{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CHETNYA CHOBEJI","gend":0,"add":"537 W BELLWOOD RD APT 25","city":"NEWPORT NEWS","state":"VA","zip":"23601-9998","dob":"1983-09-22","age":"","mstatus":"","insh":"2165603*01","cliId":"","pno":7577035361,"cno":7577035361,"email":"","ename":"","eno":"","pphy":"JONES, JOEL M DO","ppno":7573165050,"pcpadd":"209 VILLAGE AVE STE P,","pcpcity":"YORKTOWN","pcpstate":"VA","pcpzip":"23693-9998","pcpcounty":"","pcpid":"","pcpname":"Riverside Primary Care Kiln Creek","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7573692999,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.1","S20.211A","F10.220","F10.20","E11.9","Z79.4","E66.9","Z68.37","K21.9","I10.","R04.2","Z87.891","R06.02","R60.0","R60.9","L40.50","L40.9","E79.0","M25.562","R74.8","Z79.899","M25.462","F11.20","F33.2","E11.65","Z23.","E11.42","E78.2","K70.30","R05.8","R26.89","M62.831","M25.572","M25.571","R20.9","D84.9","K62.5","K64.8","R23.4","L85.3","K70.9","Z68.38","F10.239","J32.9","E66.01","Z68.39","F10.10","J06.9","Z79.84","Z91.14","E11.40","Z68.35","F10.94","Z91.19","R05.9","K13.0","Z71.9","Z92.89","Z79.85","G47.10","R06.83","Z68.30","F17.220","F32.89","G63.","R40.0","F17.290","E78.5","R27.0","R07.89","R07.81","L40.0","M51.36","M54.42","M54.41","M16.0","G89.29","T88.7XXA","NO DATA","F41.8","R35.0","R73.9","H04.123","H25.813","Z87.19","M54.6","H90.3","H93.13","E10.9","F33.0","R09.3","R73.09","R89.9","S09.90XA","R42.","W01.0XXA","M54.5","E78.00","R34.","I11.0","I50.31","R07.82","R39.11","R07.9","R53.83","G47.30","G47.00","E11.21","F17.210","F32.9","K59.00","M19.90","R09.89","G62.9","E86.0","E83.42","E83.39","R53.1","F41.9","R06.4","S61.412A","R51.9","W19.XXXA","M79.671","M79.672","L60.1","H93.293","J30.89","H61.23"],"date":["2023-04-26","2021-04-23","2021-04-23","2023-04-26","2023-01-08","2023-08-17","2023-07-21","2022-05-17","2023-01-06","2023-08-17","2021-06-16","2021-06-16","2023-01-06","2021-06-24","2021-06-24","2022-07-26","2023-09-05","2021-12-14","2021-12-14","2022-02-17","2023-08-17","2021-12-14","2022-09-28","2022-09-28","2023-05-17","2022-12-22","2023-08-17","2023-08-17","2023-08-17","2023-01-06","2023-08-21","2023-08-21","2023-08-21","2023-08-21","2023-08-21","2021-09-14","2021-09-24","2021-09-24","2022-04-04","2022-12-28","2022-10-26","2023-08-17","2023-01-15","2023-03-22","2023-08-17","2023-03-22","2021-09-13","2022-01-05","2023-08-17","2022-01-05","2023-02-03","2022-01-05","2022-01-05","2022-07-26","2023-01-07","2023-09-05","2023-09-05","2022-11-16","2023-05-17","2023-07-21","2023-07-21","2023-07-21","2023-01-06","2022-05-09","2022-07-26","2022-10-26","2022-10-26","2023-01-07","2023-01-08","2021-05-10","2021-05-17","2021-06-15","2021-07-02","2021-07-02","2021-07-02","2021-07-02","2023-02-03","2021-09-01","2023-02-03","2021-09-24","2021-11-01","2021-11-01","2023-01-05","2023-01-05","2023-02-03","2023-02-03","2023-05-24","2023-05-24","2023-01-07","2023-04-26","2023-08-17","2021-01-02","2021-01-02","2021-04-23","2021-04-23","2021-04-23","2021-05-17","2023-01-06","2021-10-18","2021-10-18","2021-10-18","2021-05-10","2021-05-10","2021-05-10","2021-08-31","2021-08-31","2023-01-06","2022-02-17","2023-01-06","2023-01-06","2023-01-06","2023-01-06","2023-01-06","2023-01-06","2021-01-02","2021-01-02","2021-01-02","2021-01-02","2021-01-02","2021-01-02","2021-02-23","2021-04-23","2021-04-23","2021-06-01","2021-06-01","2022-12-28","2023-05-03","2023-05-03","2023-05-03"],"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":[["","00603548221","PROPRANOLOL","TAB 10MG","90","Select","Select",""],["","13668021730","ARIPIPRAZOLE","TAB 5MG","30","Select","Select",""],["","50111078710","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","65862017360","TOPIRAMATE","100 MG","60","Select","Select",""],["","68645052354","SERTRALINE","TAB 100MG","60","Select","Select",""],["","00536467801","VITAMIN B-1","TAB 