{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LINDA L MYRICK","gend":1,"add":"165 HANSEN AVE","city":"PORTSMOUTH","state":"VA","zip":"23702-9998","dob":"1967-01-18","age":"","mstatus":"","insh":"20041358*01","cliId":"","pno":7578377173,"cno":7578377173,"email":"","ename":"","eno":"","pphy":"BRITTMAN, STANLEY L MD","ppno":7573976344,"pcpadd":"3640 HIGH STREET SUITE 3B,","pcpcity":"PORTSMOUTH","pcpstate":"VA","pcpzip":"23707-9998","pcpcounty":"","pcpid":"","pcpname":"EVMS Portsmouth Family Medicine","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7576061185,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R07.9","I42.2","I50.1","I34.0","I11.0","I50.33","J96.21","J44.1","E11.9","F32.9","F41.9","G47.30","E66.9","E78.5","Z79.4","Z85.850","Z91.81","F33.1","E87.70","J44.9","Z86.73","Z79.51","Z79.899","Z68.41","I16.1","I50.23","R09.02","E11.65","NO DATA","R51.9","J45.40","E66.01","E11.8","R06.00","R33.9","N17.9","M79.641","M79.642","G56.01","G56.02","M65.341","H40.013","H40.053","I10.","R49.0","M25.461","M17.11","M25.661","J80.","F43.29","R73.9","R06.02","J96.20","G47.33","R20.0","G89.29","J96.01","I50.9","D72.829","D72.9","I50.30","I16.0","F43.21","F33.2","R40.4","Z68.34","M25.561","R05.8","R00.0","R11.2","I50.32","E78.2","Z09.","Z68.35","R94.31","D72.820","E87.6","I25.10","Z20.822","Z68.37","Z90.710","Z91.14","R06.9","J96.91","J96.92","I51.7","R05.9","Z82.5","Z86.79","R26.9","T83.9XXA","Z88.0","T83.038A","J45.901","F41.8","L60.0","L03.032","B95.61","L24.0","H81.10","M54.9","H81.12","H40.003","F33.0","R60.0","G47.00","G47.36","U07.1","M20.21","E11.42","E11.21","D46.9","E26.9","E89.0","E04.9","R20.2","J45.909","R07.89","M46.1","Z86.39","G47.61","G25.81","M54.2","N28.1","R10.11","K21.9","R19.7","R11.0","M62.838","M25.511","J02.9","R03.0"],"date":["2022-07-24","2021-05-10","2021-12-20","2021-12-21","2023-02-22","2022-05-25","2021-08-05","2021-08-05","2023-03-17","2021-08-24","2021-12-20","2021-12-02","2023-02-22","2021-08-05","2023-08-28","2021-12-20","2021-08-05","2022-06-29","2021-12-02","2023-02-22","2023-02-22","2021-12-20","2023-02-22","2023-02-22","2021-12-21","2021-12-20","2021-12-20","2023-08-28","2023-08-28","2023-01-17","2023-08-28","2023-07-06","2021-12-20","2022-05-13","2022-05-31","2022-05-26","2021-02-24","2021-02-24","2021-02-24","2021-02-24","2021-02-24","2021-01-14","2021-01-14","2023-09-05","2023-09-05","2022-12-07","2023-01-10","2021-04-27","2022-05-13","2022-06-20","2021-12-20","2022-07-24","2022-05-26","2023-07-06","2023-03-10","2023-03-10","2022-05-25","2022-06-03","2021-07-06","2021-08-26","2022-07-24","2022-11-15","2023-02-09","2023-02-09","2021-06-27","2021-06-27","2021-08-17","2021-11-11","2021-12-21","2023-01-17","2023-02-22","2022-07-28","2021-06-16","2021-06-28","2022-07-24","2021-08-26","2021-12-10","2021-12-20","2022-07-24","2021-12-20","2021-12-20","2021-12-20","2022-05-24","2022-05-24","2022-05-24","2023-02-23","2022-05-25","2022-05-25","2022-05-25","2022-05-28","2022-05-28","2022-05-28","2022-05-28","2022-07-24","2022-10-07","2022-11-07","2022-11-07","2022-11-07","2022-11-15","2023-02-22","2023-02-22","2023-02-22","2023-03-17","2021-08-24","2021-08-24","2023-07-06","2022-08-22","2022-09-08","2022-10-18","2022-10-18","2021-06-26","2021-06-26","2021-06-26","2021-06-26","2021-06-26","2023-07-13","2023-07-06","2022-07-28","2023-03-02","2023-07-06","2023-07-06","2023-07-06","2023-07-13","2023-08-28","2023-08-28","2023-05-05","2023-05-05","2023-05-05","2023-05-16","2023-05-16","2023-09-05","2023-09-05"],"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":[["","00591351004","CLONIDINE","0.3MG\/24HR","12","Select","Select",""],["","64980056310","FUROSEMIDE","40 MG","30","Select","Select",""],["","31722052201","HYDRALAZINE","TAB 100MG","270","Select","Select",""],["","57664047758","METOPROL TAR","TAB 50MG","180","Select","Select",""],["","16729021101","DOXAZOSIN","TAB 1MG","90","Select","Select",""],["","08290320109","BD PEN NEEDL","MIS 31GX8MM","100","Select","Select",""],["","00597015230","JARDIANCE","10 MG","90","Select","Select",""],["","00088221905","LANTUS SOLOS","INJ 100\/ML","24","Select","Select",""],["","16571020150","DICLOFENAC","TAB 75MG DR","60","Select","Select",""],["","65702040810","ACCU-CHEK","TES AVIVA PL","100","Select","Select",""],["","00088222033","LANTUS","100\/ML","10","Select","Select",""],["","65862020399","LOSARTAN POT","TAB 100MG","30","Select","Select",""],["","53746051401","SPIRONOLACT","TAB 50MG","5","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","07610015540","MELATONIN","TAB 