{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"FREDERICK HOLLINSHED","gend":0,"add":"155 MYTILENE DR APT 65","city":"NEWPORT NEWS","state":"VA","zip":"23605-9998","dob":"1963-08-05","age":"","mstatus":"","insh":"20029332*01","cliId":"","pno":7572652442,"cno":7572652442,"email":"","ename":"","eno":"","pphy":"WALKER, KEVA FNP","ppno":7573808709,"pcpadd":"4714 MARSHALL AVE,","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":"23607-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":7579071928,"add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7579521345,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z12.11","D12.5","B20.","Z23.","Z79.899","R10.30","B18.2","F17.200","R10.84","R11.2","K92.0","D50.0","K25.7","B96.81","E11.9","I10.","K25.9","D64.9","R21.","NO DATA","M25.562","S82.209B","S82.202B","S82.831A","K25.4","D62.","N17.9","F14.10","F10.10","M79.606","G89.29","F17.210","K44.9","Z91.19","Z83.3","Z82.49","Z82.61","R10.32","Z87.19","Z98.890","Z86.19","J31.0","R56.9","K63.5","F17.209","M54.5","J44.9","E78.00","R60.9","J40.","K92.2","F19.10","R06.02","F17.290","N52.9","R19.7","K62.5","Z21."],"date":["2021-02-04","2021-02-04","2023-03-02","2022-11-04","2023-09-19","2021-12-10","2023-09-19","2021-12-10","2022-06-06","2023-09-19","2022-05-19","2022-05-19","2022-05-19","2022-05-19","2023-02-09","2023-09-19","2023-02-09","2023-02-09","2022-06-03","2023-02-09","2023-02-09","2021-04-08","2021-04-08","2021-04-06","2022-05-19","2022-05-19","2022-05-19","2022-05-19","2023-09-19","2022-05-19","2022-05-19","2023-09-19","2022-05-19","2022-05-19","2022-05-19","2022-05-19","2022-05-19","2023-09-19","2023-09-19","2022-01-13","2022-05-10","2022-11-04","2021-02-04","2021-02-04","2021-02-04","2021-08-16","2021-04-08","2022-02-01","2022-02-01","2021-08-16","2022-05-19","2022-05-19","2022-05-19","2023-03-02","2023-03-02","2023-09-19","2023-09-19","2023-09-19"],"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":[["","00781261305","AMOXICILLIN","500 MG","30","Select","Select",""],["","49035056314","ASPIRIN LOW","TAB 81MG EC","30","Select","Select",""],["","68645056259","IBUPROFEN","TAB 600MG","60","Select","Select",""],["","00591352530","LIDOCAINE","5 %","30","Select","Select",""],["","16571082201","LORATADINE","10 MG","30","Select","Select",""],["","43547040111","FUROSEMIDE","20 MG","60","Select","Select",""],["","61958250101","BIKTARVY","50-200-25","30","Select","Select",""],["","49035061246","ALLERGY RELF","TAB 10MG","30","Select","Select",""],["","29300041519","CYCLOBENZAPR","TAB 10MG","60","Select","Select",""],["","54629005024","VITAMIN D","3 25 MCG","60","Select","Select",""],["","68645051554","AMLODIPINE","TAB 5MG","90","Select","Select",""],["","68462029817","CLOTRIM\/BETA","CRE DIPROP","60","Select","Select",""],["","31604002678","D3","CAP 2000UNIT","30","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","31722070290","LOSARTAN POT","TAB 100MG","90","Select","Select",""],["","00904549280","THERA-M","TAB ","30","Select","Select",""],["","12843053642","BAYER LOW","TAB 81MG EC","90","Select","Select",""],["","49035049401","PAIN RELIEVR","TAB 500MG","100","Select","Select",""],["","20555002700","TAB-A-VITE","TAB ","100","Select","Select",""],["","80681002000","MULTIVITAMIN","TAB ","90","Select","Select",""],["","00173068220","VENTOLIN HFA","AER ","18","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","58602077321","PAIN RELIEF","TAB 500MG","100","Select","Select",""],["","80681016600","VITAMIN C","TAB 1000MG","30","Select","Select",""],["","49348098023","SM ASPIRIN","TAB 81MG EC","30","Select","Select",""],["","54629005024","VITAMIN D3","TAB 1000UNIT","60","Select","Select",""],["","00904672059","ACETAMIN","TAB 500MG","100","Select","Select",""],["","80681005000","DAILY-VITE","400 MCG","30","Select","Select",""],["","00904198359","MAPAP","TAB 500MG","100","Select","Select",""],["","80777027398","MODERNA VAC","INJ COVID-19","0","Select","Select",""],["","42858000101","OXYCODONE","TAB 5MG","12","Select","Select",""],["","49035048482","ACETAMINOPHN","TAB 500MG","100","Select","Select",""],["","00904530760","BANOPHEN","CAP 50MG","30","Select","Select",""],["","00527193206","CLARITHROMYC","TAB 500MG","28","Select","Select",""],["","65702072910","ACCU-CHEK","KIT GUIDE","1","Select","Select",""],["","31722071390","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","49035091530","OMEPRAZOLE","TAB 20MG","28","Select","Select",""],["","69315012710","FOLIC ACID","1 MG","30","Select","Select",""],["","50268085115","VITAMIN B1","TAB 100MG","30","Select","Select",""],["","68462015713","ONDANSETRON","TAB 4MG