{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ANGELA MEADOWS","gend":1,"add":"1701 KING WILLIAM ROAD","city":"VIRGINIA BEACH","state":"VA","zip":"23455-9998","dob":"1967-06-11","age":"","mstatus":"","insh":"1883547*01","cliId":"","pno":7573196380,"cno":7573196380,"email":"","ename":"","eno":"","pphy":"MEADE, MONIQUE J 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":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7574896469,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H93.8X3","H90.3","J02.9","J01.81","H93.293","F17.299","K02.9","J38.4","J34.2","Z00.00","G56.41","R07.81","M27.3","B02.9","R21.","Z71.6","H25.12","H25.012","R09.81","E78.5","E55.9","R73.09","E53.8","R35.0","R63.1","M25.512","M79.605","S90.852A","S80.12XA","M06.9","F17.210","Z87.11","Z86.73","Z82.49","Z82.61","Z88.1","Z88.0","Z88.8","M25.522","Z12.83","M45.9","K08.9","Z02.89","M51.24","M50.20","M50.30","M25.561","M25.571","M25.572","M17.0","M76.821","K13.79","Z72.0","Z68.1","M25.531","M25.511","M54.9","U07.1","J40.","G89.29","R93.7","K08.89","M54.6","L82.1","L72.0","L30.9","Z71.9","R10.9","NO DATA","K74.60","I50.9","R10.12","B19.20","Z86.19","H04.123","H35.363","H25.13","H25.013","D48.5","R76.8","Z12.11","M50.10","M51.14","K64.9","K29.70","R10.31","L90.5","Z87.19","K59.00","Z80.0","H25.11","H25.011","K58.1","B37.81","L82.0","L81.4","D22.9","D18.01","Z85.828","R63.6","F41.8","F43.10","F60.3","Z87.898","G90.511","M21.331","F17.200","Z12.31","H01.001","H01.004"],"date":["2021-08-04","2021-08-04","2021-08-04","2021-08-04","2021-08-04","2021-08-04","2021-08-04","2021-08-04","2021-08-04","2022-03-14","2022-08-04","2022-03-14","2022-03-14","2022-03-14","2022-03-14","2022-03-14","2023-06-28","2023-06-28","2021-07-06","2022-11-09","2021-07-06","2021-07-06","2021-07-06","2021-07-06","2021-07-06","2021-08-24","2021-08-24","2021-08-24","2021-08-24","2021-08-24","2021-08-24","2021-08-24","2021-08-24","2021-08-24","2021-08-24","2021-08-24","2021-08-24","2021-08-24","2021-08-24","2023-08-24","2021-10-11","2021-10-11","2021-10-11","2022-04-14","2022-04-14","2022-04-14","2022-08-10","2022-07-22","2022-07-22","2022-07-22","2022-07-22","2022-08-04","2021-08-24","2022-05-27","2022-07-26","2022-01-21","2022-01-21","2022-01-21","2022-01-21","2022-11-17","2022-03-16","2022-03-16","2022-03-16","2023-08-24","2022-04-06","2022-04-06","2023-08-24","2022-11-17","2022-11-09","2022-08-31","2022-08-31","2022-08-31","2022-08-31","2022-08-31","2023-08-15","2023-06-16","2023-06-16","2023-06-16","2023-02-23","2022-05-27","2021-07-12","2022-02-14","2022-03-18","2022-11-09","2022-11-09","2022-05-27","2022-05-27","2022-05-27","2022-08-18","2022-08-18","2023-07-12","2023-07-12","2023-09-12","2023-08-18","2023-08-24","2023-08-24","2023-08-24","2023-08-24","2023-08-24","2023-09-12","2023-09-12","2023-09-12","2023-09-12","2023-09-12","2023-09-12","2023-09-12","2023-09-12","2023-09-12","2023-08-15","2023-08-15"],"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":[["","68180016106","AZITHROMYCIN TAB","500MG","3","Select","Select",""],["","00378064205","PREDNISONE TAB","20MG","18","Select","Select",""],["","00093342210","CYCLOBENZAPR TAB","10MG","15","Select","Select",""],["","00173068220","VENTOLIN HFA AER","","18","Select","Select",""],["","66993001968","ALBUTEROL AER HFA","","18","Select","Select",""],["","31722070530","VALACYCLOVIR TAB","1GM","21","Select","Select",""],["","52959006328","ERYTHROM ETH TAB","400MG","28","Select","Select",""],["","45802000403","HYDROCORT CRE","2.5%","28","Select","Select",""],["","46581083006","SALONPAS GEL PAD","4%","24","Select","Select",""],["","00093557156","ERYTHROMYCIN TAB","250MG","56","Select","Select",""],["","00536589588","NICOTINE TD DIS","14MG\/24H","28","Select","Select",""],["","00116200116","CHLORHEX GLU SOL","0.12%","473","Select","Select",""],["","00093220401","METOCLOPRAM TAB","5MG","2","Select","Select",""],["","50428057834","CVS PAIN REL PAD","4%","30","Select","Select",""],["","43386009019","GAVILYTE-G SOL","","4000","Select","Select",""],["","50428009256","GENTLE LAXAT TAB","5MG EC","2","Select","Select",""],["","71930005552","APAP\/CODEINE TAB","300-30MG","20","Select","Select",""],["","70710114003","FLUCONAZOLE TAB","200MG","14","Select","Select",""],["","60505056000","OFLOXACIN","0.3 %","5","Select","Select",""],["","60758011905","PREDNISOLONE ACETATE","1 %","5","Select","Select",""],["","42571013725","KETOROLAC TROMETHAMINE","0.5 %","5","Select","Select",""],["","00378064205","PREDNISONE","TAB 20MG","18","Select","Select",""],["","00173068220","VENTOLIN HFA","AER ","18","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","00093342210","CYCLOBENZAPR","TAB 10MG","15","Select","Select",""],["","68180016011","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","31722070530","VALACYCLOVIR","TAB 1GM","21","Select","Select",""],["","24208091055","ERYTHROMYCIN","5 MG\/GRAM","3.5","Select","Select",""],["","52959006328","ERYTHROM ETH","TAB 400MG","28","Select","Select",""],["","00536589588","NICOTINE TD","DIS 14MG\/24H","28","Select","Select",""],["","00116200116","CHLORHEX GLU","SOL 0.0012","473","Select","Select",""],["","45802000403","HYDROCORT","CRE 0.025","28","Select","Select",""],["","46581083006","SALONPAS GEL","PAD 0.04","24","Select","Select",""],["","71930005552","APAP\/CODEINE","TAB 300-30MG","20","Select","Select",""],["","50428057834","CVS PAIN REL","PAD 0.04","30","Select","Select",""],["","00093220401","METOCLOPRAM","TAB 5MG","2","Select","Select",""],["","43386009019","GAVILYTE-G","SOL ","4000","Select","Select",""],["","70710114003","FLUCONAZOLE","200 MG","14","Select","Select",""],["","50428009256","GENTLE LAXAT","TAB 5MG EC","2","Select","Select",""],["","50428199229","FIBER THERAPY","500 MG","180","Select","Select",""],["","00143122701","DICYCLOMINE HCL","20 MG","120","Select","Select",""],["","69097083305","SERTRALINE HCL","25 MG","30","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":""}]}]}