{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"VIRGINIA  L EVANS","gend":1,"add":"300 CARVER ST","city":"CHESAPEAKE","state":"VA","zip":"23513-9998","dob":"1966-07-24","age":"","mstatus":"","insh":"20027086*01","cliId":"","pno":7577521882,"cno":7577521882,"email":"","ename":"","eno":"","pphy":"TUCKER, MICHAEL MD","ppno":7576253777,"pcpadd":"110 KINGSLEY LANE SUITE 411","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":"23505-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7576257411,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F11.20","F33.1","F20.0","I67.1","F19.20","I60.9","B30.9","I10.","F25.0","E11.9","E11.8","E11.65","M79.671","Z79.4","E11.22","I12.9","NO DATA","F17.210","F17.220","Z88.8","H35.033","H43.393","J02.9","M54.2","Z53.29","R73.09","F43.10","F33.2","F41.1","F51.01","F90.0","K21.9","R07.89","K59.09","Z68.20","J45.909","E10.9","Z00.00","F17.200","E78.5","G89.29","Z28.310","Z20.822","E11.40","N39.0","Z79.899","H53.8","F25.9","F31.9","Z71.6","F14.90","F14.20","F43.12","F41.9","G47.00","F99.","R73.9","L29.2","N90.4","G62.9","E11.43","K31.84","V58.69","Z91.128","B37.3","F17.290","Z79.891","Z82.49","Z83.3","Z59.00","Z90.49","M25.561","I66.9","F11.23","F14.23","V62.84","Z91.14","Z91.5","N76.0","S92.525A","N90.89","R11.10","E13.65","E55.9","M51.37","M43.16","M16.0","M50.20","E11.01","F39.","F33.3","F11.90","L21.8","L60.0","M79.674","M79.675","B35.1","L84.","R11.2","M54.89","H11.439","R51.9","N17.9","F60.89","E11.649","H54.7","J44.9","M16.11","G40.909","M79.89","S92.521A","E11.00","G93.41","I95.9","F19.10","E86.0","R09.02"],"date":["2023-04-21","2023-04-19","2021-03-01","2022-03-31","2021-03-05","2021-03-05","2021-07-14","2023-02-07","2022-04-06","2023-04-24","2022-02-25","2023-04-01","2023-02-01","2023-01-02","2023-03-29","2023-03-29","2023-03-29","2023-03-29","2022-03-28","2023-01-02","2022-09-15","2022-09-15","2022-07-01","2022-07-01","2022-07-01","2022-07-05","2023-03-28","2023-03-28","2023-03-28","2023-03-28","2023-03-28","2023-01-02","2022-10-20","2023-03-29","2021-02-19","2023-03-29","2022-04-28","2021-10-20","2022-09-28","2022-05-16","2022-09-13","2022-07-01","2022-07-01","2022-07-08","2022-07-05","2023-01-02","2022-07-05","2023-04-01","2021-03-08","2021-03-08","2021-03-08","2021-06-14","2021-06-14","2023-01-02","2021-06-14","2021-02-14","2022-01-25","2022-12-21","2022-12-09","2022-07-05","2022-09-13","2022-09-13","2022-09-13","2022-09-13","2022-09-13","2022-09-13","2022-09-13","2023-01-02","2023-01-02","2023-01-02","2023-03-29","2021-01-29","2021-01-29","2021-09-15","2021-09-15","2021-09-15","2021-09-15","2021-09-15","2021-09-15","2022-02-18","2022-12-21","2023-01-02","2023-01-02","2023-02-07","2023-02-21","2023-02-21","2023-02-21","2023-02-21","2022-01-20","2022-01-24","2022-01-24","2022-01-24","2022-05-18","2021-02-10","2021-02-10","2021-02-10","2023-02-01","2023-02-01","2023-01-02","2021-04-06","2021-09-22","2021-09-22","2023-04-01","2022-01-19","2022-01-19","2022-01-19","2022-01-19","2022-01-19","2022-01-19","2022-02-18","2022-04-13","2023-04-01","2023-03-29","2023-03-29","2023-03-29","2023-03-29","2023-03-29"],"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":[["","29300012510","MELOXICAM","TAB 15MG","30","Select","Select",""],["","62332002891","LOSARTAN POT","TAB 50MG","30","Select","Select",""],["","00054418425","DEXAMETHASON","TAB 4MG","15","Select","Select",""],["","69097081507","GABAPENTIN","400 MG","90","Select","Select",""],["","68180051303","LISINOPRIL","TAB 5MG","30","Select","Select",""],["","70954005940","PREDNISONE","PAK 10MG","48","Select","Select",""],["","00378561505","LEVETIRACETA","TAB 500MG","60","Select","Select",""],["","68180072003","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","65162055610","TEMAZEPAM","CAP 15MG","15","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","4","Select","Select",""],["","50111064801","FLUOXETINE","CAP 20MG","30","Select","Select",""],["","65162019050","NAPROXEN","TAB 500MG","20","Select","Select",""],["","59779036751","SLEEP AID","TAB 25MG","21","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","12496120803","SUBOXONE","MIS 8-2MG","14","Select","Select",""],["","47781035703","BUPREN\/NALOX","MIS 8-2MG","25","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","9","Select","Select",""],["","00904530660","BANOPHEN","25 MG","30","Select","Select",""],["","59779092306","ALLERGY