{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MELINDA   A BERTELSON","gend":1,"add":"1328 RIVER OAKS","city":"NORFOLK","state":"VA","zip":"23502-9998","dob":"1976-12-08","age":"","mstatus":"","insh":"8266905*01","cliId":"","pno":"757\/339-7614","cno":"","email":"","ename":"","eno":"","pphy":"JOYNER, CHRISTIAN H PA","ppno":"757\/402-3707","pcpadd":"5215 COLLEY AVE SUITE A","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23508,"pcpcounty":"","pcpid":"","pcpname":"CHRISTIAN HAUSLER JOYNER","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/266-5727","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["D72.823","K29.70","K90.89","E78.5","E11.9","K11.8","M79.672","M72.2","E11.42","M25.521","F17.210","M77.11","R59.0","J02.9","Z72.0","K58.9","I10.","E66.01","R13.10","L20.84","M77.32","M13.0","Z01.812","Z20.822","R59.1","K11.21","J44.9","G47.33","R13.14","Q17.2","R22.0","Z87.898","H71.91","B37.9","D72.829","R21.","R06.83","M77.12","M24.021","H90.11","M50.30","M54.12","E66.09","E66.3","Z68.42","G47.30","H50.34","H04.123","M25.50","Z68.41","M51.37","R05.","G47.00","Z87.828","Z09.","B37.0","R19.03","L20.9","J45.909","R42.","F32.9","K43.9","S16.1XXA","S20.219A","V87.7XXA","J98.01","L02.91","U07.1","Z78.0","R52.","N95.1","M51.36","R20.9","H92.01","H65.91"],"date":["2021-10-05","2021-03-17","2021-03-17","2022-06-08","2022-07-15","2021-10-23","2020-09-21","2020-09-21","2020-09-21","2020-03-17","2020-02-02","2020-03-17","2020-07-16","2020-07-16","2021-08-02","2021-02-16","2022-06-08","2021-07-23","2021-02-16","2020-01-21","2020-09-04","2020-09-04","2021-03-10","2022-11-15","2021-06-17","2021-06-17","2022-06-08","2021-07-23","2021-08-02","2021-08-02","2021-03-12","2021-03-12","2021-03-12","2022-06-08","2020-01-17","2020-01-17","2021-02-02","2019-09-17","2019-10-17","2019-09-10","2019-09-24","2019-09-24","2019-03-08","2019-03-08","2019-03-26","2019-03-26","2019-04-10","2019-04-10","2019-12-19","2019-09-09","2019-06-18","2019-06-16","2019-09-17","2019-09-17","2019-09-17","2019-12-11","2019-02-27","2019-04-17","2019-10-16","2019-01-28","2022-07-15","2019-09-09","2019-08-24","2019-08-24","2019-08-24","2019-10-18","2022-07-22","2022-07-22","2022-06-08","2022-06-08","2022-06-08","2022-07-15","2022-07-15","2022-11-15","2022-11-15"],"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":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"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":[["","","BUDES\/FORMOT","AER 160-4.5","","Select","Select",""],["","00597007541","SPIRIVA","CAP HANDIHLR","90","Select","Select",""],["","52817033200","CYCLOBENZAPR","TAB 10MG","90","Select","Select",""],["","00002143380","TRULICITY","INJ 0.75\/0.5","2","Select","Select",""],["","57237000511","FLUCONAZOLE","TAB 150MG","3","Select","Select",""],["","00054040013","DESVENLAFAX","TAB 50MG ER","30","Select","Select",""],["","00591544305","PREDNISONE","TAB 20MG","6","Select","Select",""],["","00378623301","CITALOPRAM","TAB 40MG","30","Select","Select",""],["","00186037020","SYMBICORT","AER 160-4.5","10","Select","Select",""],["","27808023302","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","31722072690","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","64380080707","IBUPROFEN","TAB 800MG","60","Select","Select",""],["","65862001705","AMOXICILLIN","CAP 500MG","32","Select","Select",""],["","55111012305","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","00597016860","SYNJARDY","TAB ","60","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","76204020060","ALBUTEROL","NEB 0.00083","360","Select","Select",""],["","10135013301","ALLERGY","TAB 4MG","60","Select","Select",""],["","00168000215","TRIAMCINOLON","CRE 0.005","60","Select","Select",""],["","00172572960","FAMOTIDINE","TAB 40MG","30","Select","Select",""],["","45963055550","GABAPENTIN","CAP 100MG","90","Select","Select",""],["","","CLOTRIMAZOLE","LOZ 10MG","","Select","Select",""],["","00591024105","LORAZEPAM","TAB 1MG","2","Select","Select",""],["","23155010405","METFORMIN","TAB 1000MG","60","Select","Select",""],["","59746012106","MECLIZINE","TAB 25MG","30","Select","Select",""],["","","LEVOCETIRIZI","TAB 5MG","","Select","Select",""],["","13668033005","TRAZODONE","TAB 50MG","60","Select","Select",""],["","66685100100","AMOX\/K","TAB 875-125","20","Select","Select",""],["","","SUCRALFATE","TAB 1GM","","Select","Select",""],["","65628007010","FIRST-OMEPRA","SUS 2MG\/ML","600","Select","Select",""],["","","OMEPRAZOLE","CAP 40MG","","Select","Select",""],["","12547017021","BENADRYL","CAP 25MG","2","Select","Select",""],["","00904530660","BANOPHEN","CAP 25MG","2","Select","Select",""],["","65162062711","TRAMADOL","TAB 50MG","30","Select","Select",""],["","00363089653","NICOTINE","DIS 21MG\/24H","28","Select","Select",""],["","00085720601","DULERA","AER 100-5MCG","39","Select","Select",""],["","00310461612","BREZTRI","AER SPHERE","11","Select","Select",""],["","","CICLOPIROX","GEL 0.0077","","Select","Select",""],["","00555088702","ESTRADIOL","TAB 2MG","30","Select","Select",""],["","53885001110","ONETOUCH","MIS PLUS 30G","100","Select","Select",""],["","","TERBINAFINE","TAB 250MG","","Select","Select",""],["","","XYZAL","TAB 5MG","","Select","Select",""],["","","MOMETASONE","CRE 0.001","","Select","Select",""],["","00173068220","VENTOLIN","AER ","18","Select","Select",""],["","","BREO","INH 200-25","","Select","Select",""],["","","WIXELA","AER 250\/50","","Select","Select",""],["","00173071620","ADVAIR","AER 115\/21","12","Select","Select",""],["","","FLUTIC\/SALME","AER 250\/50","","Select","Select",""],["","68180051303","LISINOPRIL","TAB 5MG","30","Select","Select",""],["","00173071920","FLOVENT","AER 110MCG","36","Select","Select",""],["","10702002501","PHENTERMINE","TAB 37.5MG","15","Select","Select",""],["","99073070805","FREESTYLE    MIS LITE","MIS LITE","1","Select","Select",""],["","99073070827","FREESTYLE    TES LITE","TES LITE","100","Select","Select",""],["","76204060060","IPRATROPIUM\/","SOL ALBUTER","360","Select","Select",""],["","76204010060","IPRATROPIUM","SOL 0.02%INH","300","Select","Select",""],["","55111068405","IBU","TAB 800MG","90","Select","Select",""],["","68382013805","TOPIRAMATE","TAB 25MG","30","Select","Select",""],["","32909071103","READI-CAT","SUS BERRY","900","Select","Select",""],["","00591352530","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","10702000350","PROMETHAZINE","TAB 25MG","30","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","10","Select","Select",""],["","00378034505","DIAZEPAM","TAB 5MG","10","Select","Select",""],["","00591079021","METHYLPRED","TAB 4MG","21","Select","Select",""],["","11086004002","TRIPLE","OIN AF 2%","57","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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}