{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"J'ANDRA   L CARTER","gend":1,"add":"PO BOX 59","city":"SHACKLEFORDS","state":"VA","zip":"23156-9998","dob":"1995-02-28","age":"","mstatus":"","insh":"7363494*01","cliId":"","pno":"804\/785-6043","cno":"804\/785-6043","email":"","ename":"","eno":"","pphy":"ALEJO, ANDREA J MD","ppno":"804\/693-2720","pcpadd":"SUITE 2200 7547 MEDICAL DRIVE","pcpcity":"GLOUCESTER","pcpstate":"VA","pcpzip":23061,"pcpcounty":"","pcpid":"","pcpname":"Internal Medicine Associates of Gloucester","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/694-0597","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H66.001","Z39.2","Z13.32","Z30.09","Z12.4","Z11.51","Z32.02","Z30.46","J01.90","N76.0","B96.89","R06.00","Z87.891","Z79.3","Z96.89","N89.8","R51.9","R10.9","R42.","R19.00","K59.00","N39.0","J98.01","F41.9","K21.9","V23.9","Z98.890","O99.213","Z3A.32","Z23.","O34.211","O99.214","Z37.0","Z3A.39","E66.01","Z98.891","R63.0","F41.1","R53.1","J02.9","J02.0","Z88.8","U07.1","H92.03","R07.89","R20.2","O99.212","Z36.2","Z3A.24","Z20.822","M25.541","M25.542","R20.0","M25.50","I11.9","R09.89","O26.891","R11.10","E66.9","R06.9","I10.","F33.9","E66.09","Z68.33","Z01.419","Z68.35","O26.892","R51.","R09.81","R68.2","R29.898","R06.02","Z79.899","Z86.16","H92.02","R47.81","R25.3","J11.1","O34.219","Z3A.00","R00.2","T50.B95A","Z32.01","V23.87","O23.12","R07.81","R50.9","J30.2","J06.9","K92.1"],"date":["2020-10-26","2021-02-24","2021-02-24","2021-02-24","2021-02-24","2021-02-24","2021-06-16","2021-06-16","2021-10-02","2021-10-02","2021-10-02","2021-10-02","2022-07-18","2021-11-21","2021-10-02","2022-02-23","2021-12-31","2021-12-31","2021-12-31","2022-07-18","2022-07-18","2022-07-18","2020-01-04","2022-01-07","2021-03-19","2020-11-23","2020-11-23","2020-11-23","2020-11-23","2020-11-23","2021-01-11","2021-01-11","2021-01-11","2021-01-11","2021-01-11","2021-01-11","2021-02-04","2021-02-04","2021-02-04","2021-07-17","2021-03-13","2021-03-13","2021-03-27","2021-03-27","2021-10-19","2022-06-29","2020-09-29","2020-09-29","2020-09-29","2021-04-04","2021-10-12","2021-10-12","2022-06-29","2021-10-12","2021-10-22","2020-04-10","2020-05-13","2020-05-13","2022-02-23","2021-07-24","2022-01-07","2022-01-07","2022-01-07","2022-01-07","2022-02-23","2022-02-23","2020-08-21","2020-08-21","2021-10-02","2021-03-19","2021-10-19","2021-10-19","2021-10-19","2022-06-29","2021-11-21","2021-11-21","2022-06-29","2020-03-13","2021-01-11","2021-01-11","2021-07-11","2021-08-28","2020-06-01","2020-06-01","2020-08-10","2020-08-10","2021-07-17","2021-07-17","2021-07-17","2022-07-18"],"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":[["","29300039619","AMLODIPINE","TAB 2.5MG","30","Select","Select",""],["","69097084805","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","57237000630","FLUCONAZOLE","TAB 200MG","5","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","21","Select","Select",""],["","13811071910","NITROFURANTN","CAP 100MG","10","Select","Select",""],["","63323004401","CYANOCOBALAM","INJ 1000MCG","3","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","10","Select","Select",""],["","60432026415","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","69452015120","VITAMIN","CAP 50000UNT","4","Select","Select",""],["","16729053308","DODEX","INJ ","3","Select","Select",""],["","65162046550","IBUPROFEN","TAB 600MG","30","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","15","Select","Select",""],["","00904645780","DOK","CAP 100MG","30","Select","Select",""],["","00143928501","AMOXICILLIN","TAB 875MG","20","Select","Select",""],["","00781808926","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","60505006501","OMEPRAZOLE","CAP 20MG","30","Select","Select",""],["","00591544305","PREDNISONE","TAB 20MG","2","Select","Select",""],["","59746012106","MECLIZINE","TAB 25MG","30","Select","Select",""],["","43598081115","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","00143980305","DOXYCYCL","CAP 100MG","14","Select","Select",""],["","69315090405","LORAZEPAM","TAB 0.5MG","12","Select","Select",""],["","08373747800","OPTICHAMBER","MIS DIAMOND","1","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","00172572860","FAMOTIDINE","TAB 20MG","20","Select","Select",""],["","57237005920","CEFUROXIME","TAB 500MG","14","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","7","Select","Select",""],["","65862050320","AMOX\/K","TAB 875-125","20","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":""}]}]}