{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ANGELA TILLEY","gend":1,"add":"23190 SPECKLE ST","city":"WINDSOR","state":"VA","zip":"23487-9998","dob":"1977-05-13","age":"","mstatus":"","insh":"2216343*01","cliId":"","pno":7575702580,"cno":7575702580,"email":"","ename":"","eno":"","pphy":"HOLLERAN, JAMES D MD","ppno":7575390251,"pcpadd":"2000 MEADE PKWY","pcpcity":"SUFFOLK","pcpstate":"VA","pcpzip":"23434-9998","pcpcounty":"","pcpid":"","pcpname":"Lakeview Internal Medicine Meade","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7579349409,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E10.9","Z79.4","R05.9","J45.909","M54.5","M51.36","M54.30","M46.1","R07.89","E11.42","G89.4","Z79.891","R07.9","V54.17","V54.19","N92.6","N92.4","I10.","E11.9","R53.81","R53.83","R11.0","E11.65","M25.511","M79.606","G25.81","E13.40","NO DATA","R11.2","E10.65","Z01.818","G89.21","M53.3","Z87.891","Z91.010","R10.9","S32.009A","S32.9XXA","S32.9XXS","Z96.41","E78.5","E03.9","Z71.6","Z01.419","Z12.39","R25.2","M25.50","Z68.29","J06.9"],"date":["2023-01-23","2023-01-23","2022-10-19","2022-10-19","2021-08-17","2023-02-01","2023-02-01","2023-02-01","2023-02-01","2021-03-23","2023-02-01","2023-02-01","2023-02-01","2023-02-01","2022-08-08","2021-06-16","2021-06-16","2021-10-11","2021-09-25","2021-06-26","2021-06-26","2021-06-26","2021-10-11","2023-02-01","2022-08-08","2023-02-01","2023-02-01","2023-02-01","2021-09-25","2023-02-16","2021-06-08","2021-09-25","2021-09-25","2021-09-25","2021-09-25","2021-09-25","2021-11-15","2021-11-15","2022-02-03","2021-10-11","2021-10-11","2021-10-11","2021-10-11","2021-10-26","2021-10-26","2022-05-23","2022-05-23","2022-05-23","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":[["","42858080301","MORPHINE SUL","TAB 60MG ER","60","Select","Select",""],["","00406853001","OXYCODONE","TAB 30MG","90","Select","Select",""],["","65862016001","ZOLPIDEM","TAB 10MG","30","Select","Select",""],["","68180098103","LISINOPRIL","20 MG","90","Select","Select",""],["","69238183407","LEVOTHYROXIN","TAB 100MCG","90","Select","Select",""],["","70700015010","OMEPRAZOLE","CAP 20MG","180","Select","Select",""],["","00002751659","HUMALOG","100\/ML","15","Select","Select",""],["","00456120330","LINZESS","72 MCG","30","Select","Select",""],["","00069046956","CHANTIX","TAB 1MG","60","Select","Select",""],["","00193731150","CONTOUR","TES NEXT","150","Select","Select",""],["","00002773701","INSULIN LISP","INJ 100\/ML","30","Select","Select",""],["","59267100002","PFIZER VACC","INJ COVID-19","0","Select","Select",""],["","59746011306","PROCHLORPER","TAB 5MG","12","Select","Select",""],["","49884072703","DOXYCYC MONO","CAP 100MG","14","Select","Select",""],["","75834025601","ATORVASTATIN","TAB 20MG","90","Select","Select",""],["","00904699860","DOCUSATE SOD","CAP 100MG","60","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","18","Select","Select",""],["","49483060350","IBUPROFEN","TAB 600MG","90","Select","Select",""],["","69238110005","DOXYCYCL HYC","CAP 100MG","14","Select","Select",""],["","08214054080","PEN NEEDLES","MIS 32GX5\/32","100","Select","Select",""],["","62088000033","INPEN 100EL","MIS PINK","1","Select","Select",""],["","68180086111","AZITHROMYCIN","250 MG","6","Select","Select",""],["","08290320550","BD PEN NEEDL","MIS 32GX5\/32","100","Select","Select",""],["","68462033190","PRAMIPEXOLE","TAB 0.25MG","60","Select","Select",""],["","69097014260","ALBUTEROL","AER HFA","20","Select","Select",""],["","10702000901","OXYCODONE HCL","30 MG","90","Select","Select",""],["","00193731221","CONTOUR NEXT TEST STRIP","","400","Select","Select",""],["","13668000805","ZOLPIDEM TARTRATE","10 MG","30","Select","Select",""],["","00002773701","INSULIN LISPRO","100\/ML","30","Select","Select",""],["","63304075801","MORPHINE SULFATE ER","60 MG","60","Select","Select",""],["","00378180910","LEVOTHYROXINE SODIUM","100 MCG","90","Select","Select",""],["","13107008305","LORAZEPAM","0.5 MG","60","Select","Select",""],["","64380071207","BENZONATATE","100 MG","30","Select","Select",""],["","62088000033","INPEN (FOR HUMALOG)","","1","Select","Select",""],["","76385012450","METHOCARBAMOL","750 MG","60","Select","Select",""],["","24208083060","NEOMYCIN-POLYMYXIN-DEXAMETH","0.1 %","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":""}]}]}