{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TONYA   R ROBINSON","gend":1,"add":"548 MARINER S WAY APT E","city":"NORFOLK","state":"VA","zip":"23503-9998","dob":"1972-11-16","age":"","mstatus":"","insh":"1205962*01","cliId":"","pno":7572899856,"cno":7572899856,"email":"","ename":"","eno":"","pphy":"BONEY, ARON MD","ppno":7572782240,"pcpadd":"155 KINGSLEY LN STE 400","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":"23505-9998","pcpcounty":"","pcpid":"","pcpname":"Depaul Medical Associates","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7574896469,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.40","F41.1","I10.","Z79.4","F41.0","F32.1","Z20.828","I50.9","J96.01","I50.22","E11.9","R06.00","I34.0","I36.1","I42.9","NO DATA","F41.8","Z86.39","G47.30","E78.2","G47.33","G47.37","J34.3","R51.9","E66.01","E11.21","I42.0","I50.20","D64.9","K21.9","F32.89","E11.65","Z00.00","Z20.822","N30.00","N76.2","R09.02","I11.0","I50.21","Z23.","I42.8","F41.9","E66.9","E78.5","E87.6","E83.42","I25.10","Z88.5","Z68.38","R91.8","R20.2","I50.43","M54.42","M43.16","M51.36","M54.41","G89.29","Z68.37","Z79.84","Z79.899","B37.3","J18.9","M47.816","J45.20","R35.0","Z12.11","F33.9","N39.0","M79.662","Z68.36","R22.42","I50.23","N17.9","E04.1","E78.00","J45.40","E66.09","N76.0","N94.9","R82.998","E04.9","B96.89","I13.0","E11.22","Z11.59","Z11.4","R42.","A08.4","Z09.","M72.2","R29.818","Z12.31","N28.9","R82.71","I08.1","R60.0","Z88.8","M51.27","J81.0"],"date":["2021-02-15","2022-09-30","2022-09-30","2023-03-23","2022-09-30","2021-08-09","2022-02-17","2023-03-24","2023-03-24","2023-01-03","2023-03-23","2022-04-14","2023-03-23","2022-04-14","2022-05-25","2023-02-28","2023-01-30","2022-05-01","2022-05-02","2022-09-30","2022-11-04","2022-11-04","2022-11-04","2022-11-04","2022-09-30","2023-02-28","2023-03-23","2023-03-23","2022-09-30","2022-11-09","2023-01-30","2022-07-28","2022-07-28","2022-11-09","2022-11-09","2022-11-23","2023-03-24","2023-01-03","2022-03-17","2022-10-18","2022-03-31","2021-12-02","2022-07-28","2022-03-31","2021-12-02","2021-12-02","2021-12-02","2023-01-03","2022-09-01","2021-12-02","2022-01-03","2022-04-25","2022-06-01","2022-06-01","2022-06-01","2022-06-01","2022-06-01","2022-07-28","2023-01-03","2023-01-03","2022-07-28","2022-03-23","2021-02-23","2021-12-14","2022-01-27","2022-07-28","2022-07-28","2022-04-21","2022-02-03","2022-06-24","2022-02-17","2022-04-30","2022-04-30","2022-04-30","2022-04-30","2022-05-25","2022-05-25","2022-06-24","2022-06-24","2022-06-24","2022-06-24","2022-06-24","2022-11-15","2022-11-15","2023-02-28","2023-02-28","2021-10-08","2022-02-17","2022-03-31","2022-04-21","2022-05-25","2022-07-28","2022-07-28","2022-10-18","2022-10-20","2022-02-03","2022-09-15","2022-09-01","2023-03-24"],"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":[["","00169255013","TRESIBA FLEX","INJ 200UNIT","15","Select","Select",""],["","70010049101","METFORMIN","TAB 500MG ER","120","Select","Select",""],["","00093005401","BUSPIRONE","TAB 10MG","60","Select","Select",""],["","29300039805","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","53885000810","ONETOUCH DEL","MIS PLUS 33G","200","Select","Select",""],["","70436016701","METOPROL SUC","TAB 200MG ER","30","Select","Select",""],["","00228202950","ALPRAZOLAM","TAB 0.5MG","30","Select","Select",""],["","29300013701","CLONIDINE","TAB 0.3MG","180","Select","Select",""],["","31722070190","LOSARTAN POT","TAB 50MG","30","Select","Select",""],["","16729017001","ESCITALOPRAM","TAB 20MG","90","Select","Select",""],["","57237002801","AMOXICILLIN","TAB 500MG","30","Select","Select",""],["","65862007701","CIPROFLOXACN","TAB 500MG","20","Select","Select",""],["","16729000515","SIMVASTATIN","TAB 20MG","90","Select","Select",""],["","65162046650","IBUPROFEN","TAB 800MG","50","Select","Select",""],["","65162011510","HYDROCO\/APAP","TAB 7.5-325","21","Select","Select",""],["","51672200306","CLOTRIMAZOLE","CRE 1% VAG","45","Select","Select",""],["","00002143480","TRULICITY","INJ 1.5\/0.5","2","Select","Select",""],["","08290320122","BD PEN NEEDL","MIS 32GX4MM","100","Select","Select",""],["","00002771559","BASAGLAR","INJ 100UNIT","15","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","57237000511","FLUCONAZOLE","150 MG","5","Select","Select",""],["","10939057833","3 DAY