{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BOSTON  S ALMEIDA","gend":1,"add":"908 LITTLE BAY AVE","city":"NORFOLK","state":"VA","zip":"23503-9998","dob":"2000-12-27","age":"","mstatus":"","insh":"20017481*01","cliId":"","pno":7576328201,"cno":7576328201,"email":"","ename":"","eno":"","pphy":"ALMEIDA, JACOB DO","ppno":7572438550,"pcpadd":"SUITE 401 11848 ROCK LANDING DR,","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":"23606-9998","pcpcounty":"","pcpid":"","pcpname":"TPMG HOSPITALIST DIVISION AT MARY IMMACULATE","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7572438552,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M79.671","M25.572","M79.672","Q79.62","M67.471","G90.50","R19.7","R10.9","K62.5","K21.9","Z00.00","F32.9","F41.1","R21.","T50.995A","L50.9","M35.7","L72.0","G90.521","F41.9","G93.2","E43.","E66.9","Z68.33","M79.661","F34.1","F43.12","F45.1","F60.3","N94.6","L23.9","N92.6","N89.8","E34.9","N94.10","I49.5","R00.2","G62.9","G89.4","M25.571","F17.210","Z91.048","Z88.0","Z88.8","Z88.1","Z91.02","M19.071","G58.9","M24.9","Z99.3","R42.","S93.691A","R55.","I49.8","M19.079","G43.909","H53.9","R03.0","R09.89","H47.11","H50.311","M25.551","M25.552","R10.2","L50.3","F39.","F43.10","R53.81","R31.29","Z68.32"],"date":["2023-01-16","2021-09-08","2023-01-16","2022-01-05","2022-01-05","2022-01-05","2021-11-09","2021-11-09","2021-11-09","2021-11-09","2022-06-30","2022-05-23","2022-05-23","2022-03-28","2022-01-07","2022-01-07","2022-06-30","2022-02-01","2023-05-02","2022-06-30","2023-03-30","2022-02-24","2022-06-22","2022-02-24","2023-01-03","2023-06-13","2023-06-13","2023-06-13","2023-06-13","2022-02-18","2022-03-28","2022-02-18","2022-02-18","2022-02-18","2022-02-18","2022-06-30","2022-08-02","2022-10-06","2023-05-02","2021-12-29","2021-12-29","2021-12-29","2021-12-29","2021-12-29","2021-12-29","2021-12-29","2021-12-20","2021-09-13","2022-02-08","2021-09-15","2021-10-11","2022-01-05","2022-06-30","2022-03-25","2023-01-16","2023-03-30","2023-03-30","2021-10-27","2021-10-27","2022-10-14","2022-10-14","2021-11-11","2021-11-11","2022-03-22","2022-02-23","2022-06-30","2022-06-30","2022-06-30","2022-06-30","2022-06-30"],"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":[["","80777027310","MODERNA VAC","INJ COVID-19","0","Select","Select",""],["","00172392770","DIAZEPAM","10 MG","40","Select","Select",""],["","57237007710","ONDANSETRON","TAB 4MG ODT","20","Select","Select",""],["","68462013701","OXCARBAZEPIN","TAB 150MG","180","Select","Select",""],["","00187510102","ELIDEL","CRE 0.01","60","Select","Select",""],["","68462060965","PIMECROLIMUS","CRE 0.01","60","Select","Select",""],["","68180032002","BUPROPN HCL","TAB 300MG XL","30","Select","Select",""],["","57237000511","FLUCONAZOLE","TAB 150MG","3","Select","Select",""],["","11917017096","VITAMIN D3","CAP 2000UNIT","60","Select","Select",""],["","00115180401","HYDROXYZ PAM","CAP 50MG","60","Select","Select",""],["","29300046810","CLONIDINE","TAB 0.1MG","180","Select","Select",""],["","00093083205","CLONAZEPAM","0.5 MG","30","Select","Select",""],["","59148003813","REXULTI","2 