{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"VERNON EVANS","gend":0,"add":"964 S MILITARY HWY APT 121","city":"VIRGINIA BEACH","state":"VA","zip":"23464-9998","dob":"1974-08-09","age":"","mstatus":"","insh":"20060830*01","cliId":"","pno":7573672315,"cno":7573672315,"email":"","ename":"","eno":"","pphy":"ELLIOTT, SANDIE KATRINA FNP","ppno":7573852437,"pcpadd":"104 N WITCHDUCK ROAD,","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":"23462-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7574317353,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.1","F43.12","G47.33","E11.42","M71.571","R20.2","M79.671","I10.","M79.672","E66.01","Z13.1","Z13.220","Z12.5","Z13.31","F41.1","Z59.5","Z62.810","Z65.1","E13.9","G47.21","R73.03","Z68.42","Z79.4","Z79.899","Z88.2","Z88.8","F17.210","R53.83","M10.9","E66.9","G47.30","G57.61","G57.62","M71.572","M72.2","M54.16","NO DATA","R06.83","G47.19","R06.81","Z68.41","Z87.828","M51.9","E78.1","E78.5","M47.816","K21.9","M77.41","M77.42","G60.3","K04.7","K11.5","K12.2","K08.89"],"date":["2023-07-07","2022-08-03","2023-08-14","2023-08-16","2023-06-14","2023-08-16","2023-08-16","2023-06-27","2023-08-16","2023-03-27","2023-03-27","2023-03-27","2023-03-27","2023-03-27","2022-08-03","2022-08-03","2022-08-03","2022-08-03","2022-11-04","2022-04-03","2023-05-12","2023-08-30","2022-04-03","2022-04-03","2022-04-03","2022-04-03","2022-04-03","2022-04-03","2022-04-25","2022-04-25","2022-04-25","2023-04-19","2023-04-19","2023-05-31","2023-05-31","2023-08-30","2023-08-30","2022-03-31","2022-03-31","2022-03-31","2022-04-18","2022-07-29","2022-07-29","2023-03-31","2023-06-27","2023-09-19","2023-06-27","2023-05-31","2023-05-31","2023-07-19","2023-05-18","2023-05-18","2023-05-18","2023-05-18"],"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":[["","00228257111","INDAPAMIDE","2.5 MG","30","Select","Select",""],["","60505265401","TRAZODONE","TAB 100MG","30","Select","Select",""],["","68180031909","BUPROPN HCL","TAB 150MG XL","180","Select","Select",""],["","52817033200","CYCLOBENZAPR","TAB 10MG","90","Select","Select",""],["","16729013516","ALLOPURINOL","TAB 300MG","44","Select","Select",""],["","68180072003","AMLODIPINE","TAB 5MG","90","Select","Select",""],["","00113030601","CLEARLAX","POW ","119","Select","Select",""],["","43547028110","ESCITALOPRAM","TAB 10MG","90","Select","Select",""],["","68382050010","OMEPRAZOLE","40 MG","90","Select","Select",""],["","00169413212","OZEMPIC","INJ 2\/1.5ML","2","Select","Select",""],["","47335072183","FEBUXOSTAT","TAB 40MG","30","Select","Select",""],["","68462012605","GABAPENTIN","600 MG","90","Select","Select",""],["","31722054201","INDOMETHACIN","25 MG","60","Select","Select",""],["","00363089588","NICOTINE TD","DIS 14MG\/24H","28","Select","Select",""],["","00002223680","TRULICITY","3 MG\/0.5ML","6","Select","Select",""],["","59779030603","CVS PURELAX","POW ","510","Select","Select",""],["","45802086803","POLYETH GLYC","POW 3350 NF","510","Select","Select",""],["","11523723404","MIRALAX","POW 3350 NF","510","Select","Select",""],["","00363030603","SMOOTH LAX","POW ","510","Select","Select",""],["","68180072003","AMLODIPINE BESYLATE","5 MG","90","Select","Select",""],["","43598083105","ATORVASTATIN CALCIUM","20 MG","30","Select","Select",""],["","00406055201","OXYCODONE HCL","5 MG","9","Select","Select",""],["","68180098003","LISINOPRIL","10 MG","90","Select","Select",""],["","65862018601","CLINDAMYCIN HCL","300 MG","28","Select","Select",""],["","45802086803","POLYETHYLENE GLYCOL","3350 17 G\/DOSE","510","Select","Select",""],["","27241009903","DULOXETINE HCL","60 MG","30","Select","Select",""],["","63481062970","PERCOCET","10MG-325MG","10","Select","Select",""],["","00406012505","HYDROCODONE-ACETAMINOPHEN","10MG-325MG","10","Select","Select",""],["","59651036205","IBUPROFEN","800 MG","28","Select","Select",""],["","57237002801","AMOXICILLIN","500 MG","21","Select","Select",""],["","00406052201","OXYCODONE-ACETAMINOPHEN","7.5-325 MG","10","Select","Select",""],["","00172392670","DIAZEPAM","5 MG","3","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":""}]}]}