R94.5","Z12.11","R39.89","M25.552","K75.81","N20.0","Z68.30","N18.2","N25.81","G44.209"],"date":["2022-10-21","2022-03-03","2020-10-12","2020-10-12","2020-01-27","2020-01-27","2020-01-27","2020-07-16","2022-03-03","2021-07-21","2020-07-16","2020-07-16","2022-02-02","2022-10-21","2021-12-03","2022-06-30","2022-08-24","2022-08-19","2022-08-19","2022-08-29","2022-08-19","2022-08-19","2020-02-06","2022-03-02","2021-08-18","2021-08-18","2022-06-24","2021-08-18","2022-04-21","2021-06-24","2021-06-24","2021-06-24","2021-06-24","2021-06-24","2021-06-24","2022-03-02","2021-10-12","2021-10-12","2022-04-21","2022-04-21","2022-07-28","2021-12-22","2021-09-14","2022-03-16","2021-03-09","2021-08-23","2022-02-02","2021-07-08","2021-07-08","2021-04-21","2021-04-21","2021-12-07","2021-12-22","2022-01-24","2022-01-05","2021-12-10","2021-12-10","2022-01-31","2022-01-31","2022-01-23","2022-01-23","2022-01-23","2022-03-16","2020-09-09","2020-11-09","2021-01-16","2021-07-08","2021-08-09","2021-08-09","2021-11-22","2022-05-05","2022-06-24","2020-02-26","2020-02-26","2020-04-30","2021-09-14","2021-04-24","2020-04-30","2021-08-23","2021-08-23","2021-08-23","2021-12-17","2022-01-31","2022-04-20","2022-04-20","2022-06-22","2022-06-22","2022-07-28","2022-07-28","2022-07-28","2022-07-28","2022-07-28","2021-02-22","2021-02-22","2021-02-22","2020-10-07","2020-10-07","2020-10-07","2020-10-07","2020-10-07","2021-01-25","2021-04-24","2021-04-24","2021-08-18","2021-08-18","2020-04-02","2020-04-02","2020-06-26","2020-09-09","2020-09-09","2021-02-03","2022-04-19","2022-06-24","2021-02-03","2021-08-23","2021-12-22","2022-02-02","2022-02-02","2022-03-16"],"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":[["","00006057761","JANUMET","TAB 50-1000","60","Select","Select",""],["","31722070090","LOSARTAN","TAB 25MG","30","Select","Select",""],["","60505014100","GLIPIZIDE","TAB 5MG","60","Select","Select",""],["","59779027408","ASPIRIN","CHW 81MG","30","Select","Select",""],["","68382012316","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","00378395277","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","53885027025","ONETOUCH","TES VERIO","150","Select","Select",""],["","13668048750","MINOCYCLINE","TAB 100MG","30","Select","Select",""],["","59779029401","HAIR","AER 0.05","60","Select","Select",""],["","00093342210","CYCLOBENZAPR","TAB 10MG","21","Select","Select",""],["","65862014990","FINASTERIDE","TAB 5MG","30","Select","Select",""],["","69097015807","MELOXICAM","TAB 7.5MG","20","Select","Select",""],["","68462053253","CLOBETASOL","SOL 0.0005","100","Select","Select",""],["","16729018201","HYDROCHLOROT","TAB 12.5MG","90","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","42571012290","LEVOCETIRIZI","TAB 5MG","30","Select","Select",""],["","55111072530","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","69584061250","METHOCARBAM","TAB 750MG","20","Select","Select",""],["","00173086910","ANORO","AER 62.5-25","60","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","51672135708","FLUOCIN","OIL 0.01% SC","118","Select","Select",""],["","00456120330","LINZESS","CAP 72MCG","30","Select","Select",""],["","00378668910","PANTOPRAZOLE","TAB 40MG","90","Select","Select",""],["","31722072250","LEVOFLOXACIN","TAB 500MG","5","Select","Select",""],["","43547040111","FUROSEMIDE","TAB 20MG","30","Select","Select",""],["","70377000812","ROSUVASTATIN","TAB 20MG","30","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","45802010901","TRIAMCINOLON","AER 55MCG\/AC","51","Select","Select",""],["","65162019050","NAPROXEN","TAB 500MG","30","Select","Select",""],["","71143037501","XHANCE","MIS 93MCG","16","Select","Select",""],["","65162047810","NITROFURANTN","CAP 100MG","10","Select","Select",""],["","59651000305","OMEPRAZOLE","CAP 40MG","30","Select","Select",""],["","12843013105","BAYER","CHW 81MG","30","Select","Select",""],["","43547042309","LOSARTAN\/HCT","TAB 50-12.5","90","Select","Select",""],["","16729022501","SPIRONOLACT","TAB 25MG","60","Select","Select",""],["","65162089129","MOMETASONE","SPR 50MCG","17","Select","Select",""],["","37000045504","PRILOSEC","TAB 20MG","60","Select","Select",""],["","31722059690","FENOFIBRATE","TAB 145MG","90","Select","Select",""],["","65162027250","SMZ\/TMP","TAB 800-160","6","Select","Select",""],["","55111046601","METOPROL","TAB 25MG ER","30","Select","Select",""],["","62332013230","OLMESA","TAB 20MG","30","Select","Select",""],["","00536100901","FERROUS","TAB 325MG","30","Select","Select",""],["","45802091939","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","65862044930","VALACYCLOVIR","TAB 1GM","20","Select","Select",""],["","29300022705","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","00603533831","PREDNISONE","PAK 10MG","48","Select","Select",""],["","45802046564","KETOCONAZOLE","SHA 0.02","120","Select","Select",""],["","60505084805","AZELASTINE","SPR 0.0015","30","Select","Select",""],["","00143924920","AMOX\/K","TAB 875-125","20","Select","Select",""],["","50428047796","SKIN","LOT 0.12","400","Select","Select",""],["","45802014167","CICLOPIROX","SOL 0.08","7","Select","Select",""],["","67877057305","BENZONATATE","CAP 100MG","15","Select","Select",""],["","45802041926","AMMONIUM","LOT 0.12","400","Select","Select",""],["","49884078611","OLM","TAB \/HCTZ","30","Select","Select",""],["","68645014059","FAMOTIDINE","TAB 20MG","60","Select","Select",""],["","68180065208","DOXYCYC","CAP 100MG","10","Select","Select",""],["","68645057390","GLIMEPIRIDE","TAB 4MG","30","Select","Select",""],["","65702059110","ACCU-CHEK","TES AVIVA PL","150","Select","Select",""],["","51672300302","HYDROCORT","CRE 0.025","28","Select","Select",""],["","67877021560","CEFUROXIME","TAB 250MG","20","Select","Select",""],["","67877032105","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","00310653004","BYDUREON","INJ 2MG","4","Select","Select",""],["","00169413212","OZEMPIC","INJ 2\/1.5ML","4","Select","Select",""],["","49035045875","ALLERGY","TAB 10MG","90","Select","Select",""],["","00904052360","VITAMIN","TAB 500MG","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":""}]}]}