{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TODD DRUMMOND","gend":0,"add":"254 E 41ST ST","city":"NORFOLK","state":"VA","zip":"23504-9998","dob":"1966-01-08","age":"","mstatus":"","insh":"20071649*01","cliId":"","pno":7576952052,"cno":7576952052,"email":"","ename":"","eno":"","pphy":"MARKOVIC, VLADIMIR MD","ppno":7575339108,"pcpadd":"155 KINGSLEY LANE SUITE 320,","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":"23505-9998","pcpcounty":"","pcpid":"","pcpname":"Hampton Roads Community Health Center","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7576226384,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F34.1","F41.1","NO DATA","I26.99","E11.9","Z86.711","N52.8","E66.01","F31.9","F41.9","I10.","Z68.41","Z79.01","Z79.899","Z79.4","Z79.84","Z79.82","M54.9","G47.30","M75.41","M75.51","I82.402","M75.111","E11.65","F17.290","Z91.11","Z88.0","Z91.040","R94.2","H35.033","H16.223","E10.9","H43.393","R06.09","J45.20","M25.512","D66.","E11.42","E11.620","L60.3","L85.3","M75.22","M54.5","R06.81","G47.23","R06.83","F32.9","E11.40","N52.9","M25.511","E13.9","I82.432","I82.442","E78.5","I83.92","R77.8","G47.00","R06.02","E11.59","Z87.891","M10.072","R26.81","E66.09","Z68.39","E11.52","E11.628","D72.829","N17.9","L08.9","Z45.2","A41.9","D84.9","Z66.","L02.612","M86.172","E11.621","E11.69","L97.529","Z80.9","K21.9","Z88.1","L03.116","L97.522","I96.","A49.01","M86.9","Z78.9","T87.44","B95.62","R65.20","Z47.81","Z79.2","T81.31XA","T81.30XA","V58.89","L97.521","T81.42XA","Z89.412","M79.89","Z86.718","Z89.422","L97.511","S90.852A","B35.1","R29.818"],"date":["2023-07-17","2023-07-17","2023-08-17","2022-12-27","2023-02-02","2023-08-17","2023-09-21","2023-07-28","2023-02-02","2023-02-02","2023-07-28","2023-06-06","2023-07-28","2023-02-02","2023-07-28","2023-02-02","2023-02-02","2021-03-09","2021-04-05","2022-04-21","2022-06-17","2022-09-09","2022-06-17","2022-09-07","2022-09-07","2022-06-29","2023-06-06","2022-06-29","2023-01-12","2021-11-19","2021-11-19","2021-11-19","2021-11-19","2023-02-02","2023-01-06","2021-11-03","2022-12-12","2023-09-15","2023-09-01","2021-04-21","2021-04-21","2021-06-04","2021-06-04","2021-06-09","2021-06-09","2021-06-09","2021-06-09","2023-08-11","2022-03-21","2022-03-21","2021-12-20","2022-09-07","2022-09-07","2022-09-07","2022-09-07","2023-07-28","2022-09-07","2022-09-08","2023-01-04","2023-08-11","2023-05-18","2023-05-18","2023-05-18","2023-05-18","2023-06-07","2023-08-29","2023-06-19","2023-07-28","2023-08-29","2023-07-28","2023-07-28","2023-06-06","2023-06-06","2023-08-29","2023-06-06","2023-09-15","2023-06-06","2023-06-06","2023-06-06","2023-07-28","2023-06-06","2023-06-09","2023-09-15","2023-08-29","2023-06-16","2023-08-29","2023-06-13","2023-06-14","2023-06-14","2023-07-28","2023-07-28","2023-07-28","2023-07-10","2023-07-26","2023-08-21","2023-08-21","2023-08-11","2023-08-11","2023-08-11","2023-08-17","2023-08-17","2023-09-15","2023-09-15","2023-09-15","2023-02-17"],"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":[["","00006057761","JANUMET","TAB 50-1000","60","Select","Select",""],["","00093506201","HYDROXYZ HCL","TAB 50MG","60","Select","Select",""],["","68180035206","SERTRALINE","TAB 50MG","30","Select","Select",""],["","00088221905","LANTUS SOLOS","INJ 100\/ML","15","Select","Select",""],["","00002771559","BASAGLAR","INJ 100UNIT","15","Select","Select",""],["","68180063609","ATORVASTATIN","TAB 