ODT","20","Select","Select",""],["","53885027025","ONETOUCH","TES VERIO","25","Select","Select",""],["","43598044828","NICOTINE TD","DIS 21MG\/24H","28","Select","Select",""],["","57896085101","VITAMIN B-1","TAB 100MG","30","Select","Select",""],["","10135011501","DAILY MULTI","TAB VITAMINS","30","Select","Select",""],["","49348004214","PAIN RELIEVE","TAB 500MG","100","Select","Select",""],["","49348011610","SM PAIN REL","TAB 500MG","100","Select","Select",""],["","16714049601","CLOTRIMAZOLE-BETAMETHASONE","1 %-0.05 %","60","Select","Select",""],["","00054327099","FLUTICASONE PROPIONATE","50 MCG","16","Select","Select",""],["","00093317431","ALBUTEROL SULFATE HFA","90 MCG","8.5","Select","Select",""],["","31722070290","LOSARTAN POTASSIUM","100 MG","90","Select","Select",""],["","49035061246","ALLERGY RELIEF","10 MG","30","Select","Select",""],["","29300041519","CYCLOBENZAPRINE HCL","10 MG","60","Select","Select",""],["","53885027025","ONETOUCH VERIO TEST STRIP","","25","Select","Select",""],["","31722071390","PANTOPRAZOLE SODIUM","40 MG","30","Select","Select",""],["","00904759080","FEROSUL","325(65) MG","60","Select","Select",""],["","68645051554","AMLODIPINE BESYLATE","5 MG","30","Select","Select",""],["","31722071030","SILDENAFIL CITRATE","50 MG","10","Select","Select",""],["","70677014402","CHILDREN'S ALLERGY RELIEF","12.5MG\/5ML","300","Select","Select",""],["","49035030882","PAIN RELIEVER","500 MG","60","Select","Select",""],["","68462029817","CLOTRIM\/BETA CRE DIPROP","","60","Select","Select",""],["","49035056314","ASPIRIN LOW TAB","81MG EC","30","Select","Select",""],["","31722070290","LOSARTAN POT TAB","100MG","30","Select","Select",""],["","00781261305","AMOXICILLIN CAP","500MG","30","Select","Select",""],["","00591352530","LIDOCAINE PAD","5%","30","Select","Select",""],["","61958250101","BIKTARVY TAB","","30","Select","Select",""],["","49348004537","ALLERGY RELF LIQ","12.5\/5ML","300","Select","Select",""],["","43547040111","FUROSEMIDE TAB","20MG","60","Select","Select",""],["","68645056259","IBUPROFEN TAB","600MG","60","Select","Select",""],["","68645051554","AMLODIPINE TAB","5MG","90","Select","Select",""],["","80681016600","VITAMIN C TAB","1000MG","30","Select","Select",""],["","45802065078","LORATADINE TAB","10MG","30","Select","Select",""],["","29300041519","CYCLOBENZAPR TAB","10MG","30","Select","Select",""],["","59310057922","PROAIR HFA AER","","8","Select","Select",""],["","80681005000","DAILY-VITE TAB","","30","Select","Select",""],["","00904672059","ACETAMIN TAB","500MG","100","Select","Select",""],["","00054327099","FLUTICASONE SPR","50MCG","16","Select","Select",""],["","42858000101","OXYCODONE TAB","5MG","12","Select","Select",""],["","49035049401","PAIN RELIEVR TAB","500MG","100","Select","Select",""],["","68180096301","ALBUTEROL AER HFA","","8","Select","Select",""],["","49035048482","ACETAMINOPHN TAB","500MG","100","Select","Select",""],["","49348098023","SM ASPIRIN TAB","81MG EC","30","Select","Select",""],["","00527193206","CLARITHROMYC TAB","500MG","28","Select","Select",""],["","58602077321","PAIN RELIEF TAB","500MG","100","Select","Select",""],["","57896085101","VITAMIN B-","1 TAB 100MG","30","Select","Select",""],["","69315012710","FOLIC ACID TAB","1000MCG","30","Select","Select",""],["","00904530760","BANOPHEN CAP","50MG","30","Select","Select",""],["","65702071110","ACCU-CHEK TES GUIDE","","100","Select","Select",""],["","70700015010","OMEPRAZOLE CAP","20MG","28","Select","Select",""],["","53885027025","ONETOUCH TES VERIO","","25","Select","Select",""],["","65702072910","ACCU-CHEK KIT GUIDE","","1","Select","Select",""],["","10135011501","DAILY MULTI TAB VITAMINS","","30","Select","Select",""],["","49035061246","ALLERGY RELF TAB","10MG","30","Select","Select",""],["","31722071390","PANTOPRAZOLE TAB","40MG","30","Select","Select",""],["","50268085115","VITAMIN B","1 TAB 100MG","30","Select","Select",""],["","70000052103","OMEPRAZOLE TAB","20MG DR","60","Select","Select",""],["","49348004214","PAIN RELIEVE TAB","500MG","100","Select","Select",""],["","68462015713","ONDANSETRON TAB","4MG ODT","20","Select","Select",""],["","43598044828","NICOTINE TD DIS","21MG\/24H","28","Select","Select",""],["","49348011610","SM PAIN REL TAB","500MG","100","Select","Select",""],["","31604002678","D","3 CAP 2000UNIT","30","Select","Select",""],["","16714049601","CLOTRIM\/BETA CRE","1-0.05%","60","Select","Select",""],["","00904698520","DIPHENHYDRAMINE HCL","12.5MG\/5ML","354","Select","Select",""],["","49035048462","ACETAMINOPHEN","500 MG","60","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":""}]}]}