{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JANELLE SPENCE","gend":1,"add":"1327 COMMERCE AVE","city":"CHESAPEAKE","state":"VA","zip":"23324-9998","dob":"1972-02-24","age":"","mstatus":"","insh":"9590676*01","cliId":"","pno":"757\/818-7399","cno":"","email":"","ename":"","eno":"","pphy":"SCHAPPERT, KACIE PA","ppno":"757\/410-2287","pcpadd":"112 GAINSBOROUGH SQUARE STE 100","pcpcity":"CHESAPEAKE","pcpstate":"VA","pcpzip":23320,"pcpcounty":"","pcpid":"","pcpname":"CHESAPEAKE REGIONAL MEDICAL GROUP","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/410-7747","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I10.","R79.89","E87.6","E66.01","Z68.42","I83.893","G47.9","E55.9","G47.33","M79.602","M54.2","L02.213","N85.01","R13.19","L02.91","R07.9","NO DATA","M20.012","B37.3","C54.1","R10.11","R07.89","Z20.828","R60.0","M54.5","D50.8","I44.4","R05.","Z23.","R10.84","R19.7","R11.2","M79.604","K59.00","K21.9","R13.10","R10.33","N89.8","Z20.2","L73.9","R50.9","U07.1","J12.89","M51.16","R59.0","K92.1","K64.2","K59.04","Z12.11","H10.31","H00.012","R20.0","M79.645","K80.20","Z85.42","Z90.710","M17.11","Z20.822","Z86.16","Z79.899","Z90.721","Z83.3","Z82.49","K62.5","K60.2","N32.81","K42.9","Z68.41","Z90.49","D22.39","L21.8","L85.3","Z01.818","K31.0","N92.0","N83.02","R93.89","N93.9","R06.00","R42.","D50.9","L08.9","R10.0","R06.02","K64.9","Z00.00","Z76.89","Z13.29","Z12.31","F41.9","R00.2","R03.0","R23.2","N83.292","E66.9","R59.1"],"date":["2021-11-29","2021-01-22","2020-03-25","2021-11-29","2020-09-10","2021-11-29","2020-06-25","2020-06-25","2021-08-17","2020-08-31","2020-08-31","2020-09-10","2020-09-10","2020-09-10","2020-09-10","2021-01-22","2021-12-17","2021-12-02","2020-07-30","2021-11-04","2020-02-23","2021-08-17","2021-10-13","2021-08-17","2021-09-27","2021-12-03","2020-12-31","2021-01-09","2021-11-04","2020-01-15","2020-01-15","2020-01-15","2020-06-05","2020-07-07","2021-06-27","2020-07-07","2021-06-27","2020-09-22","2020-09-22","2020-09-22","2020-12-27","2021-01-22","2020-12-31","2021-11-29","2021-12-03","2021-02-11","2021-02-11","2021-02-11","2021-02-11","2021-08-19","2021-08-19","2021-11-24","2021-11-29","2020-01-27","2021-06-27","2021-06-27","2020-11-02","2021-01-09","2021-01-09","2021-06-27","2021-01-09","2021-01-09","2021-01-09","2021-02-08","2021-02-08","2021-06-21","2021-06-27","2021-06-27","2021-06-27","2020-09-17","2020-09-17","2020-09-17","2020-05-05","2020-05-14","2019-02-27","2019-02-27","2019-02-27","2019-05-20","2019-05-06","2019-04-15","2019-12-11","2019-12-11","2019-04-15","2019-04-11","2019-10-03","2019-11-07","2019-11-07","2019-11-07","2019-11-07","2019-04-11","2019-04-15","2019-04-15","2019-04-30","2019-07-16","2019-04-02","2019-04-02"],"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":[["","","LISINOP\/HCTZ"," LISINOP\/HCTZ ","30","Select","Select",""],["","","FLUCONAZOLE","TAB 150MG","","Select","Select",""],["","","METOPROL","TAB 25MG ER","","Select","Select",""],["","","OMEPRAZOLE"," OMEPRAZOLE ","30","Select","Select",""],["","","VITAMIN"," VITAMIN ","30","Select","Select",""],["","","FEROSUL"," FEROSUL ","60","Select","Select",""],["","","POT  CHLORIDE"," POT  CHLORIDE","60","Select","Select",""],["","00574014560","TROSPIUM","TAB 20MG","60","Select","Select",""],["","16729018401","HYDROCHLOROT","TAB 50MG","90","Select","Select",""],["","70010049101","METFORMIN","TAB 500MG ER","30","Select","Select",""],["","69315031228","PROCTO-MED","CRE HC 2.5%","28","Select","Select",""],["","00054418625","DEXAMETHASON","TAB 6MG","10","Select","Select",""],["","43547035610","LISINOPRIL","TAB 40MG","90","Select","Select",""],["","","CETIRIZINE","TAB 10MG","","Select","Select",""],["","","FERROUS"," FERROUS ","60","Select","Select",""],["","","DOXYCYCL","TAB 100MG","","Select","Select",""],["","","MUPIROCIN"," MUPIROCIN ","22","Select","Select",""],["","27808015601","ROSUVASTATIN","TAB 10MG","30","Select","Select",""],["","59267100002","PFIZER","INJ COVID-19","0","Select","Select",""],["","65162063609","PANTOPRAZOLE","TAB 20MG","30","Select","Select",""],["","11822048932","BP","MIS AUTOMATI","1","Select","Select",""],["","17478007035","ERYTHROMYCIN","OIN 5MG\/GM","4","Select","Select",""],["","","ALBUTEROL"," ALBUTEROL ","8","Select","Select",""],["","","NORETHIN"," NORETHIN ","60","Select","Select",""],["","","TRAMADOL"," TRAMADOL ","12","Select","Select",""],["","","IBUPROFEN"," IBUPROFEN ","30","Select","Select",""],["","","OXYCOD\/APAP"," OXYCOD\/APAP ","28","Select","Select",""],["","","ESCITALOPRAM"," ESCITALOPRAM ","30","Select","Select",""],["","","PROAIR"," PROAIR ","8","Select","Select",""],["","","ACETAMIN"," ACETAMIN ","30","Select","Select",""],["","","GAVILYTE-G"," GAVILYTE-G ","4000","Select","Select",""],["","","METRONIDAZOL"," METRONIDAZOL ","14","Select","Select",""],["","","IRON"," IRON ","45","Select","Select",""],["","","DOXYCYC"," DOXYCYC ","20","Select","Select",""],["","","NAPROXEN","TAB 500MG","","Select","Select",""],["","","HYOSCYAMINE","TAB 0.125MG","","Select","Select",""],["","","CLOBETASOL","SOL 0.0005","","Select","Select",""],["","","ASPERCREME","CRE LIDOCAIN","","Select","Select",""],["","","ONDANSETRON","TAB 4MG ODT","","Select","Select",""],["","","DICYCLOMINE","TAB 20MG","","Select","Select",""],["","","HYDROCO\/APAP","TAB 5-325MG","","Select","Select",""],["","","LIDOCAINE","CRE 0.04","","Select","Select",""],["","","FLUTICASONE","SPR 50MCG","","Select","Select",""],["","","RA","DRO 6.5% OT","","Select","Select",""],["","","CLINDAMY\/BEN","GEL 1.2-5%","","Select","Select",""],["","","AMOX\/K","TAB 875-125","","Select","Select",""],["","11822033381",""," ","180","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":""}]}]}