{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ROGER W VANNIER","gend":0,"add":"1527 ELM AVE","city":"CHESAPEAKE","state":"VA","zip":"23325-9998","dob":"1960-08-14","age":"","mstatus":"","insh":"20064389*01","cliId":"","pno":7573052822,"cno":7573052822,"email":"","ename":"","eno":"","pphy":"REED, PAULINE C MD","ppno":7572281288,"pcpadd":"490 LIBERTY STREET","pcpcity":"CHESAPEAKE","pcpstate":"VA","pcpzip":"23324-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7574253625,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I50.42","I42.8","R40.0","I10.","M86.9","R53.83","M79.674","E78.5","Z72.0","L08.9","B95.62","R78.81","B18.2","K74.60","Z45.02","Z95.810","I50.22","I51.89","I50.9","I42.9","F31.81","S86.111A","M19.071","I87.2","K72.90","I42.0","Z71.6","L97.519","M79.89","M19.171","E11.40","R60.0","L97.511","G60.9","R60.9","L97.329","M86.171","I47.1","L97.514","L97.529","I11.0","K70.30","F31.9","K21.9","M21.372","M21.371","F10.20","D69.59","I25.10","G62.9","F41.9","Z45.2","Z79.2","M54.42","G57.00","M79.2","M54.2","M47.812","D69.6","M54.41","G89.29","B35.1","E66.3","C22.0","I85.00","K74.69","K31.89","B19.21","Z86.010","R16.0","K76.6","K80.20","N28.1","Z12.5","H91.93","H53.9","F10.10","Z76.0","M79.671","M79.672","L60.0","L91.8","J34.2","J34.3","R21.","I36.1","Z86.19","F32.9","H90.3","G47.30","R29.898","L30.9","D18.01","L80.","Z71.9","Z78.9"],"date":["2023-04-18","2022-07-08","2021-01-21","2023-04-18","2021-06-11","2021-01-21","2021-01-22","2021-06-11","2023-04-18","2021-01-27","2021-01-27","2021-02-27","2021-09-01","2023-01-05","2022-07-08","2023-05-01","2021-08-25","2021-08-25","2022-07-08","2022-11-23","2023-03-13","2022-07-28","2022-07-28","2022-09-29","2022-11-23","2023-04-18","2023-04-18","2021-01-22","2021-01-22","2023-01-27","2023-01-27","2022-09-29","2021-01-12","2022-01-05","2021-01-21","2021-01-21","2021-01-22","2023-05-01","2021-01-22","2021-01-22","2021-01-22","2023-01-23","2021-01-22","2022-11-23","2021-09-01","2021-09-01","2021-01-22","2023-02-06","2021-10-11","2021-01-22","2021-01-22","2021-01-27","2021-01-27","2021-09-01","2021-09-01","2021-09-01","2021-09-01","2021-09-01","2022-11-23","2021-09-01","2021-09-01","2022-01-05","2021-09-01","2023-05-04","2022-11-23","2022-11-23","2022-11-23","2022-11-23","2022-11-23","2023-01-05","2023-01-05","2023-01-05","2023-01-05","2021-06-10","2021-06-10","2021-06-10","2021-12-01","2021-12-01","2022-01-05","2022-01-05","2022-01-05","2022-01-05","2021-11-04","2021-11-04","2022-06-17","2022-09-08","2021-01-22","2021-01-22","2021-09-13","2021-10-11","2022-09-08","2023-03-28","2023-03-28","2023-03-28","2023-03-28","2023-04-18"],"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":[["","65862042005","SMZ\/TMP DS","TAB 800-160","28","Select","Select",""],["","00054430125","FUROSEMIDE","TAB 80MG","45","Select","Select",""],["","65862020299","LOSARTAN POT","TAB 50MG","90","Select","Select",""],["","68382050010","OMEPRAZOLE","40 MG","90","Select","Select",""],["","53746051105","SPIRONOLACT","TAB 25MG","22","Select","Select",""],["","43598021055","SSD","1 %","50","Select","Select",""],["","00904759080","FEROSUL","325(65) MG","30","Select","Select",""],["","00527133001","BACLOFEN","TAB 