{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"FELTON ELLIS","gend":0,"add":"9623 1ST BAY ST APT B","city":"NORFOLK","state":"VA","zip":"23518-9998","dob":"1965-02-15","age":"","mstatus":"","insh":"20086760*01","cliId":"","pno":7573594448,"cno":7573594448,"email":"","ename":"","eno":"","pphy":"LAYNE, MICHAEL MD","ppno":7574465955,"pcpadd":"825 FAIRFAX AVE SUITE 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":["I95.9","E11.40","N18.6","B20.","G63.","A31.8","F17.200","Z79.2","E66.01","Z13.31","E11.9","I12.0","R42.","T80.90XA","T85.71XA","T82.49XA","E11.22","I25.10","I25.2","G47.33","E11.42","Z95.1","Z86.73","Z79.4","Z79.899","Z79.85","Z79.02","Z79.82","Z87.891","H90.3","T82.41XA","Z99.2","T82.838A","N25.81","D63.1","Z21.","Z86.16","K02.9","NO DATA","I10.","E78.1","Z11.3","Z13.220","Z23.","Z45.2","R78.81","Z12.11","N52.9","H93.13","Z79.01","Z88.5","M25.561","M25.562","E11.65","H91.09","T36.5X5A","R55.","Z68.39"],"date":["2023-04-04","2023-01-20","2023-04-04","2023-03-02","2023-01-20","2023-03-02","2023-03-02","2022-11-09","2023-03-31","2022-11-09","2022-11-09","2023-04-04","2023-04-04","2023-01-01","2023-01-01","2022-11-16","2023-03-31","2023-03-31","2023-03-31","2023-03-31","2022-11-16","2023-01-11","2023-03-31","2023-01-11","2023-03-31","2022-11-16","2022-11-16","2022-11-16","2023-03-31","2023-02-22","2022-11-16","2023-03-31","2022-11-16","2023-01-11","2023-01-11","2023-03-31","2023-01-11","2022-12-29","2023-03-31","2023-04-11","2022-12-29","2022-12-29","2022-12-29","2022-12-29","2023-01-11","2023-01-11","2023-04-14","2023-03-02","2023-01-04","2023-01-11","2023-01-11","2022-10-15","2022-10-15","2022-10-17","2023-02-22","2023-02-22","2023-04-04","2023-03-31"],"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":[["","68382003416","VENLAFAXINE","CAP 37.5 ER","60","Select","Select",""],["","00093005805","TRAMADOL HCL","50 MG","21","Select","Select",""],["","50742026201","NIFEDIPINE","TAB 90MG ER","30","Select","Select",""],["","00002143480","TRULICITY","INJ 1.5\/0.5","2","Select","Select",""],["","64980052810","SODIUM BICAR","TAB 650MG","60","Select","Select",""],["","76385011350","CARVEDILOL","25 MG","180","Select","Select",""],["","61958250101","BIKTARVY","50-200-25","30","Select","Select",""],["","70377002911","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","55111072901","ALLOPURINOL","100 MG","90","Select","Select",""],["","65862035790","CLOPIDOGREL","75 MG","90","Select","Select",""],["","62332002991","LOSARTAN POTASSIUM","100 MG","90","Select","Select",""],["","64980052810","SODIUM BICARBONATE","650 MG","180","Select","Select",""],["","68382003516","VENLAFAXINE HCL ER","75 MG","30","Select","Select",""],["","00406012301","HYDROCODONE-ACETAMINOPHEN","5 MG-325MG","5","Select","Select",""],["","50742026201","NIFEDIPINE ER","90 MG","90","Select","Select",""],["","63044062201","RENO CAPS","1 MG","30","Select","Select",""],["","70377002911","ATORVASTATIN CALCIUM","40 MG","30","Select","Select",""],["","60258016101","RENA-VITE RX","1MG-60MG","30","Select","Select",""],["","08290320550","NANO","2ND GEN PEN NEEDLE 32GX 5\/32\"","400","Select","Select",""],["","00093220401","METOCLOPRAMIDE HCL","5 MG","2","Select","Select",""],["","00904674880","BISACODYL","5 MG","2","Select","Select",""],["","43386009019","GAVILYTE-G","236-22.74G","4000","Select","Select",""],["","00093317431","ALBUTEROL SULFATE HFA","90 MCG","8.5","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":""}]}]}