{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LAUREN VEON","gend":0,"add":"145 DIXIE PARK ROAD","city":"TAPPAHANNOCK","state":"VA","zip":"22560-9998","dob":"1962-11-18","age":"","mstatus":"","insh":"20061940*01","cliId":"","pno":8044456556,"cno":8044456556,"email":"","ename":"","eno":"","pphy":"TSUI, ALLEN Y MD","ppno":8044435378,"pcpadd":"1362 TAPPAHANNOCK BLVD,","pcpcity":"TAPPAHANNOCK","pcpstate":"VA","pcpzip":"22560-9998","pcpcounty":"","pcpid":"","pcpname":"Tappahannock Primary Care","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8044439667,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z11.59","C34.90","C77.1","C34.11","F41.9","F32.9","C67.9","I10.","Z95.0","C78.00","Z68.41","Z87.891","Z43.6","I48.0","Z93.6","I49.5","Z95.828","J44.9","Z51.11","E11.65","V58.89","T30.0","N39.0","Z68.27","R07.9","R91.1","R06.00","E66.9","S91.114A","S93.401A","S80.01XA","R55.","M25.521","M77.11","J03.90","K13.70","R06.83","G47.19","E66.01","Z23.","E03.9","Z71.9","C67.8","R63.5","F33.1","N18.2","M25.511","U09.9","I48.92","I25.118","I44.0","R94.39","K43.5","R05.2","Z68.38","Z99.89","R09.02","T50.905A","I50.9","E78.2","I73.9","E78.00","Z68.39","J98.4","Z92.3","Z51.12","E87.6","R05.9","N12.","M54.9","R10.9","R11.0","Z20.822","R06.02","R42.","G62.9","J44.1","S70.362A","E11.9","I48.91","I25.10","Z90.79","Z85.51","I44.1","S19.9XXA","S39.012S","K59.00","Z79.899","R06.09","NO DATA","B35.1","C34.91","J18.9","M54.5","I48.3","Z53.21","N32.89","L02.93","M25.512","J01.00","U07.1","K02.9","R10.84","A49.9","R94.31","A69.20","Z79.890","S09.90XA","S16.1XXA","S39.012A","S49.92XA","M25.561","M25.562","E07.9","W10.8XXA","S33.5XXA","S13.9XXA","J42.","R93.89","R73.03","R79.89","N18.4","I50.30","R09.81","J02.9","R51.9","M54.2","J40.","M20.22","R91.8","L02.12","R00.1","I51.7","V89.2XXA","V89.2XXD","N13.30","Z68.37","M77.9","M79.606","I83.899","R23.8","J04.0","J20.5","M19.90","D64.9","S59.901S","R31.0","R31.9","L72.3","B37.0","Z91.89","N64.4","R60.0","K58.9","R10.30","R14.2","Z04.9","Z71.89","R53.83","Z13.31","S90.222A","M79.675","M79.674","W19.XXXD","S91.114S","S93.401S","R10.10","K21.9","R80.9","T14.8XXA","S89.91XA","Z79.84","L60.8","G60.8","E78.5","Z85.118","Z85.46","W57.XXXA","I12.9","W17.89XA","E29.1","I95.1","M81.0","G47.33","Z79.52","D51.9","D50.9","R53.81","I42.0","I11.0","I50.22","R00.0","M79.671","L08.89","M77.42","M77.41","L03.031","T82.128S","H52.223","H52.03","R19.7","Z12.11","B35.6","M20.42","M20.41","E10.41","R07.2","E11.22","T83.510A","R07.89","J43.1"],"date":["2021-01-08","2023-09-12","2021-04-02","2023-09-21","2023-09-12","2023-02-13","2023-08-24","2023-08-24","2023-08-24","2023-08-24","2023-01-05","2023-07-11","2023-09-19","2023-05-17","2023-04-11","2023-08-24","2022-10-31","2023-08-24","2023-06-08","2023-04-11","2023-04-11","2021-04-06","2023-08-10","2021-04-06","2023-09-13","2023-07-03","2022-11-07","2022-12-19","2021-04-28","2021-04-27","2021-04-28","2022-08-25","2021-07-07","2021-07-07","2021-07-10","2021-07-10","2023-01-26","2021-08-11","2023-09-13","2022-10-19","2023-06-08","2023-09-13","2023-06-08","2023-01-05","2023-09-12","2023-03-09","2022-12-21","2023-01-26","2023-08-24","2022-04-08","2022-03-25","2022-03-25","2022-09-13","2022-11-07","2022-11-07","2023-09-07","2023-03-23","2023-01-05","2023-04-11","2023-08-24","2023-01-31","2023-01-31","2023-04-11","2022-01-05","2022-01-05","2023-06-08","2023-06-08","2022-09-04","2023-05-23","2022-03-14","2022-03-14","2022-03-14","2022-03-14","2022-04-08","2022-08-15","2022-08-22","2023-09-13","2022-08-11","2023-07-11","2023-08-24","2023-03-30","2022-08-11","2022-08-11","2023-08-24","2022-09-17","2022-09-23","2022-09-23","2022-11-03","2022-11-03","2023-08-07","2023-07-17","2023-04-11","2023-07-12","2021-08-24","2023-09-12","2021-09