RELF","TAB 25MG","30","Select","Select",""],["","43547026910","ROPINIROLE","TAB 0.5MG","30","Select","Select",""],["","70436005801","BUPROPION","TAB 100MG SR","60","Select","Select",""],["","50111056101","TRAZODONE","TAB 100MG","14","Select","Select",""],["","00185209901","AMPHET\/DEXTR","TAB 30MG","30","Select","Select",""],["","13668013701","ESCITALOPRAM","TAB 20MG","30","Select","Select",""],["","55111032101","GLIMEPIRIDE","TAB 2MG","90","Select","Select",""],["","53885027210","ONETOUCH","TES VERIO","100","Select","Select",""],["","00088221905","LANTUS SOLOS","INJ 100\/ML","15","Select","Select",""],["","00006011231","JANUVIA","50 MG","30","Select","Select",""],["","57237016199","OMEPRAZOLE","20 MG","30","Select","Select",""],["","00228212750","CLONIDINE","TAB 0.1MG","60","Select","Select",""],["","08290320550","BD PEN NEEDL","MIS 32GX4MM","120","Select","Select",""],["","59779001951","ALLERGY REL","CAP 25MG","30","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","00093216568","NALOXONE HCL","4 MG","2","Select","Select",""],["","00169413212","OZEMPIC","INJ 2\/1.5ML","2","Select","Select",""],["","00002143380","TRULICITY","0.75MG\/0.5","2","Select","Select",""],["","70677003201","SM NICOTINE","DIS 21MG\/24H","30","Select","Select",""],["","00169406012","VICTOZA","INJ 18MG\/3ML","6","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","62756014202","METFORMIN","TAB 500MG ER","60","Select","Select",""],["","56151161011","TRUEPLUS","CHW GLUCOSE","10","Select","Select",""],["","00310653004","BYDUREON PEN","INJ 2MG","4","Select","Select",""],["","00310652401","BYETTA","INJ 10MCG","2","Select","Select",""],["","00024586903","TOUJEO SOLO","INJ 300IU\/ML","4","Select","Select",""],["","00548585000","GLUCAGON","KIT 1MG","3","Select","Select",""],["","51660033301","ARTHRTS PAIN","TAB 650MG","30","Select","Select",""],["","00228202950","ALPRAZOLAM","TAB 0.5MG","1","Select","Select",""],["","50428047392","CVS ALLERGY","CAP 25MG","30","Select","Select",""],["","00093727298","PIOGLITAZONE","TAB 30MG","30","Select","Select",""],["","65862085901","FAMOTIDINE","20 MG","60","Select","Select",""],["","76385012450","METHOCARBAM","TAB 750MG","60","Select","Select",""],["","00093321992","KETOCONAZOLE","CRE 0.02","60","Select","Select",""],["","00603188016","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","14","Select","Select",""],["","70436001102","BUPROPN HCL","TAB 300MG XL","30","Select","Select",""],["","56151146001","TRUE METRIX","TES GLUCOSE","100","Select","Select",""],["","00093220305","METOCLOPRAM","TAB 10MG","20","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","12","Select","Select",""],["","56151034025","TRUPLUS LANC","MIS 28G","100","Select","Select",""],["","42806016005","HYDROXYZ HCL","TAB 25MG","30","Select","Select",""],["","70700010915","CLOBETASOL","CRE 0.0005","15","Select","Select",""],["","43386009019","GAVILYTE-G","236-22.74G","4000","Select","Select",""],["","51672404801","CLOTRIM\/BETA","CRE DIPROP","30","Select","Select",""],["","57599080300","FREESTYLE LIBRE","2 READER","1","Select","Select",""],["","00088221905","LANTUS SOLOSTAR","100\/ML (3)","30","Select","Select",""],["","13668013701","ESCITALOPRAM OXALATE","20 MG","30","Select","Select",""],["","62332002891","LOSARTAN POTASSIUM","50 MG","30","Select","Select",""],["","68180072003","AMLODIPINE BESYLATE","5 MG","90","Select","Select",""],["","70436001102","BUPROPION XL","300 MG","30","Select","Select",""],["","13668004501","LAMOTRIGINE","25 MG","60","Select","Select",""],["","70700010918","CLOBETASOL PROPIONATE","0.05 %","90","Select","Select",""],["","51672404801","CLOTRIMAZOLE-BETAMETHASONE","1 %-0.05 %","30","Select","Select",""],["","00185209901","DEXTROAMPHETAMINE-AMPHETAMINE","30 MG","30","Select","Select",""],["","00228212750","CLONIDINE HCL","0.1 MG","60","Select","Select",""],["","49502039475","INSULIN GLARGINE-YFGN","100\/ML (3)","15","Select","Select",""],["","59779092306","ALLERGY RELIEF","25 MG","30","Select","Select",""],["","49502025175","SEMGLEE (YFGN) PEN","100\/ML (3)","15","Select","Select",""],["","00172392670","DIAZEPAM","5 MG","2","Select","Select",""],["","00093727298","PIOGLITAZONE HCL","30 MG","30","Select","Select",""],["","00548585000","GLUCAGON EMERGENCY KIT","1 MG","3","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":""}]}]}