{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"VIRGINIA RODRIGUEZ","gend":1,"add":"5813 BURRELL AVE","city":"NORFOLK","state":"VA","zip":"23518-9998","dob":"1971-02-19","age":"","mstatus":"","insh":"1088206*01","cliId":"","pno":7575754778,"cno":7575754778,"email":"","ename":"","eno":"","pphy":"HUGGINS-JONES, DAWN MD","ppno":7574601207,"pcpadd":"1147 INDEPENDENCE BLVD,","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":"23455-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7574602136,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I10.","G47.00","D12.6","K21.9","E11.9","K29.50","NO DATA","K31.89","K76.0","E03.9","F17.210","G47.30","E66.9","G47.33","Z68.36","Z87.19","Z98.890","Z88.5","Z90.49","Z90.721","K29.70","R11.0","M19.90","Z68.35","E88.81","Z71.3","Z13.89","E55.9","Z86.010","K63.89","K63.3","E78.2","D34.","E21.3","D69.6","R89.8","F43.20","F43.22","N20.1","N13.30","D35.1","F41.1","K22.70","R19.8","K58.0","R10.11","Z79.899","Z01.810","Z01.812","Z20.822","U07.1","J02.9","R50.9","R09.81","E11.65","R73.03","E83.52","R10.32","R53.83","K64.9","N20.0","Z01.411","Z11.3","Z12.31","N95.2","R31.1","E21.0","E04.2","N77.1","R51.9","R07.1","L03.312","R00.0"],"date":["2023-09-25","2023-04-13","2021-04-15","2021-05-20","2022-02-07","2022-02-07","2022-02-07","2022-02-07","2022-04-13","2022-04-13","2022-02-07","2022-04-13","2022-04-13","2022-04-13","2022-02-07","2022-02-07","2022-02-07","2022-02-07","2022-02-07","2022-02-07","2022-02-07","2022-02-07","2022-04-13","2022-04-13","2022-04-13","2022-04-13","2022-04-13","2022-04-13","2021-05-20","2021-02-18","2021-02-18","2023-05-31","2022-08-19","2022-08-19","2022-09-14","2022-09-14","2022-12-07","2023-02-08","2021-08-18","2021-08-01","2021-09-10","2022-12-07","2022-02-07","2022-01-21","2022-01-21","2022-01-21","2022-10-17","2021-04-12","2021-04-12","2021-04-12","2022-07-24","2022-07-24","2022-07-24","2022-07-24","2021-07-26","2021-07-26","2021-07-26","2021-09-23","2022-03-10","2021-05-20","2021-08-18","2022-04-06","2022-04-06","2022-04-06","2022-04-06","2021-07-29","2022-05-10","2022-05-10","2023-05-31","2023-09-06","2023-09-25","2023-09-25","2023-09-25"],"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":[["","00169406013","VICTOZA","3-PAK 0.6 MG\/0.1","9","Select","Select",""],["","00074714890","SYNTHROID","200 MCG","90","Select","Select",""],["","65862016001","ZOLPIDEM","TAB 10MG","30","Select","Select",""],["","49884068905","METOCLOPRAM","TAB 10MG","2","Select","Select",""],["","68180052002","LISINOP\/HCTZ","TAB 20-25MG","90","Select","Select",""],["","00143992801","CIPROFLOXACN","TAB 500MG","6","Select","Select",""],["","69238184001","LEVOTHYROXIN","TAB 200MCG","90","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","6","Select","Select",""],["","70700015010","OMEPRAZOLE","20 MG","60","Select","Select",""],["","65162046550","IBUPROFEN","TAB 600MG","30","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","42794001812","LIOTHYRONINE","TAB 5MCG","30","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","30","Select","Select",""],["","65162062711","TRAMADOL HCL","TAB 50MG","20","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","53885027210","ONETOUCH","TES VERIO","100","Select","Select",""],["","00406051205","OXYCOD\/APAP","TAB 5-325MG","20","Select","Select",""],["","68382013201","TAMSULOSIN","CAP 0.4MG","90","Select","Select",""],["","13811071910","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","42806054701","VITAMIN D","2 1250 MCG","2","Select","Select",""],["","00378718705","METFORMIN","TAB 1000MG","180","Select","Select",""],["","65862042005","SMZ\/TMP DS","TAB 800-160","14","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","30","Select","Select",""],["","57237002801","AMOXICILLIN","TAB 500MG","35","Select","Select",""],["","65649030302","XIFAXAN","TAB 550MG","42","Select","Select",""],["","31722088530","ROSUVASTATIN","TAB 40MG","90","Select","Select",""],["","68180097903","LISINOPRIL","40 