50MG","30","Select","Select",""],["","00006027731","JANUVIA","100 MG","30","Select","Select",""],["","69315012710","FOLIC ACID","1 MG","30","Select","Select",""],["","50228017705","GABAPENTIN","600 MG","90","Select","Select",""],["","59746070401","DOXEPIN HCL","100 MG","14","Select","Select",""],["","16714057601","ALLOPURINOL","100 MG","60","Select","Select",""],["","68645058259","METFORMIN","TAB 500MG","120","Select","Select",""],["","50474071079","CIMZIA PREFL","KIT 200MG\/ML","2","Select","Select",""],["","55111032205","GLIMEPIRIDE","4 MG","60","Select","Select",""],["","31722070090","LOSARTAN POT","TAB 25MG","15","Select","Select",""],["","55111064530","OMEPRAZOLE","40 MG","90","Select","Select",""],["","51672129803","KETOCONAZOLE","CRE 0.02","60","Select","Select",""],["","00168003315","BETAMETH VAL","OIN 0.001","60","Select","Select",""],["","00002143380","TRULICITY","0.75MG\/0.5","2","Select","Select",""],["","00169413212","OZEMPIC","INJ 2\/1.5ML","2","Select","Select",""],["","51672130009","AMMONIUM LAC","LOT 0.12","400","Select","Select",""],["","00143924920","AMOX\/K CLAV","TAB 875-125","20","Select","Select",""],["","16729044310","BUPROPN HCL","TAB 150MG XL","30","Select","Select",""],["","00169633910","NOVOLOG","INJ FLEXPEN","15","Select","Select",""],["","73070010315","INSULIN ASPA","INJ FLEXPEN","15","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","52565004215","NYSTAT\/TRIAM","OIN ","15","Select","Select",""],["","00904759080","FEROSUL","325(65) MG","90","Select","Select",""],["","08290320109","BD PEN NEEDL","MIS 31GX8MM","100","Select","Select",""],["","00093505798","ATORVASTATIN","TAB 80MG","30","Select","Select",""],["","57599000101","FREESTYLE","KIT SENSOR","2","Select","Select",""],["","00088221905","LANTUS SOLOS","INJ 100\/ML","15","Select","Select",""],["","00713063415","MOMETASONE","CRE 0.001","60","Select","Select",""],["","57599080300","FREESTY LIBR","MIS 2 READER","1","Select","Select",""],["","11877001140","BINAXNOW COV","KIT HOME TES","2","Select","Select",""],["","00173085910","BREO ELLIPTA","INH 100-25","60","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","17","Select","Select",""],["","66993013597","FLUTIC\/VILAN","INH 100-25","60","Select","Select",""],["","42571036299","CLOBETASOL","SOL 0.0005","100","Select","Select",""],["","31604002612","IRON","TAB 325MG","90","Select","Select",""],["","21922001707","CLOBETASOL PROPIONATE","0.05 %","60","Select","Select",""],["","16729044416","BUPROPION XL","300 MG","30","Select","Select",""],["","00054327099","FLUTICASONE PROPIONATE","50 MCG","16","Select","Select",""],["","00713063415","MOMETASONE FUROATE","0.1 %","60","Select","Select",""],["","49502039475","INSULIN GLARGINE-YFGN","100\/ML (3)","9","Select","Select",""],["","68645058259","METFORMIN HCL","500 MG","360","Select","Select",""],["","53885027025","ONETOUCH VERIO TEST STRIP","","25","Select","Select",""],["","68180096301","ALBUTEROL SULFATE HFA","90 MCG","8.5","Select","Select",""],["","00603548221","PROPRANOLOL HCL","10 MG","90","Select","Select",""],["","50474071079","CIMZIA","400 MG\/2ML","2","Select","Select",""],["","31722070090","LOSARTAN POTASSIUM","25 MG","15","Select","Select",""],["","08290320109","ULTRA-FINE SHORT PEN NEEDLE","31 GX5\/16\"","100","Select","Select",""],["","51672300302","HYDROCORTISONE","2.5 %","28.35","Select","Select",""],["","72205001590","PREGABALIN","150 MG","60","Select","Select",""],["","00093505798","ATORVASTATIN CALCIUM","80 MG","30","Select","Select",""],["","00591352530","LIDOCAINE","5 %","30","Select","Select",""],["","00781261305","AMOXICILLIN","500 MG","30","Select","Select",""],["","00169210125","NOVOLOG FLEXPEN","100\/ML (3)","15","Select","Select",""],["","00536467801","VITAMIN B-","1 50 MG","30","Select","Select",""],["","00093081001","NORTRIPTYLINE HCL","10 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":""}]}]}