{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KERI L RINGENBACH","gend":1,"add":"8335 DICKSON DR","city":"NORFOLK","state":"VA","zip":"23518-9998","dob":"1971-06-07","age":"","mstatus":"","insh":"2079235*01","cliId":"","pno":7576515505,"cno":7576515505,"email":"","ename":"","eno":"","pphy":"PARKER, REBECCA M NP","ppno":7576898460,"pcpadd":"SUITE 100 1925 GLENN MITCHELL DR","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":"23456-9998","pcpcounty":"","pcpid":"","pcpname":"Princess Anne Medical Associates","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7576898435,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K74.1","Z80.0","I10.","Z53.21","J96.01","J18.9","E87.1","Z68.41","J98.11","N83.209","F10.10","R79.89","E66.01","Z20.822","E87.70","NO DATA","T46.1X5A","K70.30","Z79.899","Z82.61","M79.89","R23.8","K74.60","E11.9","E66.9","Z68.42","Z86.16","R21.","R00.0","A41.9","N17.9","L03.116","R65.20","I87.2","F41.9","Z76.89","E66.09","R74.8","Z13.220","Z13.1","Z00.00","Z12.39","J30.1","R05.9","R06.02","Z57.2","R11.2","K62.5","N83.8","N30.00","L03.90","Z87.19","I89.0","Z03.89","T78.40XA","I50.31","R94.5","R06.89","R60.0","L03.115","N39.0","E87.2","Z82.49","Z83.3","D50.9","A02.1","K76.6","K70.10","J44.9","F10.129","K76.0","Z09.","E66.3","G47.00","N83.201","N83.202","N93.9","R10.30","R60.9","I11.0","I50.9","F10.239","I34.0","Z04.2","K72.90","F10.29","R74.01","A46.","L30.9","Z23.","R73.9","Z20.828","U07.1","B34.9","L03.119","D64.9","R63.4","N95.1","R53.83","F32.0","K92.2","F10.920","N92.6","E88.81","R87.612","R57.9","N92.5","R09.02"],"date":["2021-08-04","2021-12-15","2023-04-24","2021-10-13","2023-05-25","2021-10-19","2022-06-10","2022-12-31","2021-10-19","2021-10-19","2023-05-26","2021-10-19","2022-11-03","2023-03-06","2021-10-19","2022-11-06","2021-10-19","2023-05-26","2022-11-03","2021-10-19","2022-11-02","2022-02-13","2022-11-04","2022-12-31","2022-12-31","2022-11-03","2022-12-31","2022-03-07","2022-04-21","2022-05-06","2022-05-25","2022-11-03","2022-05-06","2023-04-24","2023-05-19","2021-03-16","2021-03-16","2021-10-22","2022-10-13","2021-03-16","2021-03-16","2021-03-16","2021-06-25","2021-10-12","2022-11-06","2021-10-12","2021-10-21","2021-10-21","2022-01-27","2022-04-30","2022-05-06","2022-11-06","2022-11-06","2022-12-31","2023-03-06","2021-10-18","2022-04-17","2021-10-18","2022-11-01","2022-11-03","2022-04-30","2022-05-25","2022-11-02","2022-04-30","2022-04-30","2022-05-01","2022-11-03","2022-11-03","2022-11-03","2022-11-03","2022-11-03","2022-11-15","2022-05-25","2023-05-19","2023-04-13","2023-03-23","2023-03-23","2023-03-23","2022-11-02","2022-11-02","2022-11-02","2022-04-17","2022-11-04","2022-12-31","2021-06-14","2021-06-14","2021-06-14","2022-04-06","2022-10-13","2022-04-06","2021-10-26","2022-01-01","2022-01-08","2022-01-08","2022-11-15","2022-05-24","2022-05-24","2021-11-17","2023-03-06","2023-05-19","2023-05-26","2023-05-25","2023-04-13","2023-04-13","2023-04-13","2023-05-28","2023-04-07","2022-11-03"],"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":[["","68645051554","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","49035061501","EQ ITCHY EYE","DRO 0.025%OP","5","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","68645051054","HYDROCHLOROT","TAB 25MG","30","Select","Select",""],["","68180021509","LOSARTAN\/HCT","TAB 50-12.5","90","Select","Select",""],["","50111078710","AZITHROMYCIN","TAB 250MG","5","Select","Select",""],["","00093342501","LORAZEPAM","TAB 0.5MG","21","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","68382009305","CARVEDILOL","6.25 MG","180","Select","Select",""],["","50268085115","VITAMIN B1","TAB 100MG","30","Select","Select",""],["","69367022001","SOD CHLORIDE","TAB 1GM","60","Select","Select",""],["","23155014201","DOXYCYCL HYC","TAB 100MG DR","14","Select","Select",""],["","00054429931","FUROSEMIDE","40 MG","30","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","00378456177","POT CHLORIDE","TAB 10MEQ ER","7","Select","Select",""],["","00173068220","VENTOLIN HFA","AER ","18","Select","Select",""],["","57896085101","VITAMIN B-1","TAB 100MG","30","Select","Select",""],["","69452014430","BENZONATATE","CAP 200MG","30","Select","Select",""],["","31722070190","LOSARTAN POT","TAB 50MG","30","Select","Select",""],["","45802000403","HYDROCORT","CRE 0.025","28","Select","Select",""],["","59746017310","PREDNISONE","TAB 10MG","46","Select","Select",""],["","00143924920","AMOX\/K CLAV","TAB 875-125","14","Select","Select",""],["","45802005535","TRIAMCINOLON","OIN 0.001","15","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","28","Select","Select",""],["","65162027250","SMZ\/TMP DS","TAB 800-160","56","Select","Select",""],["","51672130104","AMMONIUM LAC","CRE 0.12","280","Select","Select",""],["","67877021905","CEPHALEXIN","CAP 500MG","20","Select","Select",""],["","68645052254","SERTRALINE","TAB 50MG","30","Select","Select",""],["","64980052810","SODIUM BICAR","TAB 650MG","90","Select","Select",""],["","16729022601","SPIRONOLACT","TAB 50MG","30","Select","Select",""],["","69315012710","FOLIC ACID","1 MG","30","Select","Select",""],["","16714008310","HYDROXYZ HCL","TAB 50MG","30","Select","Select",""],["","00555077902","MEDROXYPROGESTERONE ACETATE","10 MG","10","Select","Select",""],["","49035036654","ALLERGY RELIEF","180 MG","30","Select","Select",""],["","68645052254","SERTRALINE HCL","50 MG","90","Select","Select",""],["","53746051401","SPIRONOLACTONE","50 MG","30","Select","Select",""],["","00114236712",""," ","90","Select","Select",""],["","00536468010","VITAMIN B-","1 100 MG","30","Select","Select",""],["","50111056001","TRAZODONE HCL","50 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":""}]}]}