5MG","30","Select","Select",""],["","57896038125","ANTI-DIARRHE","TAB 2MG","10","Select","Select",""],["","68180035302","SERTRALINE","TAB 100MG","30","Select","Select",""],["","42806071501","BENZONATATE","CAP 200MG","15","Select","Select",""],["","53885000810","ONETOUCH DEL","MIS PLUS 33G","100","Select","Select",""],["","68382039801","POT CHLORIDE","TAB 20MEQ ER","5","Select","Select",""],["","53885027210","ONETOUCH","TES VERIO","100","Select","Select",""],["","00378668977","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","27241009803","DULOXETINE","CAP 30MG","30","Select","Select",""],["","82089010334","CATAPRES-TTS","3 0.3MG\/24HR","4","Select","Select",""],["","55111012105","ATORVASTATIN","TAB 10MG","30","Select","Select",""],["","50924097110","SOFTCLIX","MIS LANCETS","100","Select","Select",""],["","69238110002","DOXYCYCL HYC","CAP 100MG","2","Select","Select",""],["","43598081115","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","69367027216","CODEINE\/GG","SOL 10-100\/5","600","Select","Select",""],["","00173071920","FLOVENT HFA","AER 110MCG","12","Select","Select",""],["","00781808926","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","32","Select","Select",""],["","00115180401","HYDROXYZ PAM","CAP 50MG","14","Select","Select",""],["","69097016887","ARFORMOTEROL","NEB 15\/2ML","120","Select","Select",""],["","56151173201","INSULIN SYRG","MIS 0.5\/31G","60","Select","Select",""],["","76204020025","ALBUTEROL","NEB 0.00083","225","Select","Select",""],["","70954006020","PREDNISONE","TAB 20MG","15","Select","Select",""],["","00002143380","TRULICITY","0.75MG\/0.5","2","Select","Select",""],["","00088221905","LANTUS SOLOSTAR","100\/ML (3)","3","Select","Select",""],["","53746051401","SPIRONOLACTONE","50 MG","90","Select","Select",""],["","75834025501","ATORVASTATIN CALCIUM","10 MG","30","Select","Select",""],["","31722052201","HYDRALAZINE HCL","100 MG","180","Select","Select",""],["","69097052444","DICLOFENAC SODIUM","1 %","100","Select","Select",""],["","08317570050","GLUCOCARD EXPRESSION","","50","Select","Select",""],["","11917015018","ULTRA THIN LANCETS","30 GAUGE","100","Select","Select",""],["","65862018730","ONDANSETRON HCL","4 MG","30","Select","Select",""],["","45963055650","GABAPENTIN","300 MG","30","Select","Select",""],["","60505265401","TRAZODONE HCL","100 MG","30","Select","Select",""],["","68180035302","SERTRALINE HCL","100 MG","30","Select","Select",""],["","65862020399","LOSARTAN POTASSIUM","100 MG","30","Select","Select",""],["","52817033010","CYCLOBENZAPRINE HCL","5 MG","30","Select","Select",""],["","29300039810","AMLODIPINE BESYLATE","10 MG","90","Select","Select",""],["","70710116201","MECLIZINE HCL","25 MG","30","Select","Select",""],["","68382050010","OMEPRAZOLE","40 MG","30","Select","Select",""],["","76204020025","ALBUTEROL SULFATE","2.5 MG\/3ML","225","Select","Select",""],["","00054429931","FUROSEMIDE TAB","40MG","30","Select","Select",""],["","65862020399","LOSARTAN POT TAB","100MG","30","Select","Select",""],["","29300013701","CLONIDINE TAB","0.3MG","90","Select","Select",""],["","00088221905","LANTUS SOLOS INJ","100\/ML","24","Select","Select",""],["","08290320109","BD PEN NEEDL MIS","31GX8MM","100","Select","Select",""],["","43598081115","CETIRIZINE TAB","10MG","30","Select","Select",""],["","31722052201","HYDRALAZINE TAB","100MG","180","Select","Select",""],["","68180035302","SERTRALINE TAB","100MG","30","Select","Select",""],["","82089010334","CATAPRES-TTS DIS","0.3\/24HR","4","Select","Select",""],["","00115180401","HYDROXYZ PAM CAP","50MG","14","Select","Select",""],["","53746051401","SPIRONOLACT TAB","50MG","90","Select","Select",""],["","00088222033","LANTUS INJ","100\/ML","10","Select","Select",""],["","56151173201","INSULIN SYRG MIS","0.5\/31G","60","Select","Select",""],["","00591351004","CLONIDINE DIS","0.3\/24HR","12","Select","Select",""],["","76204020025","ALBUTEROL NEB","0.083%","225","Select","Select",""],["","68180072103","AMLODIPINE TAB","10MG","30","Select","Select",""],["","70954006020","PREDNISONE TAB","20MG","15","Select","Select",""],["","68382039801","POT CHLORIDE TAB","20MEQ ER","5","Select","Select",""],["","69097016887","ARFORMOTEROL NEB","15\/2ML","120","Select","Select",""],["","00597015290","JARDIANCE TAB","10MG","30","Select","Select",""],["","00002143380","TRULICITY INJ","0.75\/0.5","4","Select","Select",""],["","68180098430","BUDESONIDE","0.5 MG\/2ML","60","Select","Select",""],["","42806040021","METHYLPREDNISOLONE","4 MG","21","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":""}]}]}