{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DAVID KENDALL","gend":0,"add":"7440 FENNER ST APT 4","city":"NORFOLK","state":"VA","zip":"23505-9998","dob":"1958-12-12","age":"","mstatus":"","insh":"20046241*01","cliId":"","pno":7579201839,"cno":7579201839,"email":"","ename":"","eno":"","pphy":"VILLATE PRIETO, SUSANA MD","ppno":7572782240,"pcpadd":"155 KINGSLEY LN STE 400","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":"23505-9998","pcpcounty":"","pcpid":"","pcpname":"Depaul Medical Associates","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7574896469,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J44.1","J96.21","J96.22","R09.02","J44.9","J96.11","J96.12","NO DATA","Z93.3","K94.09","Z43.3","Z48.00","Z87.19","Z90.49","M62.81","R26.81","Z91.81","E78.5","Z99.81","A41.9","J14.","Z51.5","Z66.","R65.21","I50.32","J43.2","F10.21","E04.2","Z20.822","F41.9","G25.0","F17.210","J18.9","R06.89","F17.211","Z23.","J43.1","R91.8","J47.9","R93.3","R10.33","R10.9","Z81.1","J96.01","J96.02","J43.9","F41.8","E78.2","R19.5","Z87.891","R07.9","M54.9","E04.1","Z09.","Z68.27","G93.41","I11.0","E87.5","Z59.00","Z79.899","J84.9","F32.9","E55.9","Z79.51","Z79.52","Z87.01","J47.1","R10.30","K94.00","T81.30XA","R10.84","Z68.28","Y95.","R41.0","R06.02","J41.8","Z98.890","F10.20","D72.829","R53.81","R91.1","T81.31XA","Z28.310","Z82.3","Z82.49","Z80.6","Z80.8","Z12.11","Z56.0","I95.9","I63.9","Z12.2"],"date":["2023-03-02","2023-03-02","2023-03-02","2023-03-02","2023-01-03","2023-02-17","2022-05-21","2023-02-16","2023-03-01","2022-08-19","2022-08-19","2022-08-19","2022-08-19","2022-08-19","2022-08-19","2022-08-19","2022-08-19","2023-02-16","2023-02-17","2022-11-28","2022-11-27","2022-11-23","2023-02-16","2022-11-23","2023-02-17","2022-11-23","2022-11-23","2023-02-16","2022-11-23","2023-02-16","2023-02-16","2023-01-03","2022-11-28","2022-11-23","2021-12-13","2021-11-04","2023-01-03","2023-01-03","2023-01-03","2022-05-18","2022-05-19","2022-07-01","2022-06-24","2022-11-23","2022-11-23","2022-05-14","2022-11-23","2021-11-30","2022-03-03","2022-06-02","2022-10-14","2022-12-09","2022-12-09","2022-12-09","2022-12-09","2023-02-16","2023-02-16","2023-02-16","2023-02-16","2023-02-16","2022-10-14","2021-07-17","2022-10-14","2021-07-17","2021-07-17","2023-01-03","2021-07-20","2022-05-30","2022-06-02","2022-06-03","2022-06-06","2022-10-26","2022-11-23","2023-02-16","2023-02-16","2021-05-05","2022-05-24","2022-10-14","2022-10-14","2022-10-14","2022-10-14","2022-06-02","2022-06-02","2022-06-02","2022-06-02","2022-06-02","2022-06-02","2021-11-08","2022-05-14","2022-05-14","2023-02-16","2021-12-13"],"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":[["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","00597007541","SPIRIVA","CAP HANDIHLR","30","Select","Select",""],["","00487020103","IPRATROPIUM\/","SOL ALBUTER","360","Select","Select",""],["","00603548321","PROPRANOLOL","TAB 20MG","180","Select","Select",""],["","68645052354","SERTRALINE","TAB 100MG","90","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","00173085910","BREO ELLIPTA","INH 100-25","60","Select","Select",""],["","00093505898","ATORVASTATIN","TAB 40MG","90","Select","Select",""],["","00173089310","TRELEGY","AER ELLIPTA","60","Select","Select",""],["","59746017310","PREDNISONE","10 MG","20","Select","Select",""],["","00173068220","VENTOLIN HFA","AER ","18","Select","Select",""],["","42858000101","OXYCODONE","TAB 5MG","10","Select","Select",""],["","42799060501","LOPERAMIDE","CAP 2MG","240","Select","Select",""],["","68163119101","FIBER THERAP","CAP 0.52GM","60","Select","Select",""],["","37000002304","METAMUCIL","POW 28%ORG","30","Select","Select",""],["","00536589488","NICOTINE TD","DIS 7MG\/24HR","28","Select","Select",""],["","00310009590","DALIRESP","TAB 500MCG","30","Select","Select",""],["","66993013597","FLUTIC\/VILAN","INH 100-25","60","Select","Select",""],["","69238110005","DOXYCYCL HYC","CAP 100MG","10","Select","Select",""],["","50111078810","AZITHROMYCIN","500 MG","1","Select","Select",""],["","00603548321","PROPRANOLOL HCL","20 MG","90","Select","Select",""],["","76204060001","IPRATROPIUM-ALBUTEROL","0.5-3MG\/3","360","Select","Select",""],["","47335063149","BUDESONIDE","0.25MG\/2ML","360","Select","Select",""],["","16714061305","SERTRALINE HCL","100 MG","90","Select","Select",""],["","16714017503","ATORVASTATIN CALCIUM","40 MG","90","Select","Select",""],["","66993001968","ALBUTEROL SULFATE HFA","90 MCG","18","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":""}]}]}