{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MURLIE TYLER","gend":1,"add":"3101 LAKE POWELL ROAD","city":"WILLIAMSBURG","state":"VA","zip":"23185-9998","dob":"1977-04-10","age":"","mstatus":"","insh":"20053827*01","cliId":"","pno":7578107655,"cno":7578107655,"email":"","ename":"","eno":"","pphy":"FEROZE, AMNA H MD","ppno":7573450011,"pcpadd":"7364 RICHMOND RD,","pcpcity":"WILLIAMSBURG","pcpstate":"VA","pcpzip":"23188-9998","pcpcounty":"","pcpid":"","pcpname":"Riverside Primary Care Norge","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7573450381,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E78.2","R79.89","F32.81","E55.9","R73.9","Z71.2","M26.621","Z09.","N93.9","R93.2","N94.6","L03.319","L02.219","H81.13","J06.9","J30.89","M25.50","J30.2","K58.2","E88.81","F17.210","H43.813","NO DATA","H43.393","R05.9","J01.00","R50.9","R09.81","J34.89","R51.9","R11.0","R10.11","L01.00","R03.0","F41.9","N92.6","I10.","R94.5","L98.8","R39.15","R10.2","N39.46","L71.9","L70.0","L73.0","L57.8","N88.8","Z71.9","Z00.00","F43.10","R73.09","K82.4","G89.29","Z82.61","Z72.0","F41.1","Z01.419","N39.0","R53.82","N89.8","L08.9","L98.9","N95.1","N85.2","W19.XXXA","K02.9","R11.2","F41.8","L03.311","M26.609","M79.7","B99.9","K76.0","J21.9","K58.9","Z87.11","Z79.82","Z79.899","B34.9","E78.5","F32.9","E66.9","Z79.2","Z88.1","Z88.5","Z88.2","Z68.39","R22.31","M25.852","M53.3","I88.9","J01.90","B96.89","Z23."],"date":["2023-07-07","2023-03-24","2021-02-10","2023-07-07","2023-07-07","2023-03-24","2021-08-09","2022-07-11","2023-02-07","2022-01-27","2023-02-07","2023-04-04","2023-04-04","2023-04-04","2023-07-07","2023-04-04","2021-06-15","2023-07-07","2022-11-11","2021-01-26","2023-07-07","2021-12-10","2023-07-07","2021-12-10","2022-10-14","2022-10-14","2022-10-14","2022-10-14","2022-10-14","2022-10-14","2022-10-14","2022-11-11","2023-03-24","2023-03-16","2023-07-07","2022-07-11","2022-07-11","2022-07-11","2023-04-06","2021-01-07","2021-08-18","2021-01-07","2021-08-26","2021-08-26","2021-06-30","2021-06-30","2021-08-18","2021-08-26","2023-03-24","2022-11-11","2022-11-11","2023-03-24","2021-01-11","2021-01-11","2021-01-11","2021-01-22","2021-05-26","2021-05-26","2021-05-26","2021-05-26","2021-06-15","2021-06-15","2021-07-14","2021-07-14","2022-02-23","2022-05-22","2022-10-09","2023-03-24","2023-04-27","2023-04-27","2022-10-11","2023-07-31","2022-05-22","2022-05-22","2022-05-22","2022-05-22","2022-05-22","2022-05-22","2022-10-09","2021-09-10","2021-09-10","2021-09-10","2021-09-10","2021-09-10","2021-09-10","2021-09-10","2021-09-10","2022-09-06","2023-09-11","2023-09-11","2023-07-07","2023-06-22","2023-06-22","2023-08-10"],"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":[["","70377002711","ATORVASTATIN","TAB 10MG","90","Select","Select",""],["","68382003416","VENLAFAXINE","CAP 37.5 ER","90","Select","Select",""],["","70710122600","AMITRIPTYLIN","TAB 25MG","30","Select","Select",""],["","16571040250","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","68180065001","DOXYCYC MONO","CAP 50MG","30","Select","Select",""],["","50428054089","CVS D3","CAP 5000UNIT","90","Select","Select",""],["","45802012801","CLINDAMYCIN","LOT 0.01","60","Select","Select",""],["","49483060350","IBUPROFEN","TAB 600MG","30","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","48","Select","Select",""],["","00093342210","CYCLOBENZAPR","TAB 