{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ALLANDRA P SMITH","gend":1,"add":"1717 LAPSTONE CT APT 7","city":"VIRGINIA BEACH","state":"VA","zip":"23453-9998","dob":"1994-12-27","age":"","mstatus":"","insh":"20059996*01","cliId":"","pno":7573750881,"cno":7573750881,"email":"","ename":"","eno":"","pphy":"CHOU, KEVIN MD","ppno":7576863515,"pcpadd":"2088 S INDEPENDENCE BLVD","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":"23453-9998","pcpcounty":"","pcpid":"","pcpname":"Nowcare Princess Anne","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7576860230,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["O20.0","R10.9","Z67.41","Z86.2","F41.1","Z11.52","R51.9","Z20.822","M79.662","F41.0","F43.10","F33.1","F32.9","F51.01","F43.12","F33.2","Z30.09","O20.8","Z3A.01","O26.891","Z87.891","Z32.02","R87.810","R87.610","Z01.89","Z01.812","R68.81","R11.2","K44.9","K31.9","J45.909","F41.9","D57.3","Z79.899","Z97.5","Z88.0","D64.9","E55.9","M54.9","F31.9","Z33.1","Z13.89","R55.","F34.1","F60.9","Z91.410","R42.","N39.3","K59.00","R32.","I10.","E11.9","F60.3","R10.817","R10.84","B34.9","R10.2","N92.0","R23.2","R61.","R35.0","R63.4","R63.0","Z86.59","Z82.0","Z98.890","V62.84","G89.29","NO DATA","D50.9","R53.83","O02.1","N76.0","J01.90","Z91.89","Z80.3","R92.2","Z80.0","K31.89","K57.30","Z68.22","Z00.00","F32.89","N92.5","Z12.11","R19.4","Z01.419","Z30.431","Z11.3","Z91.09","Z82.49","Z80.9","M62.838","S09.90XA","F17.290","Z91.51","G54.9","O03.9","Z30.014","Z30.430","V87.7XXA","N89.8","F31.31"],"date":["2021-02-22","2021-10-15","2021-03-05","2022-07-03","2021-05-25","2021-08-25","2021-08-25","2021-11-09","2021-09-12","2023-04-26","2023-05-03","2023-02-22","2022-11-16","2022-11-16","2022-11-16","2023-02-14","2021-02-05","2021-02-19","2021-02-19","2021-02-19","2022-07-14","2021-12-09","2021-12-09","2021-12-09","2021-12-09","2021-12-09","2022-06-20","2022-07-08","2022-06-20","2022-06-20","2023-02-01","2023-05-03","2022-07-14","2022-07-14","2022-07-14","2022-07-14","2022-11-19","2023-02-03","2022-11-19","2023-05-03","2023-03-08","2023-03-31","2023-01-28","2023-02-03","2023-02-03","2023-02-03","2021-10-05","2022-02-02","2022-02-02","2022-02-02","2021-07-28","2021-07-28","2021-07-28","2021-10-15","2021-10-15","2021-11-09","2021-12-16","2021-12-16","2021-12-16","2021-12-16","2021-12-16","2022-07-14","2022-07-08","2022-07-03","2022-07-03","2022-07-03","2023-01-31","2023-01-31","2022-11-19","2022-11-19","2023-02-01","2021-03-12","2021-04-07","2021-08-21","2022-12-22","2022-12-22","2022-12-22","2022-07-14","2022-06-20","2022-07-14","2022-07-14","2022-11-04","2022-11-04","2022-01-13","2022-07-14","2022-07-08","2022-12-09","2022-12-09","2022-12-09","2021-07-28","2021-07-28","2021-07-28","2021-10-15","2021-10-15","2021-10-15","2023-01-31","2023-01-31","2021-03-19","2021-03-19","2021-05-26","2021-10-15","2021-10-21","2023-04-27"],"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":[["","58160088552","FLUARIX QUAD","INJ 2020-21","0","Select","Select",""],["","75987001003","DUEXIS","TAB 800-26.6","90","Select","Select",""],["","58160082152","ENGERIX-B","INJ 20MCG\/ML","1","Select","Select",""],["","42192032130","PNV-DHA","CAP ","90","Select","Select",""],["","13811058030","ZATEAN-PN","CAP DHA","7","Select","Select",""],["","50111064801","FLUOXETINE","CAP 20MG","30","Select","Select",""],["","59762500801","MISOPROSTOL","TAB 200MCG","8","Select","Select",""],["","57237007710","ONDANSETRON","TAB 4MG ODT","12","Select","Select",""],["","64380080707","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","00093506201","HYDROXYZ HCL","TAB 50MG","60","Select","Select",""],["","00406012305","HYDROCO\/APAP","TAB 5-325MG","10","Select","Select",""],["","57237000511","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","00093005401","BUSPIRONE","TAB 10MG","60","Select","Select",""],["","31604002516","VITAMIN D","2000 UNIT","14","Select","Select",""],["","11917011823","D3","CAP 400UNIT","30","Select","Select",""],["","65862069790","VENLAFAXINE","CAP 150MG ER","30","Select","Select",""],["","00093321205","CLONAZEPAM","1 MG","60","Select","Select",""],["","13107000130","MIRTAZAPINE","TAB 7.5MG","30","Select","Select",""],["","51224002250","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","52817033200","CYCLOBENZAPR","TAB 10MG","30","Select","Select",""],["","52536013301","MECLIZINE","TAB 25MG","60","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8","Select","Select",""],["","59267100001","PFIZER VACC","INJ COVID-19","0","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","11534016503","FOLIC ACID","TAB 1MG","30","Select","Select",""],["","00378668977","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","68382050010","OMEPRAZOLE","CAP 40MG","30","Select","Select",""],["","61874011530","VRAYLAR","1.5 MG","30","Select","Select",""],["","00115180301","HYDROXYZ PAM","CAP 25MG","56","Select","Select",""],["","67877043003","ARIPIPRAZOLE","TAB 2MG","14","Select","Select",""],["","33342006807","OLANZAPINE","TAB 5MG","30","Select","Select",""],["","65862052890","VENLAFAXINE HCL ER","75 MG","90","Select","Select",""],["","23155050001","HYDROXYZINE HCL","10 MG","180","Select","Select",""],["","68462022110","LITHIUM CARBONATE","300 MG","30","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":""}]}]}