{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LISA  M JORDON","gend":1,"add":"1556 ASPIN ST APT B","city":"NORFOLK","state":"VA","zip":"23502-9998","dob":"1970-02-07","age":"","mstatus":"","insh":"20030415*01","cliId":"","pno":7579983268,"cno":7579983268,"email":"","ename":"","eno":"","pphy":"BEVERLY, VERNIS MD","ppno":7574842001,"pcpadd":"STE A 3800 POPLAR HILL RD","pcpcity":"CHESAPEAKE","pcpstate":"VA","pcpzip":"23321-9998","pcpcounty":"","pcpid":"","pcpname":"Adult and Pediatric Medical Associates","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7574842182,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R10.9","I10.","R51.9","H90.3","H49.02","S39.012A","L24.89","K80.20","K66.0","Z53.31","V62.84","G43.901","H49.22","H57.02","F14.10","H91.93","Z86.59","H53.2","Z90.49","G89.18","M62.81","R26.89","F41.9","M54.9","R35.0","L30.9","M25.561","M25.562","K08.89","H91.90","E66.9","Z68.30","F17.200","Z88.6","Z88.0","R52.","I67.1","K80.80","Z20.822","F19.959","I51.7","I51.9","G44.59","W19.XXXA","Z72.0","R55.","G43.801","H93.13","H83.2X3","R44.3","T88.7XXA","M19.90","E55.9","Z23.","G45.9","J45.909","M79.605","M26.609","K21.9","L50.9","NO DATA","R10.11","R10.84","R45.851","Z91.14","R21.","T16.2XXA","H10.9","Z79.899","Z83.79","Z82.49","Z82.3","Z82.5","Z84.1","Z82.61","G43.909","F25.9","F14.23","Z80.9","Z81.8","Z87.828","Z87.892","H54.7","Z98.890","I63.9","H66.93","H65.93","G44.89","F25.0","T36.92XA","F32.9","F14.90","T50.904A","Z02.2","G89.29","F17.210","V58.89","R07.89","E78.5","M25.552","F14.24","I37.1","R07.9","R94.31"],"date":["2022-07-29","2023-02-03","2023-02-03","2022-09-30","2023-03-23","2022-07-27","2022-07-27","2022-09-14","2022-08-31","2022-08-31","2023-04-03","2022-10-03","2022-10-03","2022-10-03","2022-10-03","2023-04-02","2022-10-04","2022-10-04","2022-11-22","2022-10-25","2023-02-09","2023-02-09","2023-02-03","2022-11-22","2021-04-06","2022-02-08","2021-11-15","2023-04-13","2021-11-15","2022-07-29","2021-11-15","2021-11-15","2022-08-31","2022-09-30","2022-09-30","2022-07-27","2023-03-23","2022-08-29","2022-08-29","2022-09-13","2022-10-02","2022-10-02","2023-03-23","2023-04-11","2021-12-13","2023-04-11","2021-12-13","2022-07-05","2022-07-14","2022-09-06","2022-09-06","2023-02-03","2022-11-22","2022-11-22","2022-11-22","2022-11-22","2021-03-01","2021-03-01","2023-02-03","2021-10-19","2023-02-03","2022-09-30","2022-11-17","2021-06-05","2021-06-05","2021-10-19","2022-03-22","2022-07-29","2022-09-30","2022-08-31","2022-09-30","2022-08-31","2022-08-31","2022-09-30","2022-08-31","2022-09-30","2023-04-11","2022-09-30","2022-09-30","2022-09-30","2022-09-30","2022-09-30","2022-09-30","2022-10-01","2022-10-01","2022-12-30","2023-02-03","2022-09-30","2023-04-02","2023-04-02","2023-04-11","2023-04-11","2023-04-02","2023-04-13","2023-04-13","2023-04-03","2023-04-03","2023-04-07","2023-04-13","2023-04-13","2023-04-10","2023-04-08","2023-04-07","2023-04-07"],"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":[["","43547028211","ESCITALOPRAM","TAB 20MG","30","Select","Select",""],["","57664037713","TRAMADOL HCL","TAB 50MG","12","Select","Select",""],["","69842097417","DICLOFENAC","GEL 