{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KIMBERLY   N GASKILL","gend":1,"add":"2801 OLD WILLIAMSBURG RD APT 8J","city":"YORKTOWN","state":"VA","zip":"23690-9998","dob":"1978-10-30","age":"","mstatus":"","insh":"3843041*01","cliId":"","pno":"757\/955-5174","cno":"757\/955-5174","email":"","ename":"","eno":"","pphy":"LAWANI, BERTHA O NP","ppno":"757\/251-2170","pcpadd":"850 ENTERPRISE PARKWAY SUITE 2200","pcpcity":"HAMPTON","pcpstate":"VA","pcpzip":23666,"pcpcounty":"","pcpid":"","pcpname":"Riverside Center for Internal & Family Medicine","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/251-2185","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M17.11","M25.561","G89.29","E66.01","Z98.84","Z68.43","Z87.891","H53.8","J30.89","Z01.818","Z11.59","R57.9","J96.01","T28.2XXA","Z97.8","D25.1","N92.1","N94.5","M19.90","Z68.42","I26.99","R10.30","D64.9","H92.01","H10.13","J34.89","R09.81","L50.0","J30.1","J30.2","J30.81","Z91.018","H66.91","H60.509","F32.9","E53.8","E55.9","R53.83","F43.21","J69.0","T78.2XXA","N94.6","D21.9","D25.9","R52.","G44.89","R60.9","S90.851A","Z30.09","H53.9","I49.3","I95.9","Z20.822","H60.311","Z86.718","R03.0","Z86.711","R51.","J31.0","G51.4","R06.02","L50.9","L20.89","L29.8","T88.6XXA","T48.1X5A","N92.0","R31.0","Z78.1","T38.0X5A","R51.9","H60.331","H66.001","E66.9","R09.82","M17.10","H92.09","R21.","E05.90","J34.3","N91.2"],"date":["2020-03-09","2020-02-03","2020-02-03","2020-08-05","2021-09-14","2020-02-03","2020-08-05","2020-02-24","2021-09-14","2020-07-30","2020-07-30","2020-08-09","2020-08-09","2020-08-06","2020-08-08","2020-11-10","2020-11-10","2020-11-10","2020-02-12","2020-11-10","2020-11-10","2020-11-10","2020-11-10","2021-09-14","2021-09-14","2021-09-14","2021-09-14","2021-09-14","2021-09-14","2021-09-14","2021-09-14","2021-09-14","2021-09-14","2021-09-14","2022-10-05","2022-10-05","2022-10-05","2022-10-05","2022-10-05","2020-08-09","2020-08-09","2020-08-09","2020-08-09","2020-08-05","2021-09-04","2021-09-04","2021-09-04","2020-02-19","2020-04-17","2020-06-29","2020-08-08","2020-08-08","2021-02-24","2021-09-14","2021-09-14","2021-09-14","2021-09-14","2020-05-13","2020-05-13","2020-06-01","2020-08-05","2020-05-18","2020-05-18","2020-05-18","2020-08-05","2020-08-05","2020-08-05","2020-08-05","2020-08-05","2020-08-05","2021-09-04","2021-09-04","2021-09-04","2021-09-04","2021-09-04","2021-09-04","2021-09-04","2020-03-10","2020-08-05","2020-04-29","2020-08-05"],"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":[["","64380073706","VITAMIN","CAP 50000UNT","4","Select","Select",""],["","00904759080","FEROSUL","TAB 325MG","90","Select","Select",""],["","50383002505","OFLOXACIN","DRO 0.3%OTIC","5","Select","Select",""],["","57237002801","AMOXICILLIN","TAB 500MG","20","Select","Select",""],["","59267100002","PFIZER","INJ COVID-19","0","Select","Select",""],["","59762444002","METHYLPRED","TAB 4MG","21","Select","Select",""],["","69543038810","KETOROLAC","TAB 10MG","20","Select","Select",""],["","52565000730","LIDO\/PRILOCN","CRE 2.5-2.5%","30","Select","Select",""],["","58160088752","FLUARIX","INJ 2021-22","0","Select","Select",""],["","11822312760","LORATADINE","TAB 10MG","14","Select","Select",""],["","43598032675","CIPRO\/DEXA","SUS 0.3-0.1%","8","Select","Select",""],["","51224002206","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","11822013729","RA","CAP 100MG","60","Select","Select",""],["","00904645760","DOK","CAP 100MG","60","Select","Select",""],["","68382004101","PROMETHAZINE","TAB 25MG","90","Select","Select",""],["","67877032105","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","00536100901","FERROUS","TAB 325MG","60","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","28","Select","Select",""],["","00378076101","CYCLOBENZAPR","TAB 7.5MG","30","Select","Select",""],["","16571020110","DICLOFENAC","TAB 75MG DR","60","Select","Select",""],["","00555077902","MEDROXYPR","TAB 10MG","30","Select","Select",""],["","65862057490","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","00003089421","ELIQUIS","TAB 5MG","120","Select","Select",""],["","59746017506","PREDNISONE","TAB 20MG","10","Select","Select",""],["","00172572860","FAMOTIDINE","TAB 20MG","14","Select","Select",""],["","55111015330","ONDANSETRON","TAB 4MG","30","Select","Select",""],["","63304069301","CLINDAMYCIN","CAP 300MG","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":""}]}]}