{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ADRIAN JOHNSON","gend":1,"add":"4431 MALLARD DR","city":"GLOUCESTER","state":"VA","zip":"23061-9998","dob":"1980-10-29","age":"","mstatus":"","insh":"20066103*01","cliId":"","pno":8048155823,"cno":8048155823,"email":"","ename":"","eno":"","pphy":"KELLY, ASHLEY N NP","ppno":8046426171,"pcpadd":"2246 GEORGE WASHINGTON MEM HWY STE,","pcpcity":"HAYES","pcpstate":"VA","pcpzip":"23072-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8046425656,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G35.","H50.51","H53.8","R48.3","J10.89","R03.0","H69.83","H93.293","R42.","J30.1","R41.841","R48.8","F44.5","Z20.822","R19.7","R11.0","D68.0","K58.2","R27.0","F43.12","U07.1","J45.998","G43.109","R53.1","N20.0","N83.11","N83.12","R25.1","R47.9","J01.90","Z20.828","R05.3","NO DATA","H16.223","R10.13","R63.4","M54.2","M79.642","R20.2","M25.50","R21.","B02.9","R53.83","Z11.4","Z11.59","R10.2","N83.299","J20.9","Z01.810","Z01.812","H69.82","R35.89","K21.9","R09.89","H93.13","R07.2","R56.9","J45.909","J20.8","U09.9","I10.","Z90.710","Z79.51","Z79.899","Z88.5","F41.1","F34.1","H92.01","H92.03","G43.809","H52.221","R07.9","N83.201","N83.202","H02.88A","H02.88B","R06.02","M35.09","H92.02","H93.292","M54.9","H90.3","G72.3","Z86.16","H83.2X3","R19.4","G37.3","R26.0","E55.9","M54.16","K30.","N39.0","F33.9","G31.84","H93.25","E53.8","R53.82","E16.2","K52.9","K31.84","J30.9","G43.709","R26.81","F32.2","F41.9","F43.10","M54.12"],"date":["2023-03-07","2023-03-07","2023-03-07","2023-03-07","2022-11-11","2022-11-11","2023-06-16","2023-03-14","2023-04-24","2023-04-11","2023-08-01","2023-08-01","2022-07-12","2022-03-07","2022-03-23","2022-03-23","2022-03-11","2022-12-06","2022-05-12","2022-10-24","2022-10-29","2022-10-29","2023-02-28","2021-03-25","2021-05-13","2021-06-30","2021-06-30","2021-07-13","2021-07-13","2021-07-28","2021-11-20","2022-02-10","2022-12-06","2022-03-02","2022-12-06","2022-03-23","2022-12-13","2022-12-13","2022-12-13","2021-05-04","2021-05-04","2021-05-04","2021-05-04","2021-05-04","2021-05-04","2021-05-17","2021-05-17","2023-09-21","2022-03-07","2022-03-07","2022-03-23","2022-03-10","2022-03-11","2021-01-25","2023-01-03","2021-03-29","2021-07-13","2023-02-08","2021-11-10","2021-11-10","2022-03-11","2022-03-11","2022-03-11","2022-03-11","2022-03-11","2022-08-11","2022-08-11","2022-10-19","2023-04-24","2023-06-16","2021-03-15","2021-03-30","2021-05-13","2021-05-13","2021-07-08","2021-07-08","2022-02-10","2022-01-19","2022-01-19","2022-03-24","2022-08-29","2023-01-03","2021-01-28","2022-02-10","2023-01-03","2022-12-06","2022-12-06","2023-01-03","2023-03-08","2022-04-06","2021-11-15","2022-01-05","2022-07-12","2022-07-12","2022-08-31","2023-02-08","2023-02-08","2023-02-08","2023-02-08","2023-02-08","2023-02-08","2023-02-08","2023-06-16","2023-06-13","2023-06-13","2023-06-13","2023-06-29"],"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":[["","59651010569","ELETRIPTAN","TAB 40MG","9","Select","Select",""],["","90124000001","AIRIAL COMP","MIS COMPRESS","1","Select","Select",""],["","00049234005","RELPAX","TAB 40MG","9","Select","Select",""],["","67877021905","CEPHALEXIN","CAP 500MG","14","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","17","Select","Select",""],["","00186037220","SYMBICORT","AER 80-4.5","10","Select","Select",""],["","00310737220","BUDES\/FORMOT","AER 80-4.5","10","Select","Select",""],["","16729017101","AMITRIPTYLIN","TAB 10MG","30","Select","Select",""],["","42043022109","SUMATRIPTAN","TAB 50MG","9","Select","Select",""],["","29300022019","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","68180029706","DULOXETINE","CAP 40MG","60","Select","Select",""],["","00115521116","COLESTIPOL","TAB 1GM","180","Select","Select",""],["","29300041301","CYCLOBENZAPR","TAB 