MG","30","Select","Select",""],["","45802001402","HYDROCORT","OIN 0.025","80","Select","Select",""],["","00378727253","NORETHINDRON","TAB 0.35MG","84","Select","Select",""],["","00172572860","FAMOTIDINE","TAB 20MG","60","Select","Select",""],["","49502010202","EPINEPHRINE","INJ 0.3MG","2","Select","Select",""],["","60505083305","AZELASTINE","SPR 0.001","30","Select","Select",""],["","00430042014","LO LOESTRIN","TAB 40452","28","Select","Select",""],["","68462031829","VIORELE","21-5 (28)","28","Select","Select",""],["","65862042005","SMZ\/TMP DS","TAB 800-160","10","Select","Select",""],["","45963070911","METOPROL SUC","TAB 25MG ER","30","Select","Select",""],["","43598081115","CETIRIZINE","TAB 10MG","90","Select","Select",""],["","57237007710","ONDANSETRON ODT","4 MG","20","Select","Select",""],["","68180032002","BUPROPION XL","300 MG","30","Select","Select",""],["","72618300002","NURTEC ODT","75 MG","8","Select","Select",""],["","00115180401","HYDROXYZINE PAMOATE","50 MG","60","Select","Select",""],["","68462013701","OXCARBAZEPINE","150 MG","60","Select","Select",""],["","68462010805","TOPIRAMATE","25 MG","60","Select","Select",""],["","52817031910","BACLOFEN","5 MG","120","Select","Select",""],["","29300013601","CLONIDINE HCL","0.2 MG","180","Select","Select",""],["","69097082607","BENZTROPINE MESYLATE","0.5 MG","60","Select","Select",""],["","80777027310","MODERNA VAC INJ COVID-","19","0","Select","Select",""],["","57237007710","ONDANSETRON TAB","4MG ODT","20","Select","Select",""],["","00172392670","DIAZEPAM TAB","5MG","30","Select","Select",""],["","68462013701","OXCARBAZEPIN TAB","150MG","180","Select","Select",""],["","00115180401","HYDROXYZ PAM CAP","50MG","60","Select","Select",""],["","00093083205","CLONAZEPAM TAB","0.5MG","30","Select","Select",""],["","68180032002","BUPROPN HCL TAB","300MG XL","30","Select","Select",""],["","45802001402","HYDROCORT OIN","2.5%","80","Select","Select",""],["","00187510102","ELIDEL CRE","1%","60","Select","Select",""],["","57237000511","FLUCONAZOLE TAB","150MG","3","Select","Select",""],["","11917017096","VITAMIN D","3 CAP 2000UNIT","60","Select","Select",""],["","68462060965","PIMECROLIMUS CRE","1%","60","Select","Select",""],["","59148003713","REXULTI TAB","1MG","30","Select","Select",""],["","00378727253","NORETHINDRON TAB","0.35MG","84","Select","Select",""],["","29300046810","CLONIDINE TAB","0.1MG","180","Select","Select",""],["","49502010202","EPINEPHRINE INJ","0.3MG","2","Select","Select",""],["","00172572860","FAMOTIDINE TAB","20MG","60","Select","Select",""],["","68462031829","VIORELE TAB","","84","Select","Select",""],["","60505083305","AZELASTINE SPR","0.1%","30","Select","Select",""],["","00430042014","LO LOESTRIN TAB","1-10-10","28","Select","Select",""],["","65862042005","SMZ\/TMP DS TAB","800-160","10","Select","Select",""],["","45963070911","METOPROL SUC TAB","25MG ER","30","Select","Select",""],["","43598081115","CETIRIZINE TAB","10MG","90","Select","Select",""],["","43598081115","CETIRIZINE HCL","10 MG","30","Select","Select",""],["","45963070911","METOPROLOL SUCCINATE","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":""}]}]}