{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BYRON  C SPRINGER","gend":0,"add":"1131 30TH ST","city":"NEWPORT NEWS","state":"VA","zip":"23607-9998","dob":"1960-03-26","age":"","mstatus":"","insh":"1998461*01","cliId":"","pno":7572471879,"cno":7572471879,"email":"","ename":"","eno":"","pphy":"SMITH, SAMANTHA I DO","ppno":7575944431,"pcpadd":"12420 WARWICK BOULEVARD BLDG 3 SUIT,","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":"23606-9998","pcpcounty":"","pcpid":"","pcpname":"Riverside Primary Care - Hidenwood","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7575942936,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I63.9","F33.2","R26.81","R53.1","M54.16","R29.818","I63.59","M54.42","M79.609","R20.2","G81.94","NO DATA","R31.9","B20.","Z86.73","N18.9","I10.","E78.5","N40.0","C61.","R29.898","R27.8","G89.29","R26.89","Z79.899","F33.9","F41.1","H53.40","I65.1","I67.2","I16.1","E66.9","Z23.","M17.11","Z22.7","M54.9","Z51.89","I69.354","I12.9","R07.9","Z79.2","I44.0","N18.30","Z85.46","Z86.59","M25.511","Z91.14","E87.6","F31.9","Z91.51","Z68.38","Z87.891","Z79.82","F30.9","Z68.37","Z79.02","I63.522","M79.605","E66.01","Z68.35","D63.8","M62.81","R20.0","Z08.","I63.22","F31.30","G81.91","R29.703","H53.8","M19.011","G62.9","Z21.","F17.210","Z20.822","E03.9","E55.9","E11.9","R31.0","Z79.01","I65.22","I66.22","I69.351","N40.1","R33.8","F12.90","Z72.0","J45.909","M10.9","I25.10","M79.606","Z87.39","Z87.19","Z87.448","R26.2","I35.8","I69.398","M48.07","M43.17","M47.817","M51.37","I51.89","G89.4","Z51.81","F32.89","R03.0","M54.41","I63.232","V58.69","R29.704","F31.0","M54.31","K08.9","R26.9","R10.9"],"date":["2022-11-28","2023-03-07","2021-09-01","2022-11-28","2023-03-29","2022-05-21","2022-03-27","2022-05-31","2022-08-18","2022-12-13","2022-04-03","2023-06-30","2022-04-08","2023-03-03","2023-06-30","2022-05-21","2023-06-15","2023-03-03","2023-06-15","2023-06-30","2022-10-11","2022-10-11","2023-06-30","2022-11-28","2023-03-03","2021-06-08","2021-02-15","2021-06-07","2022-03-28","2022-05-19","2022-05-20","2022-06-10","2021-10-25","2021-11-03","2022-08-03","2022-04-01","2022-04-04","2022-12-13","2022-06-10","2022-05-21","2021-03-25","2022-05-19","2021-06-11","2022-07-25","2021-06-11","2021-06-11","2022-06-10","2022-05-18","2022-05-18","2022-05-18","2022-05-18","2023-06-15","2022-06-10","2022-06-10","2022-06-10","2023-06-15","2022-04-01","2022-04-01","2022-04-01","2022-04-01","2022-04-01","2022-04-27","2022-12-13","2022-07-25","2021-06-07","2021-06-07","2021-06-07","2021-06-07","2021-06-07","2021-06-07","2021-06-12","2023-06-15","2023-03-03","2021-06-07","2021-06-12","2021-06-12","2021-06-12","2022-03-27","2023-03-29","2022-03-28","2022-03-28","2021-06-12","2021-06-12","2021-06-12","2021-06-12","2021-06-12","2021-06-12","2021-06-12","2021-06-12","2022-05-19","2022-05-19","2022-05-19","2022-05-19","2022-09-15","2021-06-09","2023-06-15","2021-06-14","2022-02-02","2022-02-02","2022-02-02","2022-03-28","2023-06-30","2022-12-21","2022-03-28","2022-05-18","2022-05-31","2022-03-27","2022-03-27","2022-03-27","2023-07-13","2023-06-15","2023-06-15","2023-06-15","2023-07-27"],"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":[["","29300015101","QUETIAPINE","TAB 300MG","30","Select","Select",""],["","00555030204","HYDROXYZ PAM","CAP 50MG","60","Select","Select",""],["","60505258009","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","00832532515","POT CL MICRO","TAB 20MEQ ER","30","Select","Select",""],["","65862059801","TAMSULOSIN","CAP 0.4MG","30","Select","Select",""],["","49702023113","TRIUMEQ","600-50-300","30","Select","Select",""],["","67877019990","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","00603154258","POT CHLORIDE","SOL 0.1","450","Select","Select",""],["","49483070350","FLUOXETINE","CAP 40MG","30","Select","Select",""],["","10006070012","VITAMIN B-6","TAB 50MG","30","Select","Select",""],["","00555007101","ISONIAZID","TAB 300MG","30","Select","Select",""],["","00378425001","DOXEPIN HCL","CAP 50MG","30","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","68180037803","LOSARTAN POT","TAB 100MG","90","Select","Select",""],["","10006073017","VITAMIN B6","TAB 50MG","30","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","68382020401","GABAPENTIN","TAB 600MG","15","Select","Select",""],["","55111019630","CLOPIDOGREL","75 MG","90","Select","Select",""],["","57664037708","TRAMADOL HCL","TAB 50MG","10","Select","Select",""],["","00054472831","PREDNISONE","TAB 5MG","6","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","20","Select","Select",""],["","00904404073","ASPIRIN","CHW 81MG","30","Select","Select",""],["","49483034001","ACETAMIN","TAB 325MG","30","Select","Select",""],["","67877032001","IBUPROFEN","TAB 600MG","20","Select","Select",""],["","00603459315","METHYLPRED","TAB 4MG","21","Select","Select",""],["","42858011830","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","31722053301","METHOCARBAM","TAB 500MG","40","Select","Select",""],["","73796071002","OMRON 3 SERI","MIS BP MONIT","1","Select","Select",""],["","00904628880","ASPIRIN LOW","CHW 81MG","30","Select","Select",""],["","69097068105","PREGABALIN","100 MG","90","Select","Select",""],["","69367023705","FLUOXETINE HCL","40 MG","30","Select","Select",""],["","00555030204","HYDROXYZINE PAMOATE","50 MG","60","Select","Select",""],["","66993001968","ALBUTEROL SULFATE HFA","90 MCG","18","Select","Select",""],["","00378395277","ATORVASTATIN CALCIUM","40 MG","30","Select","Select",""],["","68180044902","QUETIAPINE FUMARATE","300 MG","30","Select","Select",""],["","68180037803","LOSARTAN POTASSIUM","100 MG","90","Select","Select",""],["","67877019905","AMLODIPINE BESYLATE","10 MG","90","Select","Select",""],["","68382013201","TAMSULOSIN HCL","0.4 MG","90","Select","Select",""],["","49702023113","TRIUMEQ TAB","","30","Select","Select",""],["","29300015101","QUETIAPINE TAB","300MG","30","Select","Select",""],["","00603154258","POT CHLORIDE SOL","10%","450","Select","Select",""],["","65862019399","FLUOXETINE CAP","20MG","30","Select","Select",""],["","10702001801","OXYCODONE TAB","5MG","20","Select","Select",""],["","00555007101","ISONIAZID TAB","300MG","30","Select","Select",""],["","00054472831","PREDNISONE TAB","5MG","6","Select","Select",""],["","00555030204","HYDROXYZ PAM CAP","50MG","60","Select","Select",""],["","57664037708","TRAMADOL HCL TAB","50MG","10","Select","Select",""],["","00378395277","ATORVASTATIN TAB","40MG","90","Select","Select",""],["","10006070012","VITAMIN B-","6 TAB 50MG","30","Select","Select",""],["","67877019905","AMLODIPINE TAB","10MG","90","Select","Select",""],["","65862035730","CLOPIDOGREL TAB","75MG","90","Select","Select",""],["","42858011830","LIDOCAINE PAD","5%","30","Select","Select",""],["","31722053301","METHOCARBAM TAB","500MG","40","Select","Select",""],["","67877032001","IBUPROFEN TAB","600MG","20","Select","Select",""],["","49483034001","ACETAMIN TAB","325MG","30","Select","Select",""],["","00603459315","METHYLPRED TAB","4MG","21","Select","Select",""],["","68382013201","TAMSULOSIN CAP","0.4MG","90","Select","Select",""],["","68180037803","LOSARTAN POT TAB","100MG","90","Select","Select",""],["","00378425001","DOXEPIN HCL CAP","50MG","30","Select","Select",""],["","00904679480","ASPIRIN LOW CHW","81MG","30","Select","Select",""],["","16714033002","GABAPENTIN TAB","600MG","15","Select","Select",""],["","00904404073","ASPIRIN CHW","81MG","30","Select","Select",""],["","66993001968","ALBUTEROL AER HFA","","18","Select","Select",""],["","73796071002","OMRON","3 SERI MIS BP MONIT","1","Select","Select",""],["","64980041309","PREGABALIN CAP","100MG","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":""}]}]}