{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LARRY A SPRUILL","gend":0,"add":"900 DAPHIA CIR APT 103","city":"NEWPORT NEWS","state":"VA","zip":"23601-9998","dob":"1964-09-15","age":"","mstatus":"","insh":"20040999*01","cliId":"","pno":7575062418,"cno":7575062418,"email":"","ename":"","eno":"","pphy":"FELL, ROBERT S DO","ppno":7572512170,"pcpadd":"850 ENTERPRISE PARKWAY 2200,","pcpcity":"HAMPTON","pcpstate":"VA","pcpzip":"23666-9998","pcpcounty":"","pcpid":"","pcpname":"Riverside Center for Internal & Family Medicine","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7572512185,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.0","F41.1","T81.89XA","S81.001A","V58.89","J44.9","M1A.9XX0","Z79.52","M19.90","F41.9","F32.9","NO DATA","F11.10","F10.10","F33.2","H31.092","H43.813","H25.13","H04.123","Z96.1","M24.452","Z96.642","S73.005A","G47.30","I25.10","K21.9","F33.1","M10.9","T84.53XD","H54.42A3","T84.53XA","Z96.651","M06.9","F17.210","Z79.899","M25.552","R00.0","L50.8","Z71.9","R10.84","R11.15","R69.","S39.012A","H60.91","H66.91","T81.49XA","T81.31XA","D64.9","F17.200","I10.","H16.143","R20.2","R29.898","M25.512","G89.4","M1A.09X0","G89.29","M25.561","R06.02","S73.005S","S73.004S","Z72.0","F41.3","T84.59XA","T84.021A","L08.9","Z01.818","Z20.822","S81.002A","G45.9","Z01.812","M05.79","M47.812","M47.27","G89.28","Z47.89","T84.59XD","F10.21","X50.9XXA","L27.0","D69.2","R52.","Z79.2","Z87.891","Z91.14","T14.8XXA","J44.1","E87.6","R09.02","T81.31XD","L97.812","H54.62","Z82.61","Z88.5","Z88.8","M15.9","Z23.","X58.XXXA","G62.9","Z96.643","G90.09","M06.09","M15.0","M21.372","M21.332","R50.9","L92.9","G89.18","R35.0","K13.1","M10.071","H35.61","M06.321","M06.322","R10.11","R10.32","M51.36","K22.3","Z79.631","F33.8","G47.01","M15.1","M15.2","Z96.652","Z96.641","J34.89","J34.2","Z87.39","Z01.810","V89.2XXA","S79.919A","J33.8","R35.1","S73.002S","W18.30XA","M25.559","F10.14","F41.8","N40.0","X50.1XXA","S33.6XXA","M47.896","Z98.1","Z47.1","W19.XXXA","G93.40","R41.82"],"date":["2021-05-05","2022-06-20","2022-04-17","2021-07-07","2022-09-09","2023-08-31","2021-09-30","2023-07-18","2022-12-06","2022-05-01","2022-04-25","2023-08-17","2022-04-25","2022-04-25","2023-08-02","2022-12-19","2022-12-19","2022-12-19","2022-12-19","2022-12-19","2023-07-31","2023-08-30","2023-08-31","2022-03-16","2023-08-24","2023-08-02","2023-03-30","2023-08-02","2021-07-21","2021-07-21","2022-03-11","2023-02-13","2023-08-24","2023-08-02","2023-09-14","2023-08-23","2022-04-30","2022-05-05","2022-05-05","2022-09-08","2022-09-08","2022-09-08","2023-01-17","2023-01-17","2023-01-17","2021-06-02","2021-06-23","2023-08-23","2023-08-30","2023-08-30","2022-09-02","2022-12-01","2022-12-01","2022-12-01","2023-02-13","2023-07-18","2023-09-14","2023-02-13","2022-05-01","2022-10-11","2022-10-11","2023-07-17","2023-07-25","2021-01-12","2023-08-30","2021-03-10","2021-05-05","2021-05-05","2021-05-11","2021-05-11","2021-09-08","2023-03-30","2023-03-30","2021-12-08","2022-10-11","2021-06-28","2021-06-28","2022-03-24","2022-03-16","2022-03-24","2022-03-24","2022-03-24","2022-03-24","2022-05-01","2022-08-05","2022-08-29","2022-05-01","2023-08-23","2023-08-31","2021-06-30","2021-06-30","2022-05-01","2022-03-16","2022-05-01","2022-03-16","2023-03-30","2022-10-11","2021-02-01","2022-05-01","2023-09-01","2022-05-01","2023-09-14","2022-07-20","2022-12-06","2022-12-06","2021-01-04","2021-01-12","2021-01-12","2021-08-04","2021-08-04","2022-09-03","2022-12-19","2023-03-30","2023-03-30","2023-03-30","2023-03-30","2023-03-30","2023-03-30","2023-07-18","2023-07-03","2023-07-03","2023-07-18","2023-07-18","2023-07-31","2023-07-18","2023-07-19","2023-07-19","2023-09-14","2023-08-30","2023-08-17","2023-08-23","2023-07-17","2023-07-17","2023-08-29","2023-08-30","2023-07-30","2023-08-02","2023-08-02","2023-08-02","2023-08-24","2023-08-21","2023-08-21","2023-08-21","2023-08-21","2023-08-31","2023-08-31","2023-08-24"],"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":[["","58406003204","ENBREL