-23","2022-06-09","2021-11-03","2021-11-03","2021-11-15","2022-11-15","2022-06-20","2022-06-27","2022-07-03","2022-07-03","2022-08-11","2022-08-31","2022-09-13","2022-09-17","2022-09-17","2022-09-13","2022-09-13","2022-09-13","2022-09-13","2022-09-13","2022-09-28","2022-09-28","2022-12-05","2021-01-11","2021-01-28","2023-07-08","2022-09-20","2022-08-25","2022-09-04","2022-09-04","2022-09-13","2022-09-17","2022-10-08","2022-12-19","2023-04-11","2021-07-28","2022-03-03","2022-08-15","2022-09-17","2022-09-20","2022-09-20","2022-09-20","2022-04-11","2022-05-23","2022-05-23","2022-05-23","2022-06-30","2022-10-31","2021-01-11","2021-01-11","2021-06-01","2021-06-01","2021-06-01","2021-07-30","2022-04-26","2022-05-31","2022-05-31","2022-06-09","2022-12-08","2022-07-05","2022-07-05","2022-09-13","2023-09-19","2023-03-09","2023-03-09","2021-03-30","2023-05-11","2023-05-11","2021-05-04","2021-05-04","2021-05-04","2022-03-15","2022-03-15","2022-03-15","2021-05-13","2021-05-13","2022-03-11","2022-06-09","2022-06-09","2022-07-01","2022-07-01","2022-07-01","2023-07-03","2023-07-08","2022-09-14","2022-12-19","2022-12-19","2022-12-19","2022-12-19","2022-12-19","2022-12-19","2022-12-19","2023-03-22","2023-08-24","2023-05-05","2023-05-11","2023-05-05","2023-05-11","2023-05-11","2023-05-11","2023-05-11","2023-05-11","2023-05-11","2023-06-27","2023-06-27","2023-06-14","2023-06-14","2023-07-08","2023-07-17","2023-07-17","2023-07-17","2023-07-06","2023-07-08","2023-08-10","2023-08-10","2023-09-12"],"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":[["","50111078751","AZITHROMYCIN","250 MG","6","Select","Select",""],["","00228203110","ALPRAZOLAM","1 MG","30","Select","Select",""],["","59746017310","PREDNISONE","10 MG","18","Select","Select",""],["","00054418425","DEXAMETHASON","TAB 4MG","18","Select","Select",""],["","43547040111","FUROSEMIDE","20 MG","180","Select","Select",""],["","59746011506","PROCHLORPER","TAB 10MG","30","Select","Select",""],["","55111015430","ONDANSETRON","TAB 8MG","30","Select","Select",""],["","42858000101","OXYCODONE","TAB 5MG","30","Select","Select",""],["","16729022501","SPIRONOLACT","TAB 25MG","90","Select","Select",""],["","68382009305","CARVEDILOL","6.25 MG","180","Select","Select",""],["","29033000305","SUCRALFATE","TAB 1GM","30","Select","Select",""],["","53885027210","ONETOUCH","TES VERIO","100","Select","Select",""],["","53885004401","ONE TOUCH","KIT VERIO FL","1","Select","Select",""],["","62135030920","CIPROFLOXACN","TAB 500MG","14","Select","Select",""],["","68645058259","METFORMIN","TAB 500MG","180","Select","Select",""],["","31722052101","HYDRALAZINE","TAB 50MG","180","Select","Select",""],["","13668001105","CITALOPRAM","TAB 40MG","60","Select","Select",""],["","68382005105","MELOXICAM","TAB 15MG","30","Select","Select",""],["","00310737020","BUDES\/FORMOT","AER 160-4.5","10","Select","Select",""],["","31722071390","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","65162047810","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","00186037020","SYMBICORT","160-4.5MCG","10.2","Select","Select",""],["","80777027398","MODERNA VAC","INJ COVID-19","0","Select","Select",""],["","00093101042","MUPIROCIN","2 %","22","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","00378827052","ALBUTEROL","NEB 0.00083","90","Select","Select",""],["","76204060001","IPRATROPIUM\/","SOL ALBUTER","90","Select","Select",""],["","00527193206","CLARITHROMYC","TAB 500MG","14","Select","Select",""],["","45802042578","FEXOFENADINE","TAB 60MG","30","Select","Select",""],["","53885000810","ONETOUCH DEL","MIS PLUS 33G","100","Select","Select",""],["","72305020030","EUTHYROX","200 MCG","30","Select","Select",""],["","69238106501","POT CHLORIDE","TAB 10MEQ ER","270","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","16729045515","LEVOTHYROXIN","TAB 150MCG","90","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","55111014512","FLUCONAZOLE","150 MG","2","Select","Select",""],["","00069108530","PAXLOVID","TAB 300-100","30","Select","Select",""],["","70710168400","FAMOTIDINE","40 MG","30","Select","Select",""],["","55111028130","LEVOFLOXACIN","750 MG","5","Select","Select",""],["","63304069301","CLINDAMYCIN","CAP 300MG","30","Select","Select",""],["","45963043963","CONSTULOSE","SOL 10GM\/15","480","Select","Select",""],["","62037099901","POT CL MICRO","TAB 20MEQ ER","180","Select","Select",""],["","65862078430","ESOMEPRA MAG","CAP 40MG DR","30","Select","Select",""],["","68645056259","IBUPROFEN","TAB 600MG","30","Select","Select",""],["","00093505698","ATORVASTATIN","TAB 10MG","90","Select","Select",""],["","00832105415","BACLOFEN","TAB 10MG","60","Select","Select",""],["","11877001140","BINAXNOW COV","KIT HOME TES","2","Select","Select",""],["","00904675180","ASPIRIN LOW","TAB 81MG EC","30","Select","Select",""],["","00116200116","CHLORHEX GLU","SOL 0.0012","473","Select","Select",""],["","57664037708","TRAMADOL HCL","TAB 50MG","10","Select","Select",""],["","00093216568","NALOXONE HCL","4 MG","2","Select","Select",""],["","00121087316","LACTULOSE","SOL 10GM\/15","480","Select","Select",""],["","00168020437","LIDOCAINE","OIN 0.05","35","Select","Select",""],["","69238110002","DOXYCYCL HYC","CAP 100MG","10","Select","Select",""],["","55111018015","TIZANIDINE","TAB 4MG","21","Select","Select",""],["","00536120215","LIDOCAINE PA","PAD 0.04","10","Select","Select",""],["","46581083015","SALONPAS GEL","PAD 0.04","10","Select","Select",""],["","49035013606","EQ LIDOCAINE","PAD 0.04","10","Select","Select",""],["","41167005842","ASPERCREME","PAD LIDO 4%","10","Select","Select",""],["","42192071506","CICLOPIROX","SOL 0.08","7","Select","Select",""],["","00002223680","TRULICITY","3 MG\/0.5ML","2","Select","Select",""],["","00597016061","SPIRIVA","AER 1.25MCG","4","Select","Select",""],["","00173086910","ANORO ELLIPT","AER 62.5-25","60","Select","Select",""],["","66993001968","ALBUTEROL SULFATE HFA","90 MCG","18","Select","Select",""],["","16729045715","LEVOTHYROXINE SODIUM","200 MCG","30","Select","Select",""],["","00310461612","BREZTRI AEROSPHERE","160-9-4.8","10.7","Select","Select",""],["","00093505998","ATORVASTATIN CALCIUM","20 MG","90","Select","Select",""],["","31722052001","HYDRALAZINE HCL","25 MG","180","Select","Select",""],["","00832532411","POTASSIUM CHLORIDE","10 MEQ","180","Select","Select",""],["","53746051101","SPIRONOLACTONE","25 MG","90","Select","Select",""],["","72578005518","DOXYCYCLINE HYCLATE","100 MG","14","Select","Select",""],["","13668001001","CITALOPRAM HBR","20 MG","180","Select","Select",""],["","00310737020","BUDESONIDE-FORMOTEROL FUMARATE","160-4.5MCG","10.2","Select","Select",""],["","65702071110","ACCU-CHEK GUIDE TEST STRIP","","100","Select","Select",""],["","53885027210","ONETOUCH VERIO TEST STRIP","","100","Select","Select",""],["","65862007701","CIPROFLOXACIN HCL","500 MG","14","Select","Select",""],["","00406055201","OXYCODONE HCL","5 MG","8","Select","Select",""],["","00781107905","ALPRAZOLAM TAB","1MG","20","Select","Select",""],["","16729045515","LEVOTHYROXIN TAB","150MCG","90","Select","Select",""],["","69238106901","POT CHLORIDE TAB","20MEQ ER","180","Select","Select",""],["","65162083366","DICLOFENAC GEL","1%","100","Select","Select",""],["","55111014512","FLUCONAZOLE TAB","150MG","7","Select","Select",""],["","50111078751","AZITHROMYCIN TAB","250MG","6","Select","Select",""],["","00069108530","PAXLOVID TAB","300-100","30","Select","Select",""],["","31722052101","HYDRALAZINE