{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ASHLEY N MORGAN","gend":1,"add":"305 WOODBINE ST","city":"HOPEWELL","state":"VA","zip":"23860-9998","dob":"1988-02-05","age":"","mstatus":"","insh":"2215574*01","cliId":"","pno":8047218090,"cno":8047218090,"email":"","ename":"","eno":"","pphy":"CLAY, JOHN MD","ppno":8045048025,"pcpadd":"930 SOUTH AVE,","pcpcity":"COLONIAL HEIGHTS","pcpstate":"VA","pcpzip":"23834-9998","pcpcounty":"","pcpid":"","pcpname":"Primary Health Group - Appomattox","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8045048026,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G89.4","R10.2","M51.26","Z79.891","G57.81","K80.12","Z20.822","Z88.0","Z88.1","Z88.6","Z90.710","Z90.49","Z98.891","K31.89","R10.13","F41.1","F33.2","F43.12","F90.0","M54.16","M53.3","N99.4","M47.817","F33.9","F31.9","I87.2","I83.893","I83.813","M51.36","M54.41","G89.29","R10.9","R50.9","N61.0","N61.1","Z45.2","M54.9","E87.6","S20.01XA","R23.8","F32.2","I87.001","K80.10","Z51.81","Z79.2","J10.1","T40.2X5A","I87.023","H00.014","F17.210","Z79.899","K80.20","Z86.14","Z98.890","B95.62","N64.1","F17.200","Z88.5","Z88.8","Z86.74","L02.92","Z76.89","M54.5","NO DATA","M54.17","E66.9","J45.909","G43.909","Z68.35","K21.9","T50.905A","T81.49XA","Z87.2","Z91.89","M54.31","Z80.3","M47.812","M25.512","M62.838","R20.2","M54.2","M25.511","R42.","G43.109"],"date":["2023-08-28","2022-12-01","2023-08-28","2023-05-03","2022-03-07","2021-11-12","2022-10-24","2022-10-24","2023-02-20","2022-10-24","2022-10-24","2022-10-24","2021-11-12","2021-12-03","2021-12-03","2023-08-28","2022-10-03","2022-10-03","2023-03-31","2023-08-28","2023-08-28","2022-12-01","2023-08-28","2023-08-28","2022-10-24","2021-11-11","2021-11-11","2021-11-11","2022-05-25","2022-06-30","2022-10-24","2022-06-30","2022-10-13","2022-10-25","2023-02-20","2022-11-15","2022-10-13","2021-04-04","2021-07-15","2021-07-15","2021-07-15","2021-11-11","2021-11-13","2023-08-28","2022-11-15","2022-11-28","2022-04-07","2021-10-19","2021-02-19","2021-12-03","2023-08-28","2021-11-12","2023-02-20","2022-10-24","2022-10-24","2022-10-24","2022-10-24","2022-10-24","2022-10-24","2022-10-24","2021-05-19","2021-05-19","2021-09-09","2022-08-17","2021-11-03","2021-12-03","2021-12-03","2021-12-03","2021-12-03","2021-12-20","2022-03-23","2022-10-31","2023-03-01","2023-03-01","2022-06-30","2023-01-25","2023-06-07","2023-06-07","2023-06-07","2023-06-07","2023-08-28","2023-08-28","2023-09-07","2023-09-07"],"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":[["","00832167111","FLUVOXAMINE","TAB 50MG","120","Select","Select",""],["","00781107905","ALPRAZOLAM","1 MG","90","Select","Select",""],["","24510013010","XTAMPZA ER","CAP 27MG","60","Select","Select",""],["","68462010905","TOPIRAMATE","TAB 100MG","120","Select","Select",""],["","00406851001","OXYCODONE","TAB 10MG","120","Select","Select",""],["","29300013601","CLONIDINE","TAB 0.2MG","90","Select","Select",""],["","47335030888","ZOLPIDEM ER","TAB 12.5MG","30","Select","Select",""],["","57841130101","MOVANTIK","TAB 25MG","30","Select","Select",""],["","45802086803","POLYETH GLYC","POW 3350 NF","510","Select","Select",""],["","57237007710","ONDANSETRON","TAB 4MG ODT","30","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","14","Select","Select",""],["","59779030603","CVS PURELAX","POW ","510","Select","Select",""],["","00378110101","PRAZOSIN HCL","CAP 1MG","60","Select","Select",""],["","52817033200","CYCLOBENZAPR","TAB 