SRCLK","INJ 50MG\/ML","4","Select","Select",""],["","60505265301","TRAZODONE","TAB 50MG","30","Select","Select",""],["","00591505210","PREDNISONE","5 MG","10","Select","Select",""],["","29300034901","ALLOPURINOL","100 MG","60","Select","Select",""],["","00406051205","OXYCOD\/APAP","TAB 5-325MG","15","Select","Select",""],["","70710115803","LEFLUNOMIDE","20 MG","60","Select","Select",""],["","23155050105","HYDROXYZ HCL","TAB 25MG","28","Select","Select",""],["","11917004959","HYDROCORT","CRE 0.01","56","Select","Select",""],["","27241009803","DULOXETINE","CAP 30MG","120","Select","Select",""],["","67877024760","QUETIAPINE","TAB 300MG","30","Select","Select",""],["","13107003205","MIRTAZAPINE","45 MG","90","Select","Select",""],["","10702005601","OXYCODONE","TAB 10MG","28","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","6","Select","Select",""],["","12496120803","SUBOXONE","8 MG-2 MG","10","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","59267102501","PFIZER VACC","INJ ADLT RTU","0","Select","Select",""],["","43598058230","BUPREN\/NALOX","MIS 8-2MG","30","Select","Select",""],["","68462012705","GABAPENTIN","800 MG","90","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","50484001030","SANTYL","OIN 250\/GM","30","Select","Select",""],["","00143992801","CIPROFLOXACN","TAB 500MG","14","Select","Select",""],["","00173068220","VENTOLIN HFA","AER ","18","Select","Select",""],["","00597007541","SPIRIVA","CAP HANDIHLR","30","Select","Select",""],["","31722089901","COLCHICINE","0.6 MG","30","Select","Select",""],["","63736012301","VITRON-C","TAB 65-125","30","Select","Select",""],["","29300012510","MELOXICAM","TAB 15MG","30","Select","Select",""],["","10006073027","ZINC SULFATE","TAB 220MG","30","Select","Select",""],["","11917013938","VITAMIN C","TAB 500MG","60","Select","Select",""],["","52817033200","CYCLOBENZAPR","TAB 10MG","15","Select","Select",""],["","65162052110","PROMETHAZINE","TAB 25MG","20","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","20","Select","Select",""],["","65862001705","AMOXICILLIN","CAP 500MG","4","Select","Select",""],["","00363022757","ASPIRIN","TAB 325MG EC","60","Select","Select",""],["","65162062711","TRAMADOL HCL","TAB 50MG","20","Select","Select",""],["","64380080707","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","00406048410","APAP\/CODEINE","TAB 300-30MG","6","Select","Select",""],["","45802065087","LORATADINE","10 MG","90","Select","Select",""],["","68382032001","POT CHLORIDE","TAB 10MEQ ER","30","Select","Select",""],["","23155013525","DOXYCYC MONO","TAB 100MG","20","Select","Select",""],["","68462030201","INDOMETHACIN","CAP 50MG","15","Select","Select",""],["","00713052612","PROMETHEGAN","SUP 25MG","20","Select","Select",""],["","11877001140","BINAXNOW COV","KIT HOME TES","8","Select","Select",""],["","65862042005","SMZ\/TMP DS","TAB 800-160","20","Select","Select",""],["","67877021620","CEFUROXIME","TAB 500MG","20","Select","Select",""],["","59651031577","TIZANIDINE","CAP 4MG","120","Select","Select",""],["","55111018015","TIZANIDINE HCL","4 MG","120","Select","Select",""],["","67877024760","QUETIAPINE FUMARATE","300 MG","90","Select","Select",""],["","27241009803","DULOXETINE HCL","30 MG","60","Select","Select",""],["","00781618667","CIPROFLOXACIN-DEXAMETHASONE","0.3 %-0.1%","7.5","Select","Select",""],["","43598058230","BUPRENORPHINE-NALOXONE","8 MG-2 MG","60","Select","Select",""],["","65862017760","CEFDINIR","300 MG","20","Select","Select",""],["","00591352530","LIDOCAINE","5 %","14","Select","Select",""],["","59267030401","PFIZER COVID BIVAL (","12Y UP)EUA 30 MCG\/0.3","0.3","Select","Select",""],["","70010077001","METHOCARBAMOL","750 MG","15","Select","Select",""],["","66993001968","ALBUTEROL SULFATE HFA","90 MCG","18","Select","Select",""],["","00003218851","ORENCIA CLICKJECT","125 MG\/ML","4","Select","Select",""],["","80681003400","SHEER ADHESIVE BANDAGES","0.75\"X3\"","8","Select","Select",""],["","13107003234","MIRTAZAPINE TAB","45MG","30","Select","Select",""],["","00591505210","PREDNISONE TAB","5MG","90","Select","Select",""],["","67877024760","QUETIAPINE TAB","300MG","90","Select","Select",""],["","68462012705","GABAPENTIN TAB","800MG","90","Select","Select",""],["","12496120803","SUBOXONE MIS","8-2MG","60","Select","Select",""],["","59310057922","PROAIR HFA AER","","8","Select","Select",""],["","43598058230","BUPREN\/NALOX MIS","8-2MG","60","Select","Select",""],["","16729013401","ALLOPURINOL TAB","100MG","180","Select","Select",""],["","59267100001","PFIZER VACC INJ COVID-","19","0","Select","Select",""],["","27241009803","DULOXETINE CAP","30MG","60","Select","Select",""],["","64380080707","IBUPROFEN TAB","800MG","30","Select","Select",""],["","52817033200","CYCLOBENZAPR TAB","10MG","15","Select","Select",""],["","00363022757","ASPIRIN TAB","325MG EC","60","Select","Select",""],["","68462019005","NAPROXEN TAB","500MG","20","Select","Select",""],["","00406052201","OXYCOD\/APAP TAB","7.5-325","30","Select","Select",""],["","65162062711","TRAMADOL HCL TAB","50MG","20","Select","Select",""],["","00173068220","VENTOLIN HFA AER","","18","Select","Select",""],["","66993001968","ALBUTEROL AER HFA","","18","Select","Select",""],["","00406048410","APAP\/CODEINE TAB","300-30MG","6","Select","Select",""],["","65162052110","PROMETHAZINE TAB","25MG","20","Select","Select",""],["","59267102501","PFIZER VACC INJ ADLT RTU","","0","Select","Select",""],["","65862001705","AMOXICILLIN CAP","500MG","4","Select","Select",""],["","00378108601","COLCHICINE TAB","0.6MG","30","Select","Select",""],["","45802065087","LORATADINE TAB","10MG","30","Select","Select",""],["","57237002801","AMOXICILLIN TAB","500MG","21","Select","Select",""],["","68382032001","POT CHLORIDE TAB","10MEQ ER","30","Select","Select",""],["","60505250301","LEFLUNOMIDE TAB","20MG","30","Select","Select",""],["","68462030201","INDOMETHACIN CAP","50MG","15","Select","Select",""],["","23155013525","DOXYCYC MONO TAB","100MG","20","Select","Select",""],["","00713052612","PROMETHEGAN SUP","25MG","20","Select","Select",""],["","11877001140","BINAXNOW COV KIT HOME TES","","8","Select","Select",""],["","65862042005","SMZ\/TMP DS TAB","800-160","20","Select","Select",""],["","67877021620","CEFUROXIME TAB","500MG","20","Select","Select",""],["","59651031577","TIZANIDINE CAP","4MG","120","Select","Select",""],["","10702001801","OXYCODONE HCL","5 MG","30","Select","Select",""],["","68382013201","TAMSULOSIN HCL","0.4 MG","90","Select","Select",""],["","65862050320","AMOXICILLIN-CLAVULANATE POTASS","875-125 MG","10","Select","Select",""],["","67877075360","DRONABINOL","2.5 MG","60","Select","Select",""],["","29300046810","CLONIDINE HCL","0.1 MG","180","Select","Select",""],["","31604001281","VITAMIN B-","1 100 MG","30","Select","Select",""],["","59267030401","PFIZER COVID BIVAL (12Y UP)","EUA","0.3","Select","Select",""],["","69238117109","DOXEPIN HCL","50 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":""}]}]}