{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SANDRA LAW","gend":1,"add":"720 NOTTINGHAM ROAD","city":"PORTSMOUTH","state":"VA","zip":"23701-9998","dob":"1960-09-08","age":"","mstatus":"","insh":"20041579*01","cliId":"","pno":7574883030,"cno":7574883030,"email":"","ename":"","eno":"","pphy":"HUFFMAN, FRANK H MD","ppno":7575387275,"pcpadd":"1540 BREEZEPORT WAY SUITE 100,","pcpcity":"SUFFOLK","pcpstate":"VA","pcpzip":"23435-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"7574880904, 7575827763","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7573357230,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F20.0","G20.","R00.0","R25.1","R26.89","E11.9","M46.1","J43.9","F32.3","E11.21","NO DATA","Z79.4","G89.29","Z12.11","D49.0","R10.9","E83.52","R80.9","E11.29","J44.1","Z72.0","E78.2","F33.3","R97.0","K21.9","K59.00","Z86.010","C18.1","C78.6","R55.","E86.0","D72.829","W19.XXXA","E11.42","B35.1","M14.671","M14.672","J18.9","G25.9","Z20.822","I12.9","R79.89","E11.22","R09.02","F17.210","F41.8","E55.9","F29.","E87.2","R05.9","M62.81","R93.89","R41.3","F39.","R25.9","F34.9","M25.559","M54.9","J44.9","F17.200","G25.1","M54.6","M13.88","J40.","U07.1","I10.","M54.31","E87.6","Z13.0","Z13.220","Z13.228","Z13.29","Z12.4","Z12.39","G25.0","K63.5","M19.90","F51.01","N39.41","H25.043","H16.223","H43.813","J18.1","Q89.01","M53.3","M54.16","M25.552","G89.4","M47.817","M47.814","Z79.899","E07.9","E78.5","E66.9","Z68.32","G24.01","M47.816","M79.7","Z79.51","Z79.82","Z79.84","Z91.81","L57.0","L82.1","D18.00","D22.9","L81.4","Z12.83","Z71.9","Z90.81","Z08.","Z12.31","Z85.038","R94.31","R92.2","D48.5","N39.0","R13.10","N18.31","R06.02","R94.6","K76.0","I25.10","Z98.890","Z90.49","Z90.710","Z12.2","Z87.891","S79.912A","S39.92XA","Z85.028","Z88.8","Z91.048","Z87.448","M70.62","M99.03","G57.03","M99.05","M51.36","M99.04","M99.02","M99.08","M99.01","M99.07","M99.06","M99.09","F41.1","Z86.69","R00.2","R42.","E11.40","G47.30","F41.9","F31.9"],"date":["2022-01-19","2023-08-17","2021-04-06","2021-04-06","2023-01-02","2023-06-05","2021-04-06","2021-10-06","2021-04-06","2021-04-06","2023-02-28","2021-04-06","2023-02-28","2023-02-28","2022-09-01","2021-04-28","2022-03-04","2022-12-05","2022-06-03","2021-10-25","2022-07-04","2022-12-05","2023-09-05","2022-11-15","2023-02-28","2022-10-11","2023-02-28","2022-11-15","2022-10-11","2023-09-02","2021-04-03","2023-08-17","2021-04-03","2023-06-19","2023-06-19","2023-06-19","2023-06-19","2021-10-06","2021-10-06","2021-10-06","2023-02-28","2021-10-06","2023-02-28","2021-10-06","2023-02-28","2021-10-06","2023-06-05","2021-10-06","2021-10-07","2021-10-07","2022-03-04","2022-03-31","2023-02-16","2022-08-03","2021-10-27","2021-08-03","2021-11-29","2021-11-29","2023-08-17","2022-03-24","2021-11-29","2022-02-28","2022-06-03","2022-07-04","2022-07-04","2023-06-05","2022-10-21","2022-10-21","2022-01-10","2022-01-10","2022-01-10","2022-01-10","2022-01-10","2022-01-10","2022-06-06","2023-02-28","2023-02-28","2021-04-09","2021-06-10","2022-09-23","2022-09-23","2022-09-23","2021-10-06","2021-10-06","2022-02-14","2023-08-18","2023-01-02","2023-02-16","2021-06-03","2021-03-01","2023-02-28","2022-01-24","2022-11-15","2022-11-15","2022-11-15","2023-07-28","2023-02-16","2021-06-03","2021-06-03","2021-06-03","2023-02-28","2021-06-03","2021-06-24","2022-11-08","2022-11-08","2022-11-08","2022-11-08","2022-11-08","2022-11-08","2022-09-01","2022-09-01","2021-08-26","2022-09-01","2021-10-07","2022-09-01","2022-11-08","2023-01-02","2021-03-03","2021-06-03","2021-10-09","2022-04-07","2022-08-29","2022-08-29","2022-08-29","2022-08-29","2022-08-29","2021-01-22","2023-04-07","2023-01-02","2023-01-02","2023-01-02","2023-01-02","2023-01-02","2023-06-05","2023-08-07","2023-08-07","2023-08-07","2023-08-07","2023-08-07","2023-08-07","2023-08-07","2023-08-07","2023-08-07","2023-08-07","2023-08-07","2023-08-07","2023-06-29","2023-08-17","2023-08-17","2023-08-17","2023-02-28","2023-02-28","2023-02-28","2023-02-28"],"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":[["","27241009903","DULOXETINE","CAP 