{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KENT POWELL","gend":0,"add":"2536 W PEMBROKE AVE","city":"HAMPTON","state":"VA","zip":"23661-9998","dob":"1962-10-09","age":"","mstatus":"","insh":"20052963*01","cliId":"","pno":7575895179,"cno":7575895179,"email":"","ename":"","eno":"","pphy":"ASPILI, CONCEPCION MD","ppno":7578748400,"pcpadd":"4714 MARSHALL AVE,","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":"23607-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7579280902,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.9","I10.","E78.5","C61.","B35.1","Z68.26","Z86.59","E55.9","Z79.899","F33.1","R74.8","Z51.0","Z79.818","K61.1","F41.9","E78.00","F32.9","Z79.82","Z79.84","Z87.820","Z87.81","Z87.891","Z91.02","Z91.018","M54.9","M25.561","N52.9","R51.9","Z12.11","Z12.5","R97.20","Z28.21","M54.6","N52.8","N40.1","G31.84","R42.","S06.9X0S","NO DATA","R14.0","R03.0","Z71.89","H40.003","H25.813","H52.13","H52.4","R91.8","I25.10","R91.1","Z92.3","R22.32","Z01.810","I44.4","D17.22","L72.0"],"date":["2023-07-12","2023-07-12","2023-07-12","2023-08-10","2022-12-07","2023-03-15","2023-07-12","2023-01-20","2023-07-06","2023-03-17","2022-08-31","2022-11-23","2023-07-06","2021-02-01","2023-07-06","2023-07-06","2023-07-06","2023-07-06","2023-07-06","2023-07-06","2023-07-06","2023-07-06","2023-07-06","2023-07-06","2021-07-08","2021-07-08","2023-01-25","2021-07-08","2022-01-12","2022-03-10","2022-05-18","2022-04-21","2023-01-26","2022-06-07","2022-07-19","2022-04-11","2022-04-11","2022-04-11","2023-03-15","2023-03-15","2022-01-12","2022-01-12","2022-04-06","2022-04-06","2022-04-06","2022-04-06","2023-06-12","2023-07-12","2023-06-12","2023-07-06","2023-07-11","2023-07-10","2023-07-10","2023-07-11","2023-06-30"],"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":[["","43547028111","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","23155050210","HYDROXYZ HCL","TAB 50MG","150","Select","Select",""],["","00378021410","HALOPERIDOL","2 MG","30","Select","Select",""],["","70010006505","METFORMIN","TAB 1000MG","60","Select","Select",""],["","13668018630","SILDENAFIL","TAB 25MG","18","Select","Select",""],["","00904675180","ASPIRIN LOW","TAB 81MG EC","30","Select","Select",""],["","43547037009","VALSARTAN","320 MG","30","Select","Select",""],["","69097094405","ATORVASTATIN","TAB 10MG","30","Select","Select",""],["","00904637061","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","55111028130","LEVOFLOXACIN","TAB 750MG","1","Select","Select",""],["","00536110301","ALCOHOL PREP","PAD 0.7","100","Select","Select",""],["","53885004401","ONE TOUCH","KIT VERIO FL","1","Select","Select",""],["","53885001110","ONETOUCH DEL","MIS PLUS 30G","100","Select","Select",""],["","00113200078","ALCOHOL SWAB","PAD 0.7","100","Select","Select",""],["","53885027210","ONETOUCH","TES VERIO","100","Select","Select",""],["","53885039310","ONETOUCH US","MIS LANCETS","100","Select","Select",""],["","99073011001","FREESTYLE","KIT SYSTEM","1","Select","Select",""],["","13668013705","ESCITALOPRAM OXALATE","20 MG","30","Select","Select",""],["","00904675180","ASPIRIN EC","81 MG","30","Select","Select",""],["","68180072103","AMLODIPINE BESYLATE","10 MG","90","Select","Select",""],["","53885027210","ONETOUCH VERIO TEST STRIP","","100","Select","Select",""],["","11845014479","FISH OIL","60 MG-90MG","30","Select","Select",""],["","53885001110","ONETOUCH DELICA PLUS LANCET","30 GAUGE","100","Select","Select",""],["","70010006505","METFORMIN HCL","1000 MG","60","Select","Select",""],["","68462019001","NAPROXEN","500 MG","60","Select","Select",""],["","23155050210","HYDROXYZINE HCL","50 MG","150","Select","Select",""],["","69315015510","HYDROCHLOROTHIAZIDE","12.5 MG","90","Select","Select",""],["","43547028111","ESCITALOPRAM TAB","10MG","30","Select","Select",""],["","00378021410","HALOPERIDOL TAB","2MG","30","Select","Select",""],["","23155050210","HYDROXYZ HCL TAB","50MG","150","Select","Select",""],["","00904675180","ASPIRIN LOW TAB","81MG EC","30","Select","Select",""],["","43547037009","VALSARTAN TAB","320MG","30","Select","Select",""],["","70010006505","METFORMIN TAB","1000MG","60","Select","Select",""],["","69097094405","ATORVASTATIN TAB","10MG","30","Select","Select",""],["","00093534301","SILDENAFIL TAB","100MG","6","Select","Select",""],["","69097012715","AMLODIPINE TAB","5MG","30","Select","Select",""],["","55111028130","LEVOFLOXACIN TAB","750MG","1","Select","Select",""],["","42423027101","ALCOHOL PREP PAD MED","70%","100","Select","Select",""],["","53885052401","ONETOUCH KIT ULT SMRT","","1","Select","Select",""],["","53885010207","ONETOUCH MIS LANCETS","","100","Select","Select",""],["","00536110301","ALCOHOL PREP PAD","70%","100","Select","Select",""],["","53885027210","ONETOUCH TES VERIO","","100","Select","Select",""],["","53885026701","ONETOUCH KIT VERIO IQ","","1","Select","Select",""],["","53885001110","ONETOUCH DEL MIS PLUS","30G","100","Select","Select",""],["","53885039310","ONETOUCH US MIS LANCETS","","100","Select","Select",""],["","00113200078","ALCOHOL SWAB PAD","70%","100","Select","Select",""],["","53885024510","ONETOUCH TES ULTRA","","100","Select","Select",""],["","53885004401","ONE TOUCH KIT VERIO FL","","1","Select","Select",""],["","53885024701","ONETOUCH KIT ULTRA","","1","Select","Select",""],["","99073011001","FREESTYLE KIT SYSTEM","","1","Select","Select",""],["","00904682461","HYDROCODONE-ACETAMINOPHEN","5 MG-325MG","7","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":""}]}]}