{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KIMBERLY A MORRIS","gend":1,"add":"602 74TH ST APT 7","city":"NEWPORT NEWS","state":"VA","zip":"23605-9998","dob":"1976-06-28","age":"","mstatus":"","insh":"2151945*01","cliId":"","pno":7579774778,"cno":7579774778,"email":"","ename":"","eno":"","pphy":"AGBE-DAVIES, OLANREWAJU MD","ppno":7575345100,"pcpadd":"12200 WARWICK BLVD STE 110,","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":"23601-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7575345395,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R11.2","I10.","B20.","F17.210","Z91.14","Z88.8","R19.7","R20.2","J02.9","R51.9","Z20.822","I63.9","R05.9","G44.209","U09.9","R53.1","M79.604","M79.621","R29.898","J40.","J06.9","Z21.","B15.9","D62.","B19.10","S99.929A","D64.9","I16.1","N13.6","N92.0","M79.671","R29.704","Z96.659","Z91.19","Z86.73","I51.89","N39.0","R20.0","R47.81","I66.22","F17.200","R29.701","G81.91","D50.9","R00.0","J20.9","Z28.310","Z02.79","H57.12","N20.0","E27.8","U07.1","R11.0","G45.9","N93.9","D50.0","R82.90","Z90.49","R09.81","R06.02","R53.83","R06.09","R07.9","H00.014","R22.0","N93.8","M79.601","G47.9","R00.2"],"date":["2022-07-02","2023-07-25","2022-10-17","2023-07-25","2022-07-02","2023-01-13","2022-07-02","2023-07-25","2022-01-04","2022-04-11","2023-01-13","2022-07-26","2022-04-11","2022-02-01","2022-02-01","2022-07-24","2022-07-24","2022-07-24","2022-07-24","2022-10-25","2023-01-13","2023-07-25","2022-07-24","2022-07-24","2022-07-24","2022-07-24","2023-07-25","2022-07-26","2022-07-24","2022-07-24","2022-07-24","2022-07-24","2022-07-24","2022-07-24","2023-06-08","2022-08-15","2023-07-25","2022-08-17","2022-08-17","2022-08-17","2022-08-17","2022-08-17","2022-07-26","2022-07-26","2023-07-25","2022-10-17","2023-01-13","2022-02-01","2022-02-01","2021-08-27","2021-08-27","2022-01-04","2022-01-04","2022-08-17","2022-07-25","2022-07-25","2022-08-17","2023-01-13","2023-01-13","2023-07-25","2023-06-08","2023-06-08","2023-07-25","2023-08-27","2023-08-27","2023-07-25","2023-07-25","2023-07-25","2023-07-25"],"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":[["","65162019011","NAPROXEN","500 MG","14","Select","Select",""],["","68462015713","ONDANSETRON","TAB 4MG ODT","12","Select","Select",""],["","00031873642","ROBITUSSIN","LIQ CGH\/CONG","420","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","43598044874","NICOTINE TD","DIS 21MG\/24H","28","Select","Select",""],["","16714071302","TAMSULOSIN","CAP 0.4MG","30","Select","Select",""],["","68180063809","ATORVASTATIN","TAB 80MG","30","Select","Select",""],["","29300039710","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","55111019605","CLOPIDOGREL","TAB 75MG","30","Select","Select",""],["","67877054360","CEFDINIR","300 MG","14","Select","Select",""],["","00904679480","ASPIRIN LOW","CHW 81MG","30","Select","Select",""],["","49281042250","FLUZONE QUAD","INJ 2022-23","0","Select","Select",""],["","42806071401","BENZONATATE","CAP 100MG","30","Select","Select",""],["","00781808926","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","70954006010","PREDNISONE","TAB 20MG","10","Select","Select",""],["","00121077516","GG\/CODEINE","SOL 100-10\/5","120","Select","Select",""],["","67877021905","CEPHALEXIN","500 MG","14","Select","Select",""],["","65162019011","NAPROXEN TAB","500MG","20","Select","Select",""],["","68462015713","ONDANSETRON TAB","4MG ODT","12","Select","Select",""],["","00031873642","ROBITUSSIN LIQ CGH\/CONG","","420","Select","Select",""],["","66993001968","ALBUTEROL AER HFA","","18","Select","Select",""],["","68180063809","ATORVASTATIN TAB","80MG","30","Select","Select",""],["","43598044874","NICOTINE TD DIS","21MG\/24H","28","Select","Select",""],["","00904679480","ASPIRIN LOW CHW","81MG","30","Select","Select",""],["","29300039710","AMLODIPINE TAB","5MG","30","Select","Select",""],["","55111019605","CLOPIDOGREL TAB","75MG","30","Select","Select",""],["","67877054360","CEFDINIR CAP","300MG","6","Select","Select",""],["","16714071302","TAMSULOSIN CAP","0.4MG","30","Select","Select",""],["","49281042250","FLUZONE QUAD INJ","2022-23","0","Select","Select",""],["","42806071401","BENZONATATE CAP","100MG","30","Select","Select",""],["","00121077516","GG\/CODEINE SOL","100-10\/5","120","Select","Select",""],["","00781808926","AZITHROMYCIN TAB","250MG","6","Select","Select",""],["","70954006010","PREDNISONE TAB","20MG","10","Select","Select",""],["","65162027250","SULFAMETHOXAZOLE-TRIMETHOPRIM","800-160 MG","14","Select","Select",""],["","00143924920","AMOXICILLIN-CLAVULANATE POTASS","875-125 MG","20","Select","Select",""],["","00574402435","ERYTHROMYCIN","5 MG\/GRAM","3.5","Select","Select",""],["","00904053061","TAB-A-VITE","400 MCG","30","Select","Select",""],["","49035030882","PAIN RELIEVER","500 MG","50","Select","Select",""],["","00904759080","FEROSUL","325(65) MG","60","Select","Select",""],["","49281072310","FLUBLOK QUAD","2023-2024 180MCG\/0.5","0.5","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":""}]}]}