{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"REGINALD SCHULER","gend":0,"add":"5560 VIRGINIA BEACH BLVD","city":"VIRGINIA BEACH","state":"VA","zip":"23462-9998","dob":"1971-09-16","age":"","mstatus":"","insh":"20081608*01","cliId":"","pno":7573835006,"cno":7573835006,"email":"","ename":"","eno":"","pphy":"RUBINO, MARY C MD","ppno":7574465955,"pcpadd":"825 FAIRFAX AVE STE 118","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":"23507-9998","pcpcounty":"","pcpid":"","pcpname":"EVMS Ghent Family Medicine","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7574465196,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R07.9","R56.9","NO DATA","G89.29","F25.9","Z79.899","Z88.8","R32.","G40.909","Z09.","E11.9","R39.16","M51.36","E66.9","I10.","M1A.9XX0","G47.33","F20.9","R53.1","R47.01","R26.89","M21.372","M54.30","V62.84","R44.0","R44.1","Z86.73","Z91.199","Z20.822","F31.64","F43.10","N39.0","R31.9","Z03.818","R44.3","R60.0","G47.30","R06.02","R13.10","Z78.9","M54.42","H90.3","Z04.9","R20.0","R11.0","R19.7","R10.9","S89.92XA","F39.","U07.1","Z59.01","G40.309","Z00.8","Z51.89","M25.562","M25.561","M79.89","I11.0","I50.9","R07.89","R00.0","Z68.42","M54.9","R51.9","Z91.14","R41.82","D48.5","I69.354","Z59.00","F41.1","I67.82","R26.9","M17.0","E66.01","F25.0","F19.21","F29."],"date":["2022-03-29","2022-08-12","2023-03-12","2022-05-25","2022-05-26","2022-05-25","2022-07-24","2022-05-25","2022-07-06","2022-08-12","2022-09-07","2022-06-09","2022-12-27","2022-07-06","2023-02-06","2022-07-06","2022-09-07","2023-03-14","2023-03-14","2022-07-14","2022-10-12","2022-10-12","2022-10-05","2023-03-19","2023-02-06","2023-02-06","2023-02-06","2023-02-06","2023-02-20","2023-02-20","2023-03-18","2023-02-20","2023-02-20","2023-02-20","2023-02-20","2023-02-23","2022-03-29","2022-03-29","2022-07-18","2022-07-18","2022-12-27","2022-06-24","2023-02-06","2022-02-01","2022-02-01","2022-02-01","2022-02-01","2022-02-22","2023-03-17","2022-07-24","2022-07-24","2022-08-23","2023-02-21","2023-02-21","2022-03-25","2022-03-25","2022-03-19","2022-03-27","2022-03-27","2022-03-27","2022-03-27","2022-03-27","2022-03-27","2022-05-26","2022-05-26","2023-03-14","2022-10-21","2023-03-14","2023-03-14","2023-03-14","2023-03-14","2022-02-22","2022-03-25","2022-03-25","2022-07-12","2023-03-16","2023-02-07"],"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":[["","31722071390","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","00536132710","ACETAMINOPHE","TAB 325MG","24","Select","Select",""],["","00536468010","VITAMIN B-1","TAB 100MG","30","Select","Select",""],["","65162019011","NAPROXEN","TAB 500MG","20","Select","Select",""],["","69097084507","CYCLOBENZAPR","TAB 5MG","30","Select","Select",""],["","69315012710","FOLIC ACID","TAB 1000MCG","30","Select","Select",""],["","65162021250","PHENYTOIN EX","CAP 100MG","60","Select","Select",""],["","41167005840","ASPERCREME","PAD LIDO 4%","10","Select","Select",""],["","71351001250","LACTOBACILLU","TAB ","30","Select","Select",""],["","68382011614","RISPERIDONE","TAB 3MG","60","Select","Select",""],["","68180098101","LISINOPRIL","20 MG","14","Select","Select",""],["","00378561505","LEVETIRACETA","TAB 500MG","60","Select","Select",""],["","62756014202","METFORMIN","TAB 500MG ER","30","Select","Select",""],["","68382005005","MELOXICAM","TAB 7.5MG","30","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","53885027150","ONETOUCH","TES VERIO","50","Select","Select",""],["","53885000810","ONETOUCH DEL","MIS PLUS 33G","100","Select","Select",""],["","76282066339","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","69097094312","GABAPENTIN","CAP 300MG","60","Select","Select",""],["","69097083207","BENZTROPINE","TAB 2MG","30","Select","Select",""],["","68645051554","AMLODIPINE","TAB 5MG","90","Select","Select",""],["","00904404073","ASPIRIN","CHW 81MG","30","Select","Select",""],["","00002143380","TRULICITY","INJ 0.75\/0.5","4","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","18","Select","Select",""],["","57896020110","PAIN RELIEF","TAB 500MG","90","Select","Select",""],["","00591352530","LIDOCAINE","5 %","14","Select","Select",""],["","65162046650","IBUPROFEN","TAB 800MG","90","Select","Select",""],["","42192061801","BENZONATATE","CAP 200MG","30","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","49035056314","ASPIRIN LOW","TAB 81MG EC","90","Select","Select",""],["","80681008600","MELATONIN","3 MG","28","Select","Select",""],["","16729004517","ATORVASTATIN","TAB 20MG","90","Select","Select",""],["","00904672040","ACETAMIN","TAB 500MG","90","Select","Select",""],["","27808022501","PALIPERIDONE ER","9 MG","14","Select","Select",""],["","51672208002","TERBINAFINE","1 %","30","Select","Select",""],["","00536124810","STIMULANT LAXATIVE PLUS","8.6MG-50MG","14","Select","Select",""],["","67877019905","AMLODIPINE BESYLATE","10 MG","14","Select","Select",""],["","65862001301","SERTRALINE HCL","100 MG","14","Select","Select",""],["","65597020330","SAVAYSA","60 MG","90","Select","Select",""],["","66993043185","PRAZOSIN HCL","1 MG","14","Select","Select",""],["","62756079788","DIVALPROEX SODIUM","250 MG","42","Select","Select",""],["","65162075750","DIVALPROEX SODIUM ER","500 MG","60","Select","Select",""],["","57896022110","ACETAMINOPHEN","500 MG","30","Select","Select",""],["","69238131309","PREGABALIN","100 MG","28","Select","Select",""],["","31722062260","DABIGATRAN ETEXILATE","150 MG","180","Select","Select",""],["","00003089421","ELIQUIS","5 MG","28","Select","Select",""],["","10702000650","CYCLOBENZAPRINE HCL","5 MG","42","Select","Select",""],["","59267102501","PFIZER COVID (","12Y UP) VAC(EUA) 30 MCG\/0.3","0.3","Select","Select",""],["","60505258008","ATORVASTATIN CALCIUM","40 MG","30","Select","Select",""],["","70010006301","METFORMIN HCL","500 MG","60","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":""}]}]}