5MG","60","Select","Select",""],["","00172392670","DIAZEPAM","5 MG","30","Select","Select",""],["","00603533815","PREDNISONE","10 MG","63","Select","Select",""],["","68462015713","ONDANSETRON","TAB 4MG ODT","60","Select","Select",""],["","50383002510","OFLOXACIN","DRO 0.3%OTIC","10","Select","Select",""],["","68462011944","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","72618300002","NURTEC","TAB 75MG ODT","8","Select","Select",""],["","00143924920","AMOX\/K CLAV","TAB 875-125","20","Select","Select",""],["","16729013600","CLONAZEPAM","TAB 0.5MG","90","Select","Select",""],["","82607066026","FLOWFLEX","KIT TEST","8","Select","Select",""],["","42806040021","METHYLPRED","TAB 4MG","21","Select","Select",""],["","70436015541","PROMETHAZINE","SOL DM","118","Select","Select",""],["","50228017910","GABAPENTIN","CAP 100MG","90","Select","Select",""],["","29300041301","CYCLOBENZAPRINE HCL","5 MG","60","Select","Select",""],["","42806054701","VITAMIN D","2 1250 MCG","4","Select","Select",""],["","68180021460","CYCLOSPORINE","0.05 %","60","Select","Select",""],["","60505082901","FLUTICASONE PROPIONATE","50 MCG","16","Select","Select",""],["","51991036378","RIZATRIPTAN","10 MG","8","Select","Select",""],["","00023916360","RESTASIS","0.05 %","60","Select","Select",""],["","00378638001","VERAPAMIL ER","180 MG","30","Select","Select",""],["","00093831118","ELETRIPTAN HBR","40 MG","9","Select","Select",""],["","43598081115","CETIRIZINE HCL","10 MG","30","Select","Select",""],["","00093342505","LORAZEPAM","0.5 MG","20","Select","Select",""],["","00093317431","ALBUTEROL SULFATE HFA","90 MCG","8.5","Select","Select",""],["","67877021905","CEPHALEXIN CAP","500MG","14","Select","Select",""],["","00186037220","SYMBICORT AER","80-4.5","10","Select","Select",""],["","00310737220","BUDES\/FORMOT AER","80-4.5","10","Select","Select",""],["","00049234005","RELPAX TAB","40MG","9","Select","Select",""],["","59651010569","ELETRIPTAN TAB","40MG","9","Select","Select",""],["","90124000001","AIRIAL COMP MIS COMPRESS","","1","Select","Select",""],["","00378699252","ALBUTEROL NEB","1.25MG\/3","75","Select","Select",""],["","42043022109","SUMATRIPTAN TAB","50MG","9","Select","Select",""],["","00172392660","DIAZEPAM TAB","5MG","30","Select","Select",""],["","29300022019","MONTELUKAST TAB","10MG","30","Select","Select",""],["","68180029706","DULOXETINE CAP","40MG","60","Select","Select",""],["","00054001925","PREDNISONE TAB","50MG","5","Select","Select",""],["","00115521116","COLESTIPOL TAB","1GM","180","Select","Select",""],["","16729017101","AMITRIPTYLIN TAB","10MG","90","Select","Select",""],["","72888001405","CYCLOBENZAPR TAB","10MG","30","Select","Select",""],["","50383002510","OFLOXACIN DRO","0.3%OTIC","10","Select","Select",""],["","16729013600","CLONAZEPAM TAB","0.5MG","90","Select","Select",""],["","00143924920","AMOX\/K CLAV TAB","875-125","20","Select","Select",""],["","68462011944","FLUCONAZOLE TAB","150MG","2","Select","Select",""],["","68462015713","ONDANSETRON TAB","4MG ODT","60","Select","Select",""],["","72618300002","NURTEC TAB","75MG ODT","8","Select","Select",""],["","82607066026","FLOWFLEX KIT TEST","","2","Select","Select",""],["","42806040021","METHYLPRED TAB","4MG","21","Select","Select",""],["","50228017910","GABAPENTIN CAP","100MG","90","Select","Select",""],["","68180096301","ALBUTEROL AER HFA","","17","Select","Select",""],["","00603533815","PREDNISONE PAK","10MG","21","Select","Select",""],["","70436015541","PROMETHAZINE SOL DM","","118","Select","Select",""],["","42806071501","BENZONATATE","200 MG","30","Select","Select",""],["","50111078710","AZITHROMYCIN","250 MG","6","Select","Select",""],["","00186091612","PULMICORT FLEXHALER","180 MCG","1","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":""}]}]}