{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JAMES  E THOMPSON","gend":0,"add":"3219 VIRGINIA BEACH BLVD RM B42","city":"VIRGINIA BEACH","state":"VA","zip":"23452-9998","dob":"1971-03-06","age":"","mstatus":"","insh":"1017376*01","cliId":"","pno":7573926407,"cno":7573926407,"email":"","ename":"","eno":"","pphy":"LI, WENHONG MD","ppno":7576898430,"pcpadd":"SUITE 100 1925 GLENN MITCHELL DR","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":"23456-9998","pcpcounty":"","pcpid":"","pcpname":"Princess Anne Medical Associates","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7576898435,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z20.822","R05.9","R22.32","M15.1","Z01.818","I10.","K21.9","M54.5","M10.9","E29.1","N52.9","N40.1","M79.671","J44.9","Z71.9","E66.9","Z01.810","H52.13","H52.223","H52.4","H53.10","H53.40","H50.812","M79.674","M10.071","L53.9","R60.0","N52.8","M51.37","M54.31","Y99.0","N20.0","Z12.5","R10.9","N13.8","H25.13","H50.012","M54.2","R07.9","NO DATA","J06.9","R05.","R00.0","D48.7","N18.9","E66.01","Z68.36","M25.571","Z79.82","Z79.899","Z87.442","M79.676","V89.2XXA","M54.41"],"date":["2022-03-14","2022-03-14","2022-07-20","2022-07-20","2022-08-11","2022-05-31","2021-05-13","2021-05-13","2023-04-11","2023-01-12","2022-02-14","2023-01-12","2022-04-27","2022-03-28","2022-05-05","2022-05-05","2022-08-11","2022-01-14","2022-01-14","2022-01-14","2022-01-14","2022-01-14","2022-01-14","2022-03-27","2022-09-21","2022-03-27","2022-03-27","2023-01-12","2021-06-10","2021-06-10","2021-06-10","2021-06-29","2021-06-22","2021-06-29","2021-06-22","2022-12-05","2022-12-05","2023-04-11","2023-02-03","2023-02-03","2023-03-24","2021-08-03","2021-08-03","2022-08-16","2022-08-16","2022-08-16","2022-08-16","2022-09-21","2022-05-31","2022-05-31","2022-05-31","2022-05-31","2023-04-11","2023-04-11"],"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":[["","69315015510","HYDROCHLOROT","TAB 12.5MG","90","Select","Select",""],["","00574082701","TESTOST CYP","INJ 200MG\/ML","2","Select","Select",""],["","00378018105","ALLOPURINOL","TAB 300MG","30","Select","Select",""],["","29300039705","AMLODIPINE","TAB 5MG","90","Select","Select",""],["","31722070110","LOSARTAN POT","TAB 50MG","90","Select","Select",""],["","16729004417","ATORVASTATIN","TAB 10MG","30","Select","Select",""],["","31722071310","PANTOPRAZOLE","TAB 40MG","90","Select","Select",""],["","08290309589","3ML LL SYRNG","MIS 23GX1.5\"","3","Select","Select",""],["","16714085302","METOPROL SUC","TAB 50MG ER","90","Select","Select",""],["","31722077705","ACYCLOVIR","TAB 400MG","30","Select","Select",""],["","16714071302","TAMSULOSIN","CAP 0.4MG","30","Select","Select",""],["","42858010250","OXYCOD\/APAP","TAB 5-325MG","9","Select","Select",""],["","00115169449","EPINEPHRINE","INJ 0.3MG","2","Select","Select",""],["","31722054201","INDOMETHACIN","25 MG","20","Select","Select",""],["","65162019050","NAPROXEN","TAB 500MG","20","Select","Select",""],["","00172409660","BACLOFEN","TAB 10MG","60","Select","Select",""],["","00254200801","COLCHICINE","0.6 MG","20","Select","Select",""],["","64380071207","BENZONATATE","CAP 100MG","30","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","00603459315","METHYLPRED","TAB 4MG","21","Select","Select",""],["","16571040250","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","42571016101","AMOX\/K CLAV","TAB 500-125","21","Select","Select",""],["","59267100002","PFIZER VACC","INJ COVID-19","0","Select","Select",""],["","33332032101","AFLURIA QUAD","INJ 2021-22","0","Select","Select",""],["","27241011203","TADALAFIL","TAB 5MG","30","Select","Select",""],["","08287126405","HYPO NEEDLE","MIS 25GX1\"","3","Select","Select",""],["","08290309628","SYRINGE LUER","MIS -LOK 1ML","3","Select","Select",""],["","00093005805","TRAMADOL HCL","50 MG","20","Select","Select",""],["","00781261305","AMOXICILLIN","CAP 500MG","20","Select","Select",""],["","27808008601","HYD POL\/CPM","SUS 10-8\/5ML","120","Select","Select",""],["","69097014260","ALBUTEROL","AER HFA","7","Select","Select",""],["","70954005930","PREDNISONE","10 MG","21","Select","Select",""],["","10702018950","HYDROCO\/APAP","TAB 5-325MG","12","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","21","Select","Select",""],["","65862042005","SMZ\/TMP DS","TAB 800-160","14","Select","Select",""],["","68180086111","AZITHROMYCIN","250 MG","6","Select","Select",""],["","00143965901","TESTOSTERONE CYPIONATE","200 MG\/ML","6","Select","Select",""],["","31722070110","LOSARTAN POTASSIUM","50 MG","90","Select","Select",""],["","49483060450","IBUPROFEN","800 MG","30","Select","Select",""],["","50742061610","METOPROLOL SUCCINATE","50 MG","90","Select","Select",""],["","29300039705","AMLODIPINE BESYLATE","5 MG","90","Select","Select",""],["","69097014260","ALBUTEROL SULFATE HFA","90 MCG","6.7","Select","Select",""],["","16729004417","ATORVASTATIN CALCIUM","10 MG","30","Select","Select",""],["","00093342210","CYCLOBENZAPRINE HCL","10 MG","30","Select","Select",""],["","65862056099","PANTOPRAZOLE SODIUM","40 MG","90","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":""}]}]}