{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ISMAEL RODRIGUEZ","gend":0,"add":"1764 RIVER ROCK ARCH","city":"VIRGINIA BEACH","state":"VA","zip":"23456-9998","dob":"1980-09-11","age":"","mstatus":"","insh":"1814562*01","cliId":"","pno":7572920745,"cno":7572920745,"email":"","ename":"","eno":"","pphy":"PATEL, JITENDRA M MD","ppno":7573904540,"pcpadd":"2088 S INDEPENDENCE BLVD STE 101","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":"23453-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7573902646,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R50.9","M54.9","E11.65","Z79.4","H81.22","H90.5","G95.89","NO DATA","M25.519","M48.02","M50.30","M19.90","N18.6","Z79.899","I12.9","E11.29","E66.9","Z99.2","T82.49XA","E11.22","E11.40","M48.00","Z88.5","Z87.891","Z83.3","M54.5","E11.610","E55.9","H53.9","Z49.01","A41.9","E11.69","L03.90","R06.09","E78.2","E11.9","I10.","L70.9","E11.621","E78.5","I70.25","N18.2","Z20.828","R94.31","N20.0","M25.511","M25.512","L97.511","M79.671","R60.0","R42.","E11.8","E11.628","L08.9","R51.9","R00.2","R06.00","Z00.01","R39.198","Z13.6","E07.9","N39.0","E10.621","M86.172","L97.529","R00.0","I44.4","L97.519","E78.00","Z87.442","Z82.49","Z82.3","Z83.438","Z94.7","G62.9","G44.209","L03.116","E87.2","Z91.19","Z28.21","Z68.35","Q66.72","L70.0","G35.","R90.82","H04.123","D31.32","H35.82","H25.13","T82.41XA","R93.1"],"date":["2021-05-26","2021-05-26","2021-12-21","2021-08-26","2021-09-09","2021-07-08","2021-08-27","2022-10-25","2022-03-28","2022-03-28","2022-03-28","2022-03-28","2023-03-01","2022-03-28","2022-12-12","2022-05-25","2022-05-25","2022-12-30","2022-11-17","2022-11-17","2022-11-17","2022-11-17","2022-11-17","2022-11-17","2022-11-17","2021-08-26","2021-05-23","2022-01-03","2022-07-05","2023-01-16","2021-05-25","2021-12-21","2021-12-21","2023-03-30","2023-03-30","2023-03-30","2022-10-25","2021-03-22","2021-12-19","2022-10-19","2021-12-20","2023-01-27","2021-02-14","2021-12-18","2022-10-25","2022-10-25","2022-10-25","2021-02-22","2021-02-22","2021-02-22","2021-09-23","2021-05-20","2021-12-21","2021-12-21","2022-12-12","2022-12-12","2023-02-06","2021-03-29","2021-03-29","2021-03-29","2021-03-29","2021-03-29","2021-03-29","2021-12-18","2021-03-29","2021-03-29","2021-03-29","2021-05-20","2021-12-19","2021-05-20","2021-05-20","2021-05-20","2021-05-20","2021-05-21","2021-08-26","2021-08-26","2021-12-19","2021-12-19","2021-12-19","2021-12-19","2021-12-19","2021-12-19","2021-09-22","2021-09-23","2021-09-23","2022-07-08","2022-07-08","2022-07-08","2022-07-08","2022-11-17","2023-03-30"],"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":[["","00169633910","NOVOLOG","INJ FLEXPEN","6","Select","Select",""],["","00088221905","LANTUS SOLOS","INJ 100\/ML","15","Select","Select",""],["","65162019010","NAPROXEN","TAB 500MG","60","Select","Select",""],["","67877019805","AMLODIPINE","TAB 5MG","90","Select","Select",""],["","16729004417","ATORVASTATIN","TAB 10MG","90","Select","Select",""],["","00023916360","RESTASIS","EMU 0.0005","180","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","18","Select","Select",""],["","53885004401","ONE TOUCH","KIT VERIO FL","1","Select","Select",""],["","53885001110","ONETOUCH DEL","MIS PLUS 30G","100","Select","Select",""],["","23155014201","DOXYCYCL HYC","TAB 100MG DR","30","Select","Select",""],["","53885027210","ONETOUCH","TES VERIO","100","Select","Select",""],["","64380073706","VITAMIN D","CAP 50000UNT","12","Select","Select",""],["","73070010315","INSULIN ASPA","INJ FLEXPEN","15","Select","Select",""],["","70710116201","MECLIZINE","TAB 25MG","60","Select","Select",""],["","70710112307","DOXYCYC MONO","TAB 100MG","180","Select","Select",""],["","31722070290","LOSARTAN POT","TAB 100MG","90","Select","Select",""],["","69076014601","ACYCLOVIR","CAP 200MG","100","Select","Select",""],["","59746017306","PREDNISONE","TAB 10MG","63","Select","Select",""],["","67877022405","GABAPENTIN","CAP 400MG","30","Select","Select",""],["","65162004710","OXYCODONE","TAB 5MG","60","Select","Select",""],["","00172392660","DIAZEPAM","TAB 5MG","30","Select","Select",""],["","45802031801","BENZOYL PER","LIQ 10% WASH","142","Select","Select",""],["","68382004101","PROMETHAZINE","TAB 25MG","45","Select","Select",""],["","00002879959","HUMALOG KWIK","INJ 100\/ML","15","Select","Select",""],["","08290320122","BD PEN NEEDL","MIS 32GX4MM","100","Select","Select",""],["","47335070713","TOPIRAMATE","TAB 25MG","180","Select","Select",""],["","45802026337","CLINDAMYCIN","MIS 0.01","60","Select","Select",""],["","65862050220","AMOX\/K CLAV","TAB 500-125","14","Select","Select",""],["","00093216568","NALOXONE HCL","SPR ","2","Select","Select",""],["","00536104710","SODIUM BICAR","TAB 650MG","120","Select","Select",""],["","24208091055","ERYTHROMYCIN","OIN 5MG\/GM","4","Select","Select",""],["","59267100002","PFIZER VACC","INJ COVID-19","0","Select","Select",""],["","50419054001","KERENDIA","TAB 10MG","30","Select","Select",""],["","49230064551","VELPHORO","500MG IRON","90","Select","Select",""],["","68382079805","LABETALOL","TAB 100MG","60","Select","Select",""],["","69315011710","FUROSEMIDE","40 MG","30","Select","Select",""],["","00713068315","GENTAMICIN","CRE 0.001","15","Select","Select",""],["","00527512570","LACTULOSE","SOL 10GM\/15","900","Select","Select",""],["","65162005827","SEVELAMER","TAB 800MG","150","Select","Select",""],["","72888001405","CYCLOBENZAPR","TAB 10MG","60","Select","Select",""],["","31722070290","LOSARTAN POTASSIUM","100 MG","30","Select","Select",""],["","00169633910","NOVOLOG FLEXPEN","100\/ML (3)","9","Select","Select",""],["","27808015703","ROSUVASTATIN CALCIUM","20 MG","90","Select","Select",""],["","29300039705","AMLODIPINE BESYLATE","5 MG","90","Select","Select",""],["","00002879959","HUMALOG KWIKPEN U-","100 100\/ML","15","Select","Select",""],["","00713068315","GENTAMICIN SULFATE","0.1 %","15","Select","Select",""],["","55111078927","SEVELAMER CARBONATE","800 MG","90","Select","Select",""],["","49884012301","LABETALOL HCL","200 MG","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":""}]}]}