MG","90","Select","Select",""],["","29300012810","HYDROCHLOROT","TAB 25MG","30","Select","Select",""],["","00781185220","AMOX\/K CLAV","TAB 875-125","20","Select","Select",""],["","16110058780","CORDRAN 80X3","TAP 4MCG\/CM","1","Select","Select",""],["","65862018501","CLINDAMYCIN","CAP 150MG","40","Select","Select",""],["","00406055201","OXYCODONE","TAB 5MG","10","Select","Select",""],["","11917013861","CALCIUM\/D","TAB 500-200","84","Select","Select",""],["","70954006020","PREDNISONE","TAB 20MG","6","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","50111064801","FLUOXETINE","CAP 20MG","90","Select","Select",""],["","61314064610","NEO\/POLY\/HC","SOL 1% OTIC","10","Select","Select",""],["","00378718705","METFORMIN HCL","1000 MG","180","Select","Select",""],["","53885027210","ONETOUCH VERIO TEST STRIP","","100","Select","Select",""],["","42794001812","LIOTHYRONINE SODIUM","5 MCG","30","Select","Select",""],["","50111064801","FLUOXETINE HCL","20 MG","90","Select","Select",""],["","65862016001","ZOLPIDEM TARTRATE","10 MG","30","Select","Select",""],["","45802065087","LORATADINE","10 MG","30","Select","Select",""],["","00169418113","OZEMPIC .","25 OR 0.5","3","Select","Select",""],["","60505082901","FLUTICASONE PROPIONATE","50 MCG","16","Select","Select",""],["","31722072690","MONTELUKAST SODIUM","10 MG","30","Select","Select",""],["","00002143380","TRULICITY","0.75MG\/0.5","2","Select","Select",""],["","69452015120","VITAMIN D CAP","50000UNT","2","Select","Select",""],["","42794001812","LIOTHYRONINE TAB","5MCG","30","Select","Select",""],["","68462019005","NAPROXEN TAB","500MG","30","Select","Select",""],["","00378718705","METFORMIN TAB","1000MG","60","Select","Select",""],["","68180072103","AMLODIPINE TAB","10MG","90","Select","Select",""],["","53885027210","ONETOUCH TES VERIO","","100","Select","Select",""],["","65862016001","ZOLPIDEM TAB","10MG","30","Select","Select",""],["","70700015010","OMEPRAZOLE CAP","20MG","60","Select","Select",""],["","65649030302","XIFAXAN TAB","550MG","42","Select","Select",""],["","00074714890","SYNTHROID TAB","200MCG","90","Select","Select",""],["","29300012810","HYDROCHLOROT TAB","25MG","30","Select","Select",""],["","68382013201","TAMSULOSIN CAP","0.4MG","90","Select","Select",""],["","00169406013","VICTOZA INJ","18MG\/3ML","9","Select","Select",""],["","31722088530","ROSUVASTATIN TAB","40MG","30","Select","Select",""],["","68180097903","LISINOPRIL TAB","40MG","30","Select","Select",""],["","00781185220","AMOX\/K CLAV TAB","875-125","20","Select","Select",""],["","65862018501","CLINDAMYCIN CAP","150MG","40","Select","Select",""],["","70954006020","PREDNISONE TAB","20MG","6","Select","Select",""],["","60505082901","FLUTICASONE SPR","50MCG","16","Select","Select",""],["","00406055201","OXYCODONE TAB","5MG","10","Select","Select",""],["","16110058780","CORDRAN","80X3 TAP 4MCG\/CM","1","Select","Select",""],["","11917013861","CALCIUM\/D TAB","500-200","84","Select","Select",""],["","59651030830","FLUOXETINE TAB","10MG","30","Select","Select",""],["","50111064801","FLUOXETINE CAP","20MG","30","Select","Select",""],["","61314064511","NEO\/POLY\/HC SUS","1% OTIC","10","Select","Select",""],["","61314064610","NEO\/POLY\/HC SOL","1% OTIC","10","Select","Select",""],["","65862050320","AMOXICILLIN-CLAVULANATE POTASS","875-125 MG","20","Select","Select",""],["","70710113908","FLUCONAZOLE","150 MG","2","Select","Select",""],["","68462026430","ROSUVASTATIN CALCIUM","40 MG","90","Select","Select",""],["","29300039810","AMLODIPINE BESYLATE","10 MG","90","Select","Select",""],["","29300012810","HYDROCHLOROTHIAZIDE","25 MG","90","Select","Select",""],["","33342017910","OLMESARTAN MEDOXOMIL","20 MG","90","Select","Select",""],["","65862042005","SULFAMETHOXAZOLE-TRIMETHOPRIM","800-160 MG","14","Select","Select",""],["","65862047090","LOSARTAN-HYDROCHLOROTHIAZIDE","100MG-25MG","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":""}]}]}