10MG","60","Select","Select",""],["","68462016305","CARVEDILOL","6.25 MG","180","Select","Select",""],["","69097067805","PREGABALIN","CAP 50MG","120","Select","Select",""],["","00378623201","CITALOPRAM","TAB 20MG","30","Select","Select",""],["","43598083105","ATORVASTATIN","TAB 20MG","90","Select","Select",""],["","68462022110","LITHIUM CARB","CAP 300MG","90","Select","Select",""],["","11917009215","FERROUS SULF","TAB 325MG","90","Select","Select",""],["","67877012405","SILVER SULFA","CRE 0.01","100","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","00078077720","ENTRESTO","49 MG-51MG","60","Select","Select",""],["","55111018015","TIZANIDINE","TAB 4MG","30","Select","Select",""],["","00085113204","PROVENTIL","AER HFA","7","Select","Select",""],["","59267102501","PFIZER VACC","INJ ADLT RTU","0","Select","Select",""],["","70954008510","CHLORZOXAZON","TAB 500MG","60","Select","Select",""],["","69097014260","ALBUTEROL","AER HFA","7","Select","Select",""],["","68462010805","TOPIRAMATE","TAB 25MG","90","Select","Select",""],["","43598081115","CETIRIZINE","TAB 10MG","90","Select","Select",""],["","65649030302","XIFAXAN","550 MG","60","Select","Select",""],["","50580072636","ZYRTEC ALLGY","TAB 10MG","90","Select","Select",""],["","60432026415","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","49281042150","FLUZONE QUAD","INJ 2021-22","0","Select","Select",""],["","68462013801","OXCARBAZEPIN","TAB 300MG","120","Select","Select",""],["","00121087316","LACTULOSE","SOL 10GM\/15","450","Select","Select",""],["","00536116134","MUCUS RELIEF","TAB 30-600ER","20","Select","Select",""],["","00310621030","FARXIGA","TAB 10MG","25","Select","Select",""],["","11877001140","BINAXNOW COV","KIT HOME TES","8","Select","Select",""],["","43547034150","RISPERIDONE","1 MG","90","Select","Select",""],["","42806040021","METHYLPRED","TAB 4MG","21","Select","Select",""],["","73502058610","SOAANZ","TAB 40MG","60","Select","Select",""],["","50111091701","TORSEMIDE","20 MG","240","Select","Select",""],["","00005200010","PREVNAR 20","INJ ","0","Select","Select",""],["","58160089052","FLUARIX QUAD","INJ 2022-23","0","Select","Select",""],["","59267030401","PFIZER BIVAL","INJ BA4\/BA5","0","Select","Select",""],["","62037099901","POT CL MICRO","TAB 20MEQ ER","30","Select","Select",""],["","43598083105","ATORVASTATIN CALCIUM","20 MG","90","Select","Select",""],["","53746051105","SPIRONOLACTONE","25 MG","60","Select","Select",""],["","50111033402","METRONIDAZOLE","500 MG","21","Select","Select",""],["","68462010530","ONDANSETRON HCL","4 MG","12","Select","Select",""],["","67877012405","SILVER SULFADIAZINE","1 %","50","Select","Select",""],["","68462013801","OXCARBAZEPINE","300 MG","360","Select","Select",""],["","69238106901","POTASSIUM CHLORIDE","20 MEQ","30","Select","Select",""],["","00378623201","CITALOPRAM HBR","20 MG","30","Select","Select",""],["","51672128202","TRIAMCINOLONE ACETONIDE","0.1 %","60","Select","Select",""],["","00143992801","CIPROFLOXACIN HCL","500 MG","14","Select","Select",""],["","65162062750","TRAMADOL HCL","50 MG","12","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":""}]}]}