60MG","60","Select","Select",""],["","00002143380","TRULICITY","0.75MG\/0.5","2","Select","Select",""],["","68462039710","OMEPRAZOLE","40 MG","90","Select","Select",""],["","69315013701","BENZTROPINE","TAB 1MG","90","Select","Select",""],["","70377002911","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","00228253910","CARB\/LEVO","TAB 25-100MG","90","Select","Select",""],["","69097094312","GABAPENTIN","300 MG","90","Select","Select",""],["","00591037101","LOXAPINE","CAP 25MG","60","Select","Select",""],["","00228203150","ALPRAZOLAM","1 MG","120","Select","Select",""],["","68462038630","SOLIFENACIN","TAB 5MG","30","Select","Select",""],["","13668033101","TRAZODONE","TAB 100MG","60","Select","Select",""],["","13668009590","PRAMIPEXOLE","TAB 1.5MG","710","Select","Select",""],["","70194000330","TRULANCE","TAB 3MG","90","Select","Select",""],["","50383070016","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","65862057490","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","69784018014","POLYETH GLYC","POW 3350 NF","30","Select","Select",""],["","67877056110","METFORMIN","TAB 500MG","60","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8","Select","Select",""],["","59267102504","PFIZER VACC","INJ ADLT RTU","0","Select","Select",""],["","00536120215","LIDOCAINE PA","PAD 0.04","10","Select","Select",""],["","00597015330","JARDIANCE","25 MG","30","Select","Select",""],["","64980028101","GLIPIZIDE ER","10 MG","30","Select","Select",""],["","29300041301","CYCLOBENZAPR","TAB 5MG","90","Select","Select",""],["","69238110005","DOXYCYCL HYC","CAP 100MG","20","Select","Select",""],["","00781808926","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","35046000218","VITAMIN D-3","TAB 5000UNIT","90","Select","Select",""],["","65862050320","AMOX\/K CLAV","TAB 875-125","28","Select","Select",""],["","79854007941","VITAMIN D3","TAB 5000UNIT","90","Select","Select",""],["","49035013606","EQ LIDOCAINE","PAD 0.04","10","Select","Select",""],["","70461032203","FLUCLVX QUAD","INJ 2022-23","0","Select","Select",""],["","00409330803","ACETYLCYST","SOL 0.2","30","Select","Select",""],["","64380071206","BENZONATATE","CAP 100MG","30","Select","Select",""],["","00597007541","SPIRIVA","CAP HANDIHLR","30","Select","Select",""],["","08373053100","HOMENEB","MIS SIDESTRE","1","Select","Select",""],["","59746017506","PREDNISONE","TAB 20MG","10","Select","Select",""],["","00487020103","IPRATROPIUM\/","SOL ALBUTER","90","Select","Select",""],["","29033003206","METFORMIN ER","TAB 1000MG","30","Select","Select",""],["","60687043198","HEALTHYLAX","POW ","30","Select","Select",""],["","73796045325","NEBULIZER","MIS CMPRESSR","1","Select","Select",""],["","51672129803","KETOCONAZOLE","CRE 0.02","120","Select","Select",""],["","68180051201","LISINOPRIL","TAB 2.5MG","30","Select","Select",""],["","58160088752","FLUARIX QUAD","INJ 2021-22","0","Select","Select",""],["","82607066026","FLOWFLEX","KIT TEST","4","Select","Select",""],["","00069110120","PAXLOVID","TAB 150-100","30","Select","Select",""],["","68462010530","ONDANSETRON","TAB 4MG","3","Select","Select",""],["","00005200010","PREVNAR 20","INJ ","0","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","20","Select","Select",""],["","50111045001","TRAZODONE HCL","150 MG","90","Select","Select",""],["","62332014231","CELECOXIB","200 MG","28","Select","Select",""],["","70370108001","INGREZZA","80 MG","30","Select","Select",""],["","65862057490","MONTELUKAST SODIUM","10 