{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DONNA LOWE CHANDLER","gend":1,"add":"7700 NEWMAN ROAD","city":"WILLIAMSBURG","state":"VA","zip":"23188-9998","dob":"1979-01-12","age":"","mstatus":"","insh":"1112656*01","cliId":"","pno":7572085907,"cno":7572085907,"email":"","ename":"","eno":"","pphy":"MAIGI, KIMBERLY D NP","ppno":7573450011,"pcpadd":"7364 RICHMOND ROAD,","pcpcity":"WILLIAMSBURG","pcpstate":"VA","pcpzip":"23188-9998","pcpcounty":"","pcpid":"","pcpname":"Riverside Primary Care Norge","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7573450381,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M86.9","F90.0","K43.9","L89.323","F17.200","G89.4","Z51.81","M86.40","V54.13","V54.19","L89.154","F17.210","Z87.440","N81.9","T14.90XA","M54.16","M62.81","N39.0","N81.4","L98.429","K46.9","G89.29","Z47.89","Z98.1","U07.1","Z01.812","N94.6","N31.9","N81.3","R33.9","NO DATA","M86.48","M25.50","Z71.3","M86.19","L89.153","G89.21","R52.","V58.89","S32.10XK","S32.2XXK","Z96.9","L89.159","Z13.220","E78.2","E55.9","E53.8","M46.26","M46.28","R23.2","K94.19","R19.04","K21.9","R19.4","K94.09","Z98.84","Z43.3","R39.81","R03.0","R23.3","B37.9","F31.32","F33.0","D50.9","F33.1","F90.2"],"date":["2022-12-12","2022-12-12","2022-04-07","2022-04-07","2022-04-07","2022-12-05","2022-12-05","2022-12-05","2022-12-05","2022-12-05","2021-10-12","2022-01-06","2021-10-12","2022-01-28","2021-10-12","2022-02-09","2023-06-20","2022-01-28","2022-01-28","2022-01-06","2022-01-06","2023-04-13","2021-06-10","2022-01-25","2021-07-29","2021-11-01","2023-04-13","2022-01-28","2022-01-28","2022-01-28","2023-04-13","2022-02-17","2023-04-13","2021-02-01","2021-02-01","2022-01-28","2022-01-28","2021-04-29","2022-01-06","2022-01-06","2022-01-06","2022-01-25","2021-03-16","2022-02-17","2023-04-13","2023-04-13","2023-04-13","2023-04-13","2023-04-13","2023-04-13","2023-04-13","2023-04-13","2023-05-18","2023-04-24","2023-04-24","2023-04-24","2023-06-19","2023-06-20","2023-05-18","2023-05-18","2023-05-18","2023-05-18","2023-05-18","2023-05-18","2023-08-24","2023-08-24"],"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":[["","65862056099","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","69238131409","PREGABALIN","150 MG","60","Select","Select",""],["","00713055273","TERCONAZOLE","SUP 80MG","3","Select","Select",""],["","63717010001","ICAR-C PLUS","TAB ","30","Select","Select",""],["","10702000850","OXYCODONE","TAB 15MG","21","Select","Select",""],["","42571016201","AMOX\/K CLAV","TAB 875-125","28","Select","Select",""],["","62559099212","FLUCONAZOLE","150 MG","2","Select","Select",""],["","42858080101","MORPHINE SUL","TAB 15MG ER","28","Select","Select",""],["","16729017317","AMITRIPTYLIN","TAB 50MG","30","Select","Select",""],["","00185084201","AMPHET\/DEXTR","TAB 10MG","30","Select","Select",""],["","65162027250","SMZ\/TMP DS","TAB 800-160","20","Select","Select",""],["","00093031101","LOPERAMIDE","CAP 2MG","60","Select","Select",""],["","00527411637","PROPRANOLOL","CAP 60MG ER","15","Select","Select",""],["","57237007730","ONDANSETRON","TAB 4MG ODT","45","Select","Select",""],["","70069007110","NALOXONE","INJ 0.4MG\/ML","4","Select","Select",""],["","00185012201","NITROFURANTN","CAP 100MG","10","Select","Select",""],["","68382005005","MELOXICAM","7.5 MG","30","Select","Select",""],["","43547038111","DULOXETINE","CAP 60MG","30","Select","Select",""],["","61442010310","DICLOFENAC","TAB 75MG DR","60","Select","Select",""],["","27241009990","DULOXETINE HCL","60 MG","60","Select","Select",""],["","29300042110","AMITRIPTYLINE HCL","50 MG","30","Select","Select",""],["","57237023305","SULFAMETHOXAZOLE-TRIMETHOPRIM","800-160 MG","14","Select","Select",""],["","31722071310","PANTOPRAZOLE SODIUM","40 MG","30","Select","Select",""],["","68180031902","BUPROPION XL","150 MG","30","Select","Select",""],["","00536100901","FERROUS SULFATE","325(65) MG","30","Select","Select",""],["","00185084201","AMPHET\/DEXTR TAB","10MG","30","Select","Select",""],["","42858080101","MORPHINE SUL TAB","15MG ER","42","Select","Select",""],["","65162004910","OXYCODONE TAB","15MG","120","Select","Select",""],["","70069007110","NALOXONE INJ","0.4MG\/ML","4","Select","Select",""],["","50228035490","PREGABALIN CAP","150MG","60","Select","Select",""],["","00185012201","NITROFURANTN CAP","100MG","10","Select","Select",""],["","65862056099","PANTOPRAZOLE TAB","40MG","30","Select","Select",""],["","16729017317","AMITRIPTYLIN TAB","50MG","30","Select","Select",""],["","43547038111","DULOXETINE CAP","60MG","60","Select","Select",""],["","68382005005","MELOXICAM TAB","7.5MG","30","Select","Select",""],["","61442010310","DICLOFENAC TAB","75MG DR","60","Select","Select",""],["","47781017601","DEXTROAMPHETAMINE-AMPHETAMINE","10 MG","60","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":""}]}]}