{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DEBORAH HAMLIN","gend":1,"add":"810 HATTON ST","city":"NORFOLK","state":"VA","zip":"23523-9998","dob":"1969-11-23","age":"","mstatus":"","insh":"20069578*01","cliId":"","pno":7575742352,"cno":7575742352,"email":"","ename":"","eno":"","pphy":"NEWBY, JAMES E MD","ppno":7576276892,"pcpadd":"STE 220 930 MAJESTIC AVE,","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":"23504-9998","pcpcounty":"","pcpid":"","pcpname":"Primary Care Specialists","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7576275809,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I50.9","I10.","E11.9","J44.9","R60.0","E66.9","R06.89","I50.33","I51.7","J96.01","J96.02","J44.1","E87.5","R09.02","J30.1","E11.65","Z68.42","E78.2","R21.","B35.6","I11.0","Z68.41","Z20.822","F32.9","F41.9","E78.00","G43.909","NO DATA","E78.5","F17.210","E66.01","E11.40","E11.29","Z99.81","F41.8","Z72.0","L60.0","M79.674","M79.675","I27.0","G47.33","E11.51","B35.1","R55.","I20.8","R01.1","R09.89","F51.01","R77.8","R79.89","I50.32","Z79.4","J96.21","N17.9","I13.0","E87.4","J96.22","Z82.49","Z83.3","Z79.899","G45.9","E11.22","I25.10","E11.21","M25.531","R06.02","S63.501A","R60.1","S52.125A","Z86.73","M25.422"],"date":["2023-06-30","2023-03-29","2023-06-30","2023-06-30","2021-05-06","2022-09-01","2022-09-01","2021-08-18","2022-04-01","2022-09-03","2021-07-07","2022-09-03","2022-09-03","2023-05-19","2023-05-19","2023-03-29","2022-08-15","2023-03-29","2021-01-26","2021-01-26","2023-06-30","2023-03-29","2022-09-01","2021-07-05","2022-09-01","2023-06-30","2021-07-08","2022-09-01","2022-09-01","2023-06-30","2021-07-05","2022-08-15","2022-08-15","2023-06-30","2022-09-27","2022-08-15","2022-04-21","2022-04-21","2022-04-21","2021-09-07","2021-07-22","2022-01-31","2022-01-31","2022-04-01","2022-04-01","2022-04-01","2022-04-01","2022-04-01","2022-09-01","2022-09-01","2022-09-02","2022-09-02","2021-07-06","2021-07-08","2022-09-01","2021-07-05","2021-07-06","2022-09-01","2022-09-01","2021-08-18","2021-07-08","2022-09-01","2022-09-01","2021-07-06","2022-02-14","2021-08-18","2022-02-14","2023-06-30","2023-06-30","2023-06-30","2023-06-30"],"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":[["","00088221905","LANTUS SOLOS","INJ 100\/ML","15","Select","Select",""],["","65162019011","NAPROXEN","TAB 500MG","60","Select","Select",""],["","67877025130","TRIAMCINOLON","CRE 0.001","30","Select","Select",""],["","50228018010","GABAPENTIN","300 MG","90","Select","Select",""],["","68645055254","LISINOPRIL","10 MG","90","Select","Select",""],["","00093505898","ATORVASTATIN","TAB 40MG","90","Select","Select",""],["","68645058459","METFORMIN","TAB 1000MG","60","Select","Select",""],["","51672126302","NYSTAT\/TRIAM","CRE ","60","Select","Select",""],["","08290320550","BD PEN NEEDL","MIS 32GX5\/32","100","Select","Select",""],["","00002771559","BASAGLAR","INJ 100UNIT","15","Select","Select",""],["","53885027150","ONETOUCH","TES VERIO","150","Select","Select",""],["","68382009716","PAROXETINE","TAB 10MG","30","Select","Select",""],["","00173088710","TRELEGY","AER ELLIPTA","60","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","36","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","00603533815","PREDNISONE","PAK 10MG","42","Select","Select",""],["","00173086910","ANORO ELLIPT","AER 62.5-25","180","Select","Select",""],["","00085113201","PROVENTIL","AER HFA","7","Select","Select",""],["","00597010061","SPIRIVA","SPR 2.5MCG","4","Select","Select",""],["","00173085910","BREO ELLIPTA","100-25MCG","60","Select","Select",""],["","42571016142","AMOX\/K