10MG","30","Select","Select",""],["","13668000805","ZOLPIDEM","TAB 10MG","30","Select","Select",""],["","00228202750","ALPRAZOLAM","TAB 0.25MG","15","Select","Select",""],["","13668000905","CITALOPRAM","TAB 10MG","90","Select","Select",""],["","68180051303","LISINOPRIL","5 MG","90","Select","Select",""],["","70710113908","FLUCONAZOLE","150 MG","2","Select","Select",""],["","68180012202","CEPHALEXIN","500 MG","14","Select","Select",""],["","59651000305","OMEPRAZOLE","40 MG","90","Select","Select",""],["","65162052110","PROMETHAZINE","TAB 25MG","30","Select","Select",""],["","64380071307","BENZONATATE","CAP 200MG","20","Select","Select",""],["","65862050320","AMOX\/K CLAV","TAB 875-125","14","Select","Select",""],["","27241009809","DULOXETINE","CAP 30MG","90","Select","Select",""],["","50428054089","VITAMIN D","3 125 MCG","90","Select","Select",""],["","00054327099","FLUTICASONE PROPIONATE","50 MCG","16","Select","Select",""],["","00093342210","CYCLOBENZAPRINE HCL","10 MG","30","Select","Select",""],["","16571040250","CETIRIZINE HCL","10 MG","90","Select","Select",""],["","27241009809","DULOXETINE HCL","30 MG","30","Select","Select",""],["","13668000805","ZOLPIDEM TARTRATE","10 MG","30","Select","Select",""],["","70377002711","ATORVASTATIN CALCIUM","10 MG","90","Select","Select",""],["","53489011905","DOXYCYCLINE HYCLATE","100 MG","20","Select","Select",""],["","00093101042","MUPIROCIN","2 %","22","Select","Select",""],["","65862050320","AMOXICILLIN-CLAVULANATE POTASS","875-125 MG","28","Select","Select",""],["","68382003516","VENLAFAXINE CAP","75MG ER","90","Select","Select",""],["","70377002711","ATORVASTATIN TAB","10MG","90","Select","Select",""],["","16571040250","CETIRIZINE TAB","10MG","30","Select","Select",""],["","70710122600","AMITRIPTYLIN TAB","25MG","90","Select","Select",""],["","68180065001","DOXYCYC MONO CAP","50MG","30","Select","Select",""],["","50428054089","CVS D","3 CAP 5000UNIT","90","Select","Select",""],["","45802012801","CLINDAMYCIN LOT","1%","60","Select","Select",""],["","00093342210","CYCLOBENZAPR TAB","10MG","30","Select","Select",""],["","49483060350","IBUPROFEN TAB","600MG","30","Select","Select",""],["","00054327099","FLUTICASONE SPR","50MCG","16","Select","Select",""],["","13668000805","ZOLPIDEM TAB","10MG","30","Select","Select",""],["","13668000905","CITALOPRAM TAB","10MG","30","Select","Select",""],["","00228202750","ALPRAZOLAM TAB","0.25MG","15","Select","Select",""],["","68180051303","LISINOPRIL TAB","5MG","30","Select","Select",""],["","59651000305","OMEPRAZOLE CAP","40MG","30","Select","Select",""],["","65862050320","AMOX\/K CLAV TAB","875-125","14","Select","Select",""],["","64380071307","BENZONATATE CAP","200MG","20","Select","Select",""],["","70710113908","FLUCONAZOLE TAB","150MG","2","Select","Select",""],["","65162052110","PROMETHAZINE TAB","25MG","30","Select","Select",""],["","68180012202","CEPHALEXIN CAP","500MG","14","Select","Select",""],["","27241009809","DULOXETINE CAP","30MG","30","Select","Select",""],["","59746000103","METHYLPREDNISOLONE","4 MG","21","Select","Select",""],["","68180086111","AZITHROMYCIN","250 MG","6","Select","Select",""],["","69097015907","MELOXICAM","15 MG","30","Select","Select",""],["","70436015542","PROMETHAZINE-DM","6.25-15\/5","120","Select","Select",""],["","00781618667","CIPROFLOXACIN-DEXAMETHASONE","0.3 %-0.1%","7.5","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":""}]}]}