10MG","45","Select","Select",""],["","53489012002","DOXYCYCL HYC","TAB 100MG","28","Select","Select",""],["","59267100001","PFIZER VACC","INJ COVID-19","0","Select","Select",""],["","00781317307","SUMATRIPTAN","INJ 6MG\/0.5","2","Select","Select",""],["","68382050010","OMEPRAZOLE","40 MG","30","Select","Select",""],["","00143992801","CIPROFLOXACN","TAB 500MG","14","Select","Select",""],["","43598044870","NICOTINE TD","DIS 21MG\/24H","28","Select","Select",""],["","00363042098","NICOTINE POL","GUM 2MG REF","170","Select","Select",""],["","00591544305","PREDNISONE","TAB 20MG","15","Select","Select",""],["","23155050105","HYDROXYZ HCL","TAB 25MG","20","Select","Select",""],["","00172572860","FAMOTIDINE","TAB 20MG","10","Select","Select",""],["","64980037503","ATOMOXETINE","CAP 25MG","30","Select","Select",""],["","00054350049","LIDOCAINE","SOL 2% VISC","200","Select","Select",""],["","63323031461","VANCOMYCIN","INJ 10GM","10","Select","Select",""],["","51672131201","MUPIROCIN","OIN 0.02","15","Select","Select",""],["","68382070718","DOXYCYC MONO","CAP 100MG","28","Select","Select",""],["","00093216568","NALOXONE HCL","SPR 4MG","2","Select","Select",""],["","64980037503","ATOMOXETINE HCL","25 MG","30","Select","Select",""],["","00832167111","FLUVOXAMINE MALEATE","50 MG","120","Select","Select",""],["","43547056610","CLONIDINE HCL","0.2 MG","90","Select","Select",""],["","42858000201","OXYCODONE HCL","10 MG","120","Select","Select",""],["","29300041510","CYCLOBENZAPRINE HCL","10 MG","90","Select","Select",""],["","57237007710","ONDANSETRON ODT","4 MG","30","Select","Select",""],["","68180078001","ZOLPIDEM TARTRATE ER","12.5 MG","30","Select","Select",""],["","53329024401",""," ","5","Select","Select",""],["","68382091634","METHYLPREDNISOLONE","4 MG","21","Select","Select",""],["","00781317307","SUMATRIPTAN INJ","6MG\/0.5","2","Select","Select",""],["","00406851001","OXYCODONE TAB","10MG","28","Select","Select",""],["","29300013601","CLONIDINE TAB","0.2MG","90","Select","Select",""],["","68382050010","OMEPRAZOLE CAP","40MG","30","Select","Select",""],["","00781107905","ALPRAZOLAM TAB","1MG","60","Select","Select",""],["","57237007710","ONDANSETRON TAB","4MG ODT","30","Select","Select",""],["","68180078001","ZOLPIDEM ER TAB","12.5MG","30","Select","Select",""],["","00832167111","FLUVOXAMINE TAB","50MG","120","Select","Select",""],["","00172572860","FAMOTIDINE TAB","20MG","10","Select","Select",""],["","23155050105","HYDROXYZ HCL TAB","25MG","20","Select","Select",""],["","43598044870","NICOTINE TD DIS","21MG\/24H","28","Select","Select",""],["","00363042098","NICOTINE POL GUM","2MG REF","170","Select","Select",""],["","00591544305","PREDNISONE TAB","20MG","15","Select","Select",""],["","52817033200","CYCLOBENZAPR TAB","10MG","45","Select","Select",""],["","31722071630","ATOMOXETINE CAP","25MG","30","Select","Select",""],["","68382070718","DOXYCYC MONO CAP","100MG","28","Select","Select",""],["","51672131201","MUPIROCIN OIN","2%","15","Select","Select",""],["","00054350049","LIDOCAINE SOL","2% VISC","200","Select","Select",""],["","00093216568","NALOXONE HCL SPR","4MG","2","Select","Select",""],["","63323031461","VANCOMYCIN INJ","10GM","125","Select","Select",""],["","70010077001","METHOCARBAMOL","750 MG","10","Select","Select",""],["","00002143611","EMGALITY PEN","120 MG\/ML","3","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":""}]}]}