{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CLARENCE WATTS","gend":0,"add":"100 MARTHA LEE APT 154","city":"HAMPTON","state":"VA","zip":"23666-9998","dob":"1962-12-23","age":"","mstatus":"","insh":"20049809*01","cliId":"","pno":7579475551,"cno":7579475551,"email":"","ename":"","eno":"","pphy":"KAMINER, JON J MD","ppno":7575943800,"pcpadd":"10510 JEFFERSON AVENUE STE A,","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":"23601-9998","pcpcounty":"","pcpid":"","pcpname":"Riverside Brentwood Medical Center","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7575943818,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F20.0","F25.1","F43.10","E11.9","H25.13","E87.1","I12.9","N18.2","R80.9","E83.42","V58.89","Z23.","I10.","R06.00","G47.33","F31.9","K21.9","F20.9","Z79.899","Z79.84","Z88.0","R06.02","I89.0","M79.89","R60.0","M79.675","E11.42","B35.3","B35.1","R23.4","Z71.89","Z92.29","D63.1","R79.89","E66.01","Z68.41","NO DATA","I11.0","I50.33","I16.1","M10.9","Z80.9","Z82.49","Z88.8","E11.65","E78.5","E87.6","R77.8","I35.2","I34.0","I36.1","E11.22","R22.0","T78.40XA","I16.0"],"date":["2023-08-29","2021-11-09","2021-11-09","2023-08-29","2021-05-20","2022-10-31","2022-10-31","2022-10-31","2021-10-07","2023-08-27","2022-11-28","2022-11-28","2023-09-05","2022-01-29","2022-01-29","2023-08-27","2023-08-27","2022-01-29","2022-04-29","2022-01-29","2023-08-27","2022-01-29","2023-09-05","2022-04-29","2022-06-21","2022-06-21","2021-12-14","2021-12-14","2021-12-14","2021-12-14","2023-08-29","2021-12-14","2022-10-31","2022-10-31","2022-10-31","2022-10-31","2023-08-29","2023-08-27","2023-08-29","2023-08-29","2023-08-27","2023-08-27","2023-08-27","2023-08-27","2023-08-27","2023-08-27","2023-08-27","2023-08-29","2023-08-28","2023-08-28","2023-08-28","2023-09-05","2022-11-27","2022-11-27","2023-08-27"],"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":[["","00228212910","CLONIDINE","TAB 0.3MG","60","Select","Select",""],["","67877019905","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","00591533501","TRIHEXYPHEN","TAB 2MG","62","Select","Select",""],["","67457035959","FLUPHENAZ DE","INJ 25MG\/ML","5","Select","Select",""],["","69097094505","ATORVASTATIN","TAB 20MG","30","Select","Select",""],["","65162089809","ARIPIPRAZOLE","TAB 10MG","30","Select","Select",""],["","00904578051","HEARTBURN","TAB 20MG","60","Select","Select",""],["","45963067711","METOPROL SUC","TAB 100MG ER","30","Select","Select",""],["","43547035611","LISINOPRIL","TAB 40MG","30","Select","Select",""],["","70010006310","METFORMIN","TAB 500MG","120","Select","Select",""],["","67877084210","FAMOTIDINE","20 MG","60","Select","Select",""],["","00603020922","MAG OXIDE","TAB 400MG","180","Select","Select",""],["","51672127502","CLOTRIMAZOLE","CRE 0.01","30","Select","Select",""],["","00904759180","FEROSUL","325(65) MG","15","Select","Select",""],["","00527179001","FLUPHENAZINE","TAB 5MG","30","Select","Select",""],["","69315011710","FUROSEMIDE","40 MG","28","Select","Select",""],["","69238149101","BUMETANIDE","2 MG","30","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","64980033912","MAGNESIUM-OX","TAB 400MG","180","Select","Select",""],["","65862020299","LOSARTAN POT","TAB 50MG","17","Select","Select",""],["","45802065078","LORATADINE","TAB 10MG","28","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","00228212910","CLONIDINE HCL","0.3 MG","56","Select","Select",""],["","70436016601","METOPROLOL SUCCINATE","100 MG","28","Select","Select",""],["","69097012815","AMLODIPINE BESYLATE","10 MG","28","Select","Select",""],["","70010006310","METFORMIN HCL","500 MG","60","Select","Select",""],["","43547036111","LOSARTAN POTASSIUM","50 MG","28","Select","Select",""],["","60505082901","FLUTICASONE PROPIONATE","50 MCG","16","Select","Select",""],["","63304082890","ATORVASTATIN CALCIUM","20 MG","28","Select","Select",""],["","64980033912","MAGNESIUM OXIDE","400 MG","168","Select","Select",""],["","96295012932",""," ","1","Select","Select",""],["","00527179001","FLUPHENAZINE TAB","5MG","30","Select","Select",""],["","45963067711","METOPROL SUC TAB","100MG ER","30","Select","Select",""],["","70954021210","TRIHEXYPHEN TAB","2MG","60","Select","Select",""],["","00172572860","FAMOTIDINE TAB","20MG","60","Select","Select",""],["","70010006310","METFORMIN TAB","500MG","120","Select","Select",""],["","69097094505","ATORVASTATIN TAB","20MG","30","Select","Select",""],["","00228212910","CLONIDINE TAB","0.3MG","60","Select","Select",""],["","51672127502","CLOTRIMAZOLE CRE","1%","30","Select","Select",""],["","68180097903","LISINOPRIL TAB","40MG","30","Select","Select",""],["","00603020922","MAG OXIDE TAB","400MG","180","Select","Select",""],["","00904759180","FEROSUL TAB","325MG","15","Select","Select",""],["","68180072103","AMLODIPINE TAB","10MG","30","Select","Select",""],["","67877043205","ARIPIPRAZOLE TAB","10MG","30","Select","Select",""],["","00054429931","FUROSEMIDE TAB","40MG","30","Select","Select",""],["","60505082901","FLUTICASONE SPR","50MCG","16","Select","Select",""],["","69238149101","BUMETANIDE TAB","2MG","30","Select","Select",""],["","64980033912","MAGNESIUM-OX TAB","400MG","180","Select","Select",""],["","65862020230","LOSARTAN POT TAB","50MG","17","Select","Select",""],["","59746000103","METHYLPRED TAB","4MG","21","Select","Select",""],["","45802065078","LORATADINE TAB","10MG","28","Select","Select",""],["","16714066102","GABAPENTIN","100 MG","30","Select","Select",""],["","23155000401","HYDRALAZINE HCL","100 MG","28","Select","Select",""],["","69584085350","SPIRONOLACTONE","50 MG","30","Select","Select",""],["","70954021210","TRIHEXYPHENIDYL HCL","2 MG","56","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":""}]}]}