{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ROBERT STUBBS","gend":0,"add":"349 MAIN ST APT 3","city":"SMITHFIELD","state":"VA","zip":"23430-9998","dob":"1960-02-15","age":"","mstatus":"","insh":"2084360*01","cliId":"","pno":7573716663,"cno":7573716663,"email":"","ename":"","eno":"","pphy":"RIDLEY, DERRICK E MD","ppno":7578272200,"pcpadd":"SUITE 100 4000 COLISEUM DRIVE","pcpcity":"HAMPTON","pcpstate":"VA","pcpzip":"23666-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7578272266,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["C34.11","Z00.6","F17.200","F32.1","G89.3","E03.9","E61.1","Z01.810","I25.10","R06.02","J98.8","F17.210","Z79.899","J44.9","J18.9","R60.9","Z88.0","Z88.2","Z91.040","E03.8","NO DATA","J96.01","J18.1","J44.1","C34.31","E86.0","J44.0","B37.0","J15.1","C34.90","I10.","E78.5","Z72.0","K40.90","J40.","I44.4","I51.7","D71.","E27.8","J43.2","K75.3","M43.8X6","M47.814","M47.816","M51.36","J98.4","D50.9","Z45.2","Z85.118","R91.1","R91.8","Z23.","R07.9","J43.8","J84.10","K59.00","J47.9","I70.0","K57.30","M47.815","M16.0","Z95.828","J43.1","J47.0","D84.9","E78.00","Z20.822","J20.9","M19.90","Z79.51","R05.9"],"date":["2023-04-04","2023-03-14","2023-04-04","2023-01-31","2023-02-21","2023-02-14","2023-03-14","2022-02-01","2023-02-14","2023-02-15","2022-10-06","2023-02-10","2022-10-06","2023-02-15","2023-02-21","2022-06-17","2022-06-17","2022-06-17","2022-06-17","2022-07-27","2023-02-10","2023-02-15","2023-02-15","2023-02-15","2023-02-15","2021-05-08","2023-02-15","2022-10-18","2022-11-29","2023-02-13","2023-02-14","2023-02-14","2023-02-14","2023-03-14","2023-04-04","2023-02-12","2023-02-12","2021-09-09","2021-09-09","2021-09-09","2021-09-09","2021-09-09","2021-09-09","2022-01-14","2021-09-09","2023-02-02","2021-01-18","2021-04-12","2022-04-11","2022-04-11","2022-04-11","2022-11-08","2023-04-17","2022-01-14","2022-01-14","2022-01-14","2022-01-14","2022-01-14","2022-01-14","2022-01-14","2022-01-14","2022-01-14","2022-01-31","2023-02-10","2023-02-10","2023-02-10","2023-02-10","2023-02-10","2023-02-10","2023-02-10","2023-04-04"],"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":[["","59746011506","PROCHLORPER","TAB 10MG","30","Select","Select",""],["","68180097201","LEVOTHYROXIN","TAB 137MCG","30","Select","Select",""],["","00121086816","NYSTATIN","SUS 100000","600","Select","Select",""],["","68180035206","SERTRALINE","TAB 50MG","90","Select","Select",""],["","31722088390","ROSUVASTATIN","TAB 10MG","90","Select","Select",""],["","00310737020","BUDES\/FORMOT","AER 160-4.5","10","Select","Select",""],["","00406055201","OXYCODONE","TAB 5MG","150","Select","Select",""],["","47781042447","FENTANYL","25 MCG\/HR","10","Select","Select",""],["","70710116101","MECLIZINE","TAB 12.5MG","90","Select","Select",""],["","69367029820","MAG OXIDE","TAB 400MG","60","Select","Select",""],["","59746017506","PREDNISONE","20 MG","15","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","00186037020","SYMBICORT","AER 160-4.5","10","Select","Select",""],["","69097084087","IPRATROPIUM\/","SOL ALBUTER","360","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8","Select","Select",""],["","31722071390","PANTOPRAZOLE","TAB 40MG","60","Select","Select",""],["","55111015430","ONDANSETRON","TAB 8MG","30","Select","Select",""],["","64380071206","BENZONATATE","CAP 100MG","90","Select","Select",""],["","70010014801","POT CHLORIDE","CAP 10MEQ ER","90","Select","Select",""],["","00254101196","SUCRALFATE","SUS 1GM\/10ML","1200","Select","Select",""],["","50383066730","LIDO\/PRILOCN","CRE 2.5-2.5%","30","Select","Select",""],["","59267100003","PFIZER VACC","INJ COVID-19","0","Select","Select",""],["","00173088710","TRELEGY","AER ELLIPTA","60","Select","Select",""],["","00597007541","SPIRIVA","CAP HANDIHLR","30","Select","Select",""],["","00904759080","FEROSUL","325(65) MG","15","Select","Select",""],["","00115703301","FLUDROCORT","TAB 0.1MG","90","Select","Select",""],["","00173071720","ADVAIR HFA","AER 230\/21","12","Select","Select",""],["","59762444002","METHYLPRED","TAB 4MG","21","Select","Select",""],["","69238110005","DOXYCYCL HYC","CAP 100MG","20","Select","Select",""],["","49502080693","YUPELRI","175MCG\/3ML","90","Select","Select",""],["","00310008828","DALIRESP","TAB 250MCG","30","Select","Select",""],["","62332065560","FORMOTEROL","NEB 20\/2ML","120","Select","Select",""],["","70748025760","ARFORMOTEROL","NEB 15\/2ML","120","Select","Select",""],["","55111028130","LEVOFLOXACIN","750 MG","7","Select","Select",""],["","00093681573","BUDESONIDE","0.25MG\/2ML","120","Select","Select",""],["","70010013901","NAPROXEN","500 MG","60","Select","Select",""],["","00406055201","OXYCODONE HCL","5 MG","150","Select","Select",""],["","31722071390","PANTOPRAZOLE SODIUM","40 MG","60","Select","Select",""],["","68180096301","ALBUTEROL SULFATE HFA","90 MCG","8.5","Select","Select",""],["","69238110005","DOXYCYCLINE HYCLATE","100 MG","28","Select","Select",""],["","68180097201","LEVOTHYROXINE SODIUM","137 MCG","30","Select","Select",""],["","69367029820","MAGNESIUM OXIDE","400 MG","60","Select","Select",""],["","62332065560","FORMOTEROL FUMARATE","20 MCG\/2ML","120","Select","Select",""],["","00093216568","NALOXONE HCL","4 MG","2","Select","Select",""],["","69097084087","IPRATROPIUM-ALBUTEROL","0.5-3MG\/3","360","Select","Select",""],["","43598044828","NICOTINE PATCH","21 MG\/24HR","56","Select","Select",""],["","00115703301","FLUDROCORTISONE ACETATE","0.1 MG","30","Select","Select",""],["","62332025118","AZITHROMYCIN","250 MG","6","Select","Select",""],["","68180035309","SERTRALINE HCL","100 MG","90","Select","Select",""],["","70000041503","CLEARLAX","17 G\/DOSE","510","Select","Select",""],["","00536124710","SENEXON-S","8.6MG-50MG","30","Select","Select",""],["","50228018001","GABAPENTIN","300 MG","30","Select","Select",""],["","70010014801","POTASSIUM CHLORIDE","10 MEQ","90","Select","Select",""],["","00904759161","FERROUS SULFATE","325(65) MG","45","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":""}]}]}