{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CAROLYN DRUMGOLD","gend":1,"add":"974 SAINT JULIAN AVE","city":"NORFOLK","state":"VA","zip":"23504-9998","dob":"1963-07-13","age":"","mstatus":"","insh":"3227251*01","cliId":"","pno":"757\/324-6202","cno":"757\/324-6202","email":"","ename":"","eno":"","pphy":"NEWBY-GOODMAN, MARCIA MD","ppno":"757\/942-8020","pcpadd":"930 MAJESTIC AVE STE 220","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23504,"pcpcounty":"","pcpid":"","pcpname":"Primary Care Specialists","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/942-8015","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.65","L84.","B35.1","H59.033","NO DATA","N17.9","I82.412","Z86.79","I10.","H40.043","E11.621","L97.501","S91.302A","E11.3211","E11.42","L81.9","R60.0","Z68.41","R74.8","Z12.11","E11.9","H25.811","E10.8","Z79.4","E10.10","E78.2","I82.492","H11.32","H25.812","I82.422","I82.432","I82.442","I82.812","I87.8","D72.829","E66.01","Z20.822","Z86.73","S91.332A","K04.7","M79.89","R22.43","Z79.01","E11.21","E78.5","Z12.4","Z03.818","E11.3213","H35.033","E11.51","E11.40","I87.2","H04.123","M79.605","H25.813","H26.9"],"date":["2021-03-16","2020-10-12","2020-10-12","2022-02-16","2021-02-18","2021-02-18","2022-05-16","2021-02-19","2022-02-09","2022-04-07","2022-02-14","2022-01-28","2022-02-14","2022-03-03","2022-09-30","2020-07-08","2020-09-17","2022-09-20","2020-12-16","2020-09-21","2020-07-27","2020-10-06","2021-03-31","2022-09-30","2021-02-19","2021-03-16","2022-09-20","2022-01-01","2020-09-22","2022-05-16","2021-02-18","2021-02-18","2021-02-18","2021-02-18","2021-02-18","2021-02-18","2021-02-18","2021-02-18","2020-05-27","2020-02-29","2020-06-29","2021-02-18","2021-05-11","2022-02-09","2020-12-16","2020-12-16","2021-02-18","2022-04-07","2022-04-07","2020-07-15","2020-11-06","2020-07-15","2021-01-15","2021-02-18","2020-08-24","2020-09-17"],"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":[["","08508200005","OMNIPOD","MIS 5 PACK","10","Select","Select",""],["","00023320503","LUMIGAN","SOL 0.0001","5","Select","Select",""],["","50458057930","XARELTO","TAB 20MG","30","Select","Select",""],["","50228018105","GABAPENTIN","CAP 400MG","60","Select","Select",""],["","00093057610","LOVASTATIN","TAB 20MG","90","Select","Select",""],["","00597015230","JARDIANCE","TAB 10MG","30","Select","Select",""],["","00002773701","INSULIN","INJ 100\/ML","30","Select","Select",""],["","68645058459","METFORMIN","TAB 1000MG","60","Select","Select",""],["","16729018201","HYDROCHLOROT","TAB 12.5MG","90","Select","Select",""],["","00065924007","DUREZOL","EMU 0.0005","5","Select","Select",""],["","67877021905","CEPHALEXIN","CAP 500MG","30","Select","Select",""],["","00023921105","COMBIGAN","SOL 0.2\/0.5%","5","Select","Select",""],["","42571014126","DORZOLAMIDE","SOL 2% OP","10","Select","Select",""],["","68180076506","AMLOD\/VALSAR","TAB 10-160MG","30","Select","Select",""],["","00002143480","TRULICITY","INJ 1.5\/0.5","2","Select","Select",""],["","11877001140","BINAXNOW","KIT HOME TES","2","Select","Select",""],["","00002879959","HUMALOG","INJ 100\/ML","15","Select","Select",""],["","24208060203","PROLENSA","SOL 0.0007","3","Select","Select",""],["","70069023101","BRIMONIDINE","SOL 0.2% OP","10","Select","Select",""],["","68645059090","CLOPIDOGREL","TAB 75MG","90","Select","Select",""],["","00003376474","ELIQUIS","TAB 5MG","74","Select","Select",""],["","67425099917","BROMDAY","SOL 0.0009","3","Select","Select",""],["","00088221905","LANTUS","INJ 100\/ML","30","Select","Select",""],["","72065012112","GVOKE","INJ 1MG\/.2ML","0","Select","Select",""],["","00093227534","AMOX\/K","TAB 875-125","20","Select","Select",""],["","67877032105","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","70069013101","TOBRAMYCIN","SOL 0.3% OP","5","Select","Select",""],["","59746021601","SPIRONOLACT","TAB 25MG","60","Select","Select",""],["","43386005019","GAVILYTE-N","SOL FLAV PK","4000","Select","Select",""],["","68645051654","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","64380076921","PEG-3350\/KCL","SOL \/SODIUM","4000","Select","Select",""],["","17478010012","CYCLOPENTOL","SOL 1% OP","15","Select","Select",""],["","61314012605","KETOROLAC","SOL 0.005","5","Select","Select",""],["","60758011905","PREDNISOLONE","SUS 1% OP","5","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":""}]}]}