{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"EVETTE  Y NEWBY","gend":1,"add":"670 AQUA VISTA DR APT B","city":"NEWPORT NEWS","state":"VA","zip":"23607-9998","dob":"1966-10-23","age":"","mstatus":"","insh":"2152364*01","cliId":"","pno":7577818897,"cno":7577818897,"email":"","ename":"","eno":"","pphy":"WHITE, SHARONEE MARSHELLE FNP","ppno":7573808709,"pcpadd":"4714 MARSHALL AVE,","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":"23607-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7579521345,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["S22.20XA","S22.058A","S22.089A","V89.2XXA","S32.011A","F10.10","V54.17","V54.19","R26.2","D61.818","I10.","F25.0","F10.20","Z72.0","E83.42","E55.9","K59.00","Z11.3","Z11.4","R31.0","R82.2","R80.9","N76.0","R03.0","Z87.891","NO DATA","H53.9","Z12.31","Z12.11","Z71.89","K92.1","M54.41","M54.42","N39.0","F20.9","F31.9","Z32.02","Z79.899","Z88.1","R82.998","S05.90XA","Z68.29","Z13.89","H16.012","H04.129","S22.050A","S22.088A","S32.008A","V47.1XXA","R78.0","Y90.2","R78.2","R78.4","F12.90","Z86.59","D64.9","R51.9","H10.32","S05.02XA","H40.033","M41.86","M43.16","G89.29","H16.002","F17.210","M54.16","S32.001A","U07.1","R05.","N89.8","Z23.","K64.9","Z20.2","Z86.19","A54.9","A74.9","M79.2","M54.31","M54.32","H57.12","Z47.89","V87.7XXD","F11.90","Z51.81","M54.12","M41.9","Z88.2","M79.661","V58.89","B35.3","S32.019A","S22.22XA","S22.059A","F14.10","I45.81"],"date":["2023-06-09","2023-06-09","2023-06-09","2023-06-09","2023-06-09","2023-06-09","2023-07-12","2023-06-11","2023-06-09","2023-06-11","2023-07-05","2023-06-09","2023-06-15","2023-07-05","2023-06-11","2023-06-11","2023-06-16","2021-09-06","2021-09-06","2021-09-06","2021-09-06","2021-09-06","2021-09-06","2021-09-06","2022-09-15","2023-07-25","2022-05-10","2022-05-10","2022-05-10","2022-05-10","2022-09-15","2022-09-15","2022-09-15","2022-09-15","2023-06-11","2022-09-15","2022-09-15","2023-01-18","2023-01-18","2022-09-15","2023-01-05","2023-01-05","2023-01-05","2023-04-26","2023-04-26","2023-06-05","2023-06-05","2023-06-05","2023-06-05","2023-06-05","2023-06-05","2023-06-05","2023-06-05","2023-06-15","2023-06-15","2023-06-11","2021-08-20","2023-01-23","2023-01-31","2023-02-09","2023-07-12","2023-07-12","2023-07-12","2023-01-18","2023-01-18","2023-07-25","2023-07-18","2021-08-20","2021-08-20","2021-09-15","2021-09-08","2021-09-15","2021-09-15","2022-03-02","2021-09-15","2021-09-15","2021-11-02","2021-11-02","2021-11-02","2023-01-18","2023-06-16","2023-06-16","2023-07-25","2023-07-25","2021-11-02","2021-11-02","2021-11-02","2021-11-02","2023-06-16","2021-03-09","2023-06-05","2023-06-05","2023-06-05","2023-06-05","2023-06-05"],"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":[["","68645051654","AMLODIPINE TAB","10MG","30","Select","Select",""],["","58160082311","SHINGRIX INJ","50\/0.5ML","1","Select","Select",""],["","68382005105","MELOXICAM TAB","15MG","30","Select","Select",""],["","59267102504","PFIZER VACC INJ ADLT RTU","","0","Select","Select",""],["","49035053112","EQ ACETAMIN TAB","500MG","24","Select","Select",""],["","49035030890","PAIN RELIEVR TAB","500MG","24","Select","Select",""],["","67877021905","CEPHALEXIN CAP","500MG","10","Select","Select",""],["","29300041519","CYCLOBENZAPR TAB","10MG","15","Select","Select",""],["","49035048462","ACETAMINOPHN TAB","500MG","24","Select","Select",""],["","00591352530","LIDOCAINE PAD","5%","30","Select","Select",""],["","00832141003","MOXIFLOXACIN","0.5 %","12","Select","Select",""],["","49035013606","LIDOCAINE PAIN RELIEF","4 %","10","Select","Select",""],["","31722077701","ACYCLOVIR","400 MG","80","Select","Select",""],["","00406055201","OXYCODONE HCL","5 MG","42","Select","Select",""],["","53191036201","D","3-50 1250 MCG","4","Select","Select",""],["","00093005805","TRAMADOL HCL","50 MG","20","Select","Select",""],["","00078087601","TOBRADEX","0.3 %-0.1%","3.5","Select","Select",""],["","24208044605","BESIVANCE","0.6 %","5","Select","Select",""],["","24208058060","GENTAMICIN SULFATE","0.3 %","5","Select","Select",""],["","00574402435","ERYTHROMYCIN","5 MG\/GRAM","3.5","Select","Select",""],["","68645051654","AMLODIPINE BESYLATE","10 MG","30","Select","Select",""],["","31722053301","METHOCARBAMOL","500 MG","90","Select","Select",""],["","50228017910","GABAPENTIN","100 MG","90","Select","Select",""],["","00093216568","NALOXONE HCL","4 MG","2","Select","Select",""],["","61314065605","CIPROFLOXACIN HCL","0.3 %","5","Select","Select",""],["","70710113803","FLUCONAZOLE","100 MG","20","Select","Select",""],["","60758011905","PREDNISOLONE ACETATE","1 %","5","Select","Select",""],["","61314012605","KETOROLAC TROMETHAMINE","0.5 %","5","Select","Select",""],["","24208073501","CYCLOPENTOLATE HCL","1 %","2","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":""}]}]}