VAGINL","CRE 0.02","21","Select","Select",""],["","00169406013","VICTOZA","3-PAK 0.6 MG\/0.1","9","Select","Select",""],["","59267100002","PFIZER VACC","INJ COVID-19","0","Select","Select",""],["","00088221905","LANTUS SOLOS","INJ 100\/ML","45","Select","Select",""],["","16571066401","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","65862042005","SMZ\/TMP DS","TAB 800-160","20","Select","Select",""],["","00169633910","NOVOLOG","INJ FLEXPEN","18","Select","Select",""],["","57599000200","FREESTYLE","MIS READER","2","Select","Select",""],["","67877021901","CEPHALEXIN","CAP 500MG","40","Select","Select",""],["","57599080300","FREESTY LIBR","MIS 2 READER","2","Select","Select",""],["","16714079701","SUMATRIPTAN","TAB 50MG","9","Select","Select",""],["","00185061501","HYDROXYZ PAM","CAP 50MG","60","Select","Select",""],["","51672130406","TERCONAZOLE","CRE 0.004","45","Select","Select",""],["","16714043901","NITROFURANTN","CAP 100MG","60","Select","Select",""],["","69238110005","DOXYCYCL HYC","CAP 100MG","20","Select","Select",""],["","58160088752","FLUARIX QUAD","INJ 2021-22","0","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","08489831510","PEN NEEDLES","MIS 32GX4MM","200","Select","Select",""],["","68180063809","ATORVASTATIN","TAB 80MG","30","Select","Select",""],["","16729022501","SPIRONOLACT","TAB 25MG","30","Select","Select",""],["","13668010501","ISOSORB MONO","TAB 60MG ER","30","Select","Select",""],["","67877057305","BENZONATATE","CAP 100MG","15","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","65162068110","PHENAZOPYRID","TAB 100MG","6","Select","Select",""],["","50111032701","HYDRALAZINE","TAB 25MG","240","Select","Select",""],["","53885004401","ONE TOUCH","KIT VERIO FL","1","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","53885027150","ONETOUCH","TES VERIO","200","Select","Select",""],["","70010077001","METHOCARBAM","TAB 750MG","60","Select","Select",""],["","11822010233","PAIN RELIEF","TAB 500MG","30","Select","Select",""],["","00143312610","DICYCLOMINE","CAP 10MG","28","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","10","Select","Select",""],["","00054429731","FUROSEMIDE","TAB 20MG","60","Select","Select",""],["","42571016242","AMOX\/K CLAV","TAB 875-125","20","Select","Select",""],["","00310621030","FARXIGA","TAB 10MG","90","Select","Select",""],["","57664037708","TRAMADOL HCL","TAB 50MG","42","Select","Select",""],["","00904701661","BUMETANIDE","TAB 1MG","60","Select","Select",""],["","66993013597","FLUTIC\/VILAN","INH 100-25","60","Select","Select",""],["","29300022019","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","00173085910","BREO ELLIPTA","INH 100-25","60","Select","Select",""],["","00078069620","ENTRESTO","TAB 97-103MG","60","Select","Select",""],["","61269073607","MICONAZOLE 7","SUP 100MG","7","Select","Select",""],["","00904759080","FEROSUL","TAB 325MG","30","Select","Select",""],["","66993058597","FLUTIC\/SALME","AER 250\/50","180","Select","Select",""],["","70010013701","NAPROXEN","TAB 250MG","60","Select","Select",""],["","10939004633","SM MICON 7","SUP 100MG","7","Select","Select",""],["","00597015230","JARDIANCE","TAB 10MG","30","Select","Select",""],["","00173069600","ADVAIR DISKU","AER 250\/50","180","Select","Select",""],["","00172392660","DIAZEPAM","TAB 5MG","2","Select","Select",""],["","00955172805","INSULIN GLAR","INJ 100U\/ML","15","Select","Select",""],["","69097081507","GABAPENTIN","400 MG","90","Select","Select",""],["","00169280015","SAXENDA","3 MG\/0.5ML","15","Select","Select",""],["","00002149580","MOUNJARO","5 MG\/0.5ML","2","Select","Select",""],["","67877021560","CEFUROXIME","TAB 250MG","20","Select","Select",""],["","68462039130","ESOMEPRA MAG","CAP 40MG DR","14","Select","Select",""],["","08489831510","DROPLET PEN NEEDLE","32GX 5\/32\"","300","Select","Select",""],["","00002771559","BASAGLAR KWIKPEN U-","100 100\/ML (3)","45","Select","Select",""],["","53885027150","ONETOUCH VERIO TEST STRIP","","200","Select","Select",""],["","50111039701","HYDRALAZINE HCL","100 MG","180","Select","Select",""],["","16714043901","NITROFURANTOIN MONO-MACRO","100 MG","20","Select","Select",""],["","00904404073","ASPIRIN","81 MG","30","Select","Select",""],["","00169633910","NOVOLOG FLEXPEN","100\/ML (3)","27","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":""}]}]}