TAB","50MG","12","Select","Select",""],["","59310057922","PROAIR HFA AER","","8","Select","Select",""],["","68645058259","METFORMIN TAB","500MG","60","Select","Select",""],["","16729022501","SPIRONOLACT TAB","25MG","90","Select","Select",""],["","59746017310","PREDNISONE TAB","10MG","30","Select","Select",""],["","68382009305","CARVEDILOL TAB","6.25MG","180","Select","Select",""],["","72305013730","EUTHYROX TAB","137MCG","90","Select","Select",""],["","00054429731","FUROSEMIDE TAB","20MG","180","Select","Select",""],["","63304069301","CLINDAMYCIN CAP","300MG","30","Select","Select",""],["","68645056259","IBUPROFEN TAB","600MG","30","Select","Select",""],["","31722072250","LEVOFLOXACIN TAB","500MG","7","Select","Select",""],["","13668001105","CITALOPRAM TAB","40MG","60","Select","Select",""],["","00093505698","ATORVASTATIN TAB","10MG","90","Select","Select",""],["","68180096301","ALBUTEROL AER HFA","","8","Select","Select",""],["","65162047810","NITROFURANTN CAP","100MG","14","Select","Select",""],["","62037099901","POT CL MICRO TAB","20MEQ ER","180","Select","Select",""],["","65862086099","FAMOTIDINE TAB","40MG","30","Select","Select",""],["","65862078430","ESOMEPRA MAG CAP","40MG DR","30","Select","Select",""],["","00832105415","BACLOFEN TAB","10MG","60","Select","Select",""],["","49035056314","ASPIRIN LOW TAB","81MG EC","30","Select","Select",""],["","45963043963","CONSTULOSE SOL","10GM\/15","480","Select","Select",""],["","69238110002","DOXYCYCL HYC CAP","100MG","10","Select","Select",""],["","11877001140","BINAXNOW COV KIT HOME TES","","2","Select","Select",""],["","00168020437","LIDOCAINE OIN","5%","35","Select","Select",""],["","00054418425","DEXAMETHASON TAB","4MG","18","Select","Select",""],["","00121087316","LACTULOSE SOL","10GM\/15","480","Select","Select",""],["","55111018015","TIZANIDINE TAB","4MG","21","Select","Select",""],["","00116200116","CHLORHEX GLU SOL","0.12%","473","Select","Select",""],["","00173086910","ANORO ELLIPT AER","62.5-25","60","Select","Select",""],["","00597016061","SPIRIVA AER","1.25MCG","4","Select","Select",""],["","57664037708","TRAMADOL HCL TAB","50MG","10","Select","Select",""],["","00487950103","ALBUTEROL NEB","0.083%","90","Select","Select",""],["","00093216568","NALOXONE HCL SPR","4MG","2","Select","Select",""],["","00310737020","BUDES\/FORMOT AER","160-4.5","10","Select","Select",""],["","42192071506","CICLOPIROX SOL","8%","7","Select","Select",""],["","68382005105","MELOXICAM TAB","15MG","30","Select","Select",""],["","46581083015","SALONPAS GEL PAD","4%","10","Select","Select",""],["","41167005842","ASPERCREME PAD LIDO","4%","10","Select","Select",""],["","00186037020","SYMBICORT AER","160-4.5","10","Select","Select",""],["","41167005847","ASPERCREME PAD LID","4%","10","Select","Select",""],["","00002143480","TRULICITY INJ","1.5\/0.5","2","Select","Select",""],["","49035013606","EQ LIDOCAINE PAD","4%","10","Select","Select",""],["","70512001430","LIDOCAINE PAD","4%","10","Select","Select",""],["","00536120215","LIDOCAINE PA PAD","4%","10","Select","Select",""],["","51672129802","KETOCONAZOLE","2 %","30","Select","Select",""],["","00487020160","IPRATROPIUM-ALBUTEROL","0.5-3MG\/3","360","Select","Select",""],["","16729029310","EPLERENONE","25 MG","45","Select","Select",""],["","68462063945","NITROGLYCERIN","0.4 MG","25","Select","Select",""],["","67877021660","CEFUROXIME","500 MG","14","Select","Select",""],["","00169413013","OZEMPIC","1\/0.75 (3)","3","Select","Select",""],["","65162047810","NITROFURANTOIN MONO-MACRO","100 MG","10","Select","Select",""],["","65162027250","SULFAMETHOXAZOLE-TRIMETHOPRIM","800-160 MG","14","Select","Select",""],["","00597015561","STIOLTO RESPIMAT","2.5-2.5MCG","4","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":""}]}]}