CLAV","TAB 500-125","14","Select","Select",""],["","00173069600","ADVAIR DISKU","AER 250\/50","180","Select","Select",""],["","66993058597","FLUTIC\/SALME","AER 250\/50","180","Select","Select",""],["","43547028211","ESCITALOPRAM","TAB 20MG","30","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","49502025175","SEMGLEE","INJ 100U\/ML","15","Select","Select",""],["","00002143480","TRULICITY","1.5 MG\/0.5","2","Select","Select",""],["","66993013597","FLUTIC\/VILAN","INH 100-25","60","Select","Select",""],["","00173068220","VENTOLIN HFA","90 MCG","36","Select","Select",""],["","78206012701","DULERA","100-5 MCG","39","Select","Select",""],["","49502039475","INSULIN GLAR","INJ 100U\/ML","15","Select","Select",""],["","53885027150","ONETOUCH VERIO TEST STRIP","","50","Select","Select",""],["","68645052054","ESCITALOPRAM OXALATE","20 MG","30","Select","Select",""],["","00088221905","LANTUS SOLOSTAR","100\/ML (3)","15","Select","Select",""],["","00093505898","ATORVASTATIN CALCIUM","40 MG","90","Select","Select",""],["","00597010061","SPIRIVA RESPIMAT","2.5 MCG","4","Select","Select",""],["","68645058459","METFORMIN HCL","1000 MG","180","Select","Select",""],["","08290320550","NANO","2ND GEN PEN NEEDLE 32GX 5\/32\"","100","Select","Select",""],["","66993001968","ALBUTEROL SULFATE HFA","90 MCG","54","Select","Select",""],["","00173085910","BREO ELLIPTA INH","100-25","60","Select","Select",""],["","68382009716","PAROXETINE TAB","10MG","30","Select","Select",""],["","76204020060","ALBUTEROL NEB","0.083%","270","Select","Select",""],["","68645058459","METFORMIN TAB","1000MG","60","Select","Select",""],["","00173069600","ADVAIR DISKU AER","250\/50","180","Select","Select",""],["","66993058597","FLUTIC\/SALME AER","250\/50","180","Select","Select",""],["","00088221905","LANTUS SOLOS INJ","100\/ML","15","Select","Select",""],["","43547028211","ESCITALOPRAM TAB","20MG","30","Select","Select",""],["","59310057922","PROAIR HFA AER","","8","Select","Select",""],["","53885027150","ONETOUCH TES VERIO","","150","Select","Select",""],["","65162083366","DICLOFENAC GEL","1%","100","Select","Select",""],["","00093505898","ATORVASTATIN TAB","40MG","90","Select","Select",""],["","68645055254","LISINOPRIL TAB","10MG","90","Select","Select",""],["","50228018010","GABAPENTIN CAP","300MG","270","Select","Select",""],["","00597007541","SPIRIVA CAP HANDIHLR","","90","Select","Select",""],["","08290320550","BD PEN NEEDL MIS","32GX5\/32","100","Select","Select",""],["","66993001968","ALBUTEROL AER HFA","","54","Select","Select",""],["","00173086910","ANORO ELLIPT AER","62.5-25","180","Select","Select",""],["","00173068220","VENTOLIN HFA AER","","18","Select","Select",""],["","66993013597","FLUTIC\/VILAN INH","100-25","180","Select","Select",""],["","00002143380","TRULICITY INJ","0.75\/0.5","2","Select","Select",""],["","49502025175","SEMGLEE INJ","100U\/ML","15","Select","Select",""],["","00603533815","PREDNISONE PAK","10MG","42","Select","Select",""],["","00597010051","SPIRIVA SPR","2.5MCG","4","Select","Select",""],["","59746017310","PREDNISONE TAB","10MG","42","Select","Select",""],["","49502039475","INSULIN GLAR INJ","100U\/ML","15","Select","Select",""],["","78206012701","DULERA AER","100-5MCG","39","Select","Select",""],["","00406012301","HYDROCODONE-ACETAMINOPHEN","5 MG-325MG","6","Select","Select",""],["","57664037718","TRAMADOL HCL","50 MG","28","Select","Select",""],["","49502039475","INSULIN GLARGINE-YFGN","100\/ML (3)","15","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":""}]}]}