0.01","50","Select","Select",""],["","65162019050","NAPROXEN","TAB 500MG","30","Select","Select",""],["","65862042005","SMZ\/TMP DS","TAB 800-160","6","Select","Select",""],["","45802041926","AMMONIUM LAC","LOT 0.12","400","Select","Select",""],["","65162046650","IBUPROFEN","TAB 800MG","42","Select","Select",""],["","68462022517","MOMETASONE","OIN 0.001","15","Select","Select",""],["","63304069301","CLINDAMYCIN","CAP 300MG","28","Select","Select",""],["","50428028552","ACETAMINOPHN","TAB 500MG","21","Select","Select",""],["","70461032103","FLUCLVX QUAD","INJ 2021-22","0","Select","Select",""],["","71930005552","APAP\/CODEINE","TAB 300-30MG","12","Select","Select",""],["","42806016105","HYDROXYZ HCL","TAB 50MG","40","Select","Select",""],["","00378064110","PREDNISONE","TAB 10MG","43","Select","Select",""],["","50428047796","SKIN TRTMENT","LOT 0.12","400","Select","Select",""],["","00116200116","CHLORHEX GLU","SOL 0.0012","473","Select","Select",""],["","00093310905","AMOXICILLIN","CAP 500MG","28","Select","Select",""],["","68382004001","PROMETHAZINE","TAB 12.5MG","20","Select","Select",""],["","69292053201","PROPRANOLOL","TAB 20MG","30","Select","Select",""],["","68382003616","VENLAFAXINE","CAP 150MG ER","30","Select","Select",""],["","00143122701","DICYCLOMINE","TAB 20MG","30","Select","Select",""],["","00093342210","CYCLOBENZAPR","TAB 10MG","15","Select","Select",""],["","42806054701","VITAMIN D","2 1250 MCG","4","Select","Select",""],["","76385012450","METHOCARBAM","TAB 750MG","56","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","10","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","20","Select","Select",""],["","00536120207","LIDOCAINE PA","PAD 0.04","30","Select","Select",""],["","67618012012","SENOKOT EXTR","TAB 17.2MG","36","Select","Select",""],["","00904675180","ASPIRIN LOW","TAB 81MG EC","30","Select","Select",""],["","24208031510","POLYMYXIN B\/","SOL TRIMETHP","10","Select","Select",""],["","41167005840","ASPERCREME","PAD LIDO 4%","30","Select","Select",""],["","70756020511","AMITRIPTYLIN","TAB 100MG","30","Select","Select",""],["","16714048401","DIVALPROEX","TAB 250MG ER","49","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","24338010213","ERYTHROMYCIN","250 MG","40","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","49281042250","FLUZONE QUAD","2022-2023 60MCG\/.5ML","0.5","Select","Select",""],["","69097012203","TOPIRAMATE","25 MG","90","Select","Select",""],["","82607066026","FLOWFLEX COVID-","19 AG HOME TEST","8","Select","Select",""],["","69292053201","PROPRANOLOL HCL","20 MG","60","Select","Select",""],["","43547028211","ESCITALOPRAM OXALATE","20 MG","30","Select","Select",""],["","70710122901","AMITRIPTYLINE HCL","100 MG","30","Select","Select",""],["","51224002218","AZITHROMYCIN","250 MG","6","Select","Select",""],["","42571025201","CLINDAMYCIN HCL","300 MG","21","Select","Select",""],["","50111056001","TRAZODONE HCL","50 MG","30","Select","Select",""],["","00093317431","ALBUTEROL SULFATE HFA","90 MCG","8.5","Select","Select",""],["","69097015807","MELOXICAM","7.5 MG","20","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":""}]}]}