20MG","30","Select","Select",""],["","68180097901","LISINOPRIL","40 MG","30","Select","Select",""],["","00088222033","LANTUS","INJ 100\/ML","10","Select","Select",""],["","00536110945","UREA 20 INTN","CRE 0.2","85","Select","Select",""],["","58160082311","SHINGRIX","INJ 50\/0.5ML","1","Select","Select",""],["","59267100002","PFIZER VACC","INJ COVID-19","0","Select","Select",""],["","58160089052","FLUARIX QUAD","INJ 2022-23","0","Select","Select",""],["","60219175203","SILDENAFIL","TAB 50MG","30","Select","Select",""],["","16571020110","DICLOFENAC","TAB 75MG DR","60","Select","Select",""],["","00003376474","ELIQUIS ST P","TAB 5MG","74","Select","Select",""],["","00003089421","ELIQUIS","5 MG","60","Select","Select",""],["","51672403201","WARFARIN","TAB 5MG","30","Select","Select",""],["","50458057930","XARELTO","TAB 20MG","30","Select","Select",""],["","00002143380","TRULICITY","0.75MG\/0.5","2","Select","Select",""],["","59267030402","PFIZER COVID BIVAL (","12Y UP)EUA 30 MCG\/0.3","0.3","Select","Select",""],["","70010006505","METFORMIN HCL","1000 MG","60","Select","Select",""],["","00093506201","HYDROXYZINE HCL","50 MG","60","Select","Select",""],["","68180035209","SERTRALINE HCL","50 MG","30","Select","Select",""],["","55111018015","TIZANIDINE HCL","4 MG","60","Select","Select",""],["","68462039610","OMEPRAZOLE","20 MG","90","Select","Select",""],["","00088221905","LANTUS SOLOSTAR","100\/ML (3)","30","Select","Select",""],["","63304082890","ATORVASTATIN CALCIUM","20 MG","30","Select","Select",""],["","00310621030","FARXIGA","10 MG","30","Select","Select",""],["","65162046650","IBUPROFEN","800 MG","90","Select","Select",""],["","70954040310","DEXAMETHASONE","4 MG","3","Select","Select",""],["","00143301801","COLCHICINE","0.6 MG","60","Select","Select",""],["","69238110005","DOXYCYCLINE HYCLATE","100 MG","20","Select","Select",""],["","31722072320","LEVOFLOXACIN","750 MG","7","Select","Select",""],["","00006057761","JANUMET TAB","50-1000","60","Select","Select",""],["","00088221905","LANTUS SOLOS INJ","100\/ML","15","Select","Select",""],["","16714008310","HYDROXYZ HCL TAB","50MG","60","Select","Select",""],["","68180035209","SERTRALINE TAB","50MG","30","Select","Select",""],["","43547035410","LISINOPRIL TAB","20MG","30","Select","Select",""],["","60219175303","SILDENAFIL TAB","100MG","30","Select","Select",""],["","16571020110","DICLOFENAC TAB","75MG DR","60","Select","Select",""],["","00003089421","ELIQUIS TAB","5MG","60","Select","Select",""],["","51672403201","WARFARIN TAB","5MG","30","Select","Select",""],["","50458057930","XARELTO TAB","20MG","30","Select","Select",""],["","58160089052","FLUARIX QUAD INJ","2022-23","0","Select","Select",""],["","00003376474","ELIQUIS ST P TAB","5MG","74","Select","Select",""],["","00406012301","HYDROCODONE-ACETAMINOPHEN","5 MG-325MG","24","Select","Select",""],["","29300039805","AMLODIPINE BESYLATE","10 MG","30","Select","Select",""],["","00093729601","CARVEDILOL","25 MG","60","Select","Select",""],["","51672127502","CLOTRIMAZOLE","1 %","30","Select","Select",""],["","57664037713","TRAMADOL HCL","50 MG","20","Select","Select",""],["","16714066101","GABAPENTIN","100 MG","90","Select","Select",""],["","59267030402","PFIZER COVID BIVAL (12Y UP)","EUA","0.3","Select","Select",""],["","31722064630","TADALAFIL","20 MG","30","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":""}]}]}