MG","30","Select","Select",""],["","60505267108","ATORVASTATIN CALCIUM","80 MG","90","Select","Select",""],["","27241009903","DULOXETINE HCL","60 MG","60","Select","Select",""],["","69097084507","CYCLOBENZAPRINE HCL","5 MG","90","Select","Select",""],["","29300034301","BACLOFEN","10 MG","45","Select","Select",""],["","00378718705","METFORMIN HCL","1000 MG","60","Select","Select",""],["","68180012202","CEPHALEXIN","500 MG","14","Select","Select",""],["","45802048678","DOCUSATE SODIUM","100 MG","8","Select","Select",""],["","68462010530","ONDANSETRON HCL","4 MG","3","Select","Select",""],["","43386009019","GAVILYTE-G","236-22.74G","4000","Select","Select",""],["","65162083366","DICLOFENAC SODIUM","1 %","100","Select","Select",""],["","00781107905","ALPRAZOLAM TAB","1MG","120","Select","Select",""],["","00002143380","TRULICITY INJ","0.75\/0.5","2","Select","Select",""],["","69097094312","GABAPENTIN CAP","300MG","60","Select","Select",""],["","59310057922","PROAIR HFA AER","","8","Select","Select",""],["","51224001060","BENZONATATE CAP","100MG","15","Select","Select",""],["","27241009903","DULOXETINE CAP","60MG","60","Select","Select",""],["","00591037101","LOXAPINE CAP","25MG","60","Select","Select",""],["","68462038630","SOLIFENACIN TAB","5MG","30","Select","Select",""],["","65862057490","MONTELUKAST TAB","10MG","30","Select","Select",""],["","51672129803","KETOCONAZOLE CRE","2%","120","Select","Select",""],["","00597015230","JARDIANCE TAB","10MG","30","Select","Select",""],["","69315013701","BENZTROPINE TAB","1MG","90","Select","Select",""],["","64980028101","GLIPIZIDE ER TAB","10MG","30","Select","Select",""],["","69097084507","CYCLOBENZAPR TAB","5MG","90","Select","Select",""],["","29033003206","METFORMIN ER TAB","1000MG","30","Select","Select",""],["","67877056110","METFORMIN TAB","500MG","60","Select","Select",""],["","00597007541","SPIRIVA CAP HANDIHLR","","30","Select","Select",""],["","00093317431","ALBUTEROL AER HFA","","8","Select","Select",""],["","68180051201","LISINOPRIL TAB","2.5MG","30","Select","Select",""],["","50111056101","TRAZODONE TAB","100MG","60","Select","Select",""],["","59651000305","OMEPRAZOLE CAP","40MG","90","Select","Select",""],["","59267102504","PFIZER VACC INJ ADLT RTU","","0","Select","Select",""],["","58160088752","FLUARIX QUAD INJ","2021-22","0","Select","Select",""],["","00069110120","PAXLOVID TAB","150-100","30","Select","Select",""],["","82607066026","FLOWFLEX KIT TEST","","4","Select","Select",""],["","00781808926","AZITHROMYCIN TAB","250MG","6","Select","Select",""],["","70377002911","ATORVASTATIN TAB","40MG","30","Select","Select",""],["","47781030301","NITROFURANTN CAP","100MG","20","Select","Select",""],["","65862050320","AMOX\/K CLAV TAB","875-125","28","Select","Select",""],["","68462010530","ONDANSETRON TAB","4MG","3","Select","Select",""],["","70461032203","FLUCLVX QUAD INJ","2022-23","0","Select","Select",""],["","00005200010","PREVNAR","20 INJ","0","Select","Select",""],["","00093317431","ALBUTEROL SULFATE HFA","90 MCG","8.5","Select","Select",""],["","00597007541","SPIRIVA HANDIHALER","18 MCG","30","Select","Select",""],["","60505025203","TIZANIDINE HCL","4 MG","90","Select","Select",""],["","49483060450","IBUPROFEN","800 MG","20","Select","Select",""],["","70461032303","FLUCELVAX QUAD","2023-2024 60MCG\/.5ML","0.5","Select","Select",""],["","58160084811","AREXVY","120MCG\/0.5","1","Select","Select",""],["","47781030301","NITROFURANTOIN MONO-MACRO","100 MG","10","Select","Select",""],["","87701043001","LIDOCAINE PAIN RELIEF","4 %","3","Select","Select",""],["","43598016360","LUBIPROSTONE","8 MCG","180","Select","Select",""],["","45963043864","ENULOSE","10 G\/15 ML","900","Select","Select",""],["","65162019050","NAPROXEN","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":""}]}]}