{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JANINE CARTER-WEAVER","gend":1,"add":"913 VIRGINIA BEACH BLVD TRLR 232","city":"VIRGINIA BEACH","state":"VA","zip":"23451-9998","dob":"1982-02-03","age":"","mstatus":"","insh":"2222838*01","cliId":"","pno":7572749047,"cno":7572749047,"email":"","ename":"","eno":"","pphy":"KIRKLAND, C STOKES MD","ppno":7576226520,"pcpadd":"STE 1 425 W 20TH ST","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":"23517-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7576227205,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E66.01","Z32.02","R87.810","R00.2","F34.1","F51.01","Z68.41","I10.","K21.9","G47.33","J45.909","F41.1","F43.12","F90.2","M79.652","Z98.84","E66.9","Z68.38","M25.552","Z87.891","Z88.8","R42.","M79.605","D50.0","N92.0","M79.7","N84.0","D50.9","Z20.822","N94.6","N87.9","O20.9","O10.911","Z3A.01","Z88.6","NO DATA","K91.2","R11.0","R55.","Z68.24","Z86.39","Z01.419","M25.50","R35.0","I07.1","R10.13","Z68.27","Z68.26","Z01.818","H60.90","R82.71","M54.16","M47.816","Z71.89","F17.290","R07.89","Z01.411","N85.9","R87.615","R06.00","N94.5","D25.9","N70.91","N99.820","H60.543","T16.2XXA","R20.2","S46.912A","M54.5","R50.9","N39.3","M19.90","Z68.32","Z01.810","L28.2","K59.00","M79.671","Q82.8","E55.9","Z76.89","J45.40","E66.09","R91.1","M25.512","B02.9","B37.2","L25.5","M79.601","R00.1","I49.8","R06.09","L08.9","M72.2","M76.71","G44.209","N30.00","R41.1","M12.9","Z90.49","Z98.891","Z79.899","R87.613","Z71.6","Z71.3","Z87.19","R06.02","Z91.119"],"date":["2022-03-16","2022-08-10","2022-06-13","2022-10-04","2022-05-09","2022-01-17","2022-03-16","2022-10-07","2022-03-16","2022-03-16","2022-03-16","2021-12-13","2022-05-09","2022-05-09","2022-04-01","2023-04-04","2022-06-16","2022-04-01","2022-04-01","2023-03-02","2022-11-24","2022-12-01","2022-04-02","2023-02-06","2022-10-28","2022-07-25","2022-08-04","2022-08-04","2022-08-22","2022-10-28","2022-10-28","2022-11-24","2022-11-24","2022-11-24","2022-11-24","2022-11-24","2023-04-04","2023-04-04","2022-12-01","2022-12-01","2022-12-01","2021-03-01","2021-08-05","2021-08-05","2022-09-08","2022-10-13","2022-09-13","2022-10-13","2022-10-10","2022-10-10","2022-10-10","2022-12-12","2022-12-12","2022-12-12","2022-12-12","2021-12-06","2022-04-15","2022-06-30","2022-05-20","2022-09-08","2022-10-28","2022-10-28","2022-10-28","2022-11-24","2023-01-03","2023-01-03","2023-02-07","2023-03-02","2021-02-02","2021-02-02","2022-03-16","2022-03-16","2022-06-16","2022-10-07","2022-11-07","2022-11-07","2023-03-24","2023-03-24","2021-04-05","2021-04-05","2023-04-03","2023-04-03","2023-04-03","2023-03-02","2021-05-06","2021-05-06","2021-05-06","2022-05-12","2022-08-18","2022-09-08","2022-09-08","2021-03-29","2021-05-24","2021-05-24","2021-06-18","2021-06-18","2021-06-18","2022-03-16","2022-03-16","2022-03-16","2022-03-16","2022-06-13","2021-03-15","2021-03-15","2021-12-06","2021-12-06","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":[["","00591288001","VERAPAMIL","CAP 120MG SR","30","Select","Select",""],["","13107006101","PHENTERMINE","TAB 37.5MG","30","Select","Select",""],["","51672131201","MUPIROCIN","OIN 0.02","45","Select","Select",""],["","51672129803","KETOCONAZOLE","CRE 0.02","60","Select","Select",""],["","65862044930","VALACYCLOVIR","TAB 1GM","21","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","45802006336","TRIAMCINOLON","CRE 0.00025","80","Select","Select",""],["","57664037713","TRAMADOL HCL","TAB 50MG","20","Select","Select",""],["","50111078751","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","00781324664","ENOXAPARIN","INJ 40\/0.4ML","3","Select","Select",""],["","57237007730","ONDANSETRON","TAB 4MG ODT","12","Select","Select",""],["","00173089310","TRELEGY","AER 200MCG","60","Select","Select",""],["","42192033901","HYOSCYAMINE","SUB 0.125MG","12","Select","Select",""],["","00591352530","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","31722071390","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","00173072020","FLOVENT HFA","AER 220MCG","12","Select","Select",""],["","31722099601","HYDROCO\/APAP","TAB 5-325MG","28","Select","Select",""],["","65162047810","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","00173068220","VENTOLIN HFA","90 MCG","18","Select","Select",""],["","42806040021","METHYLPRED","TAB 4MG","21","Select","Select",""],["","68382056410","METOPROLOL SUCCINATE","25 MG","30","Select","Select",""],["","66993001968","ALBUTEROL SULFATE HFA","90 MCG","18","Select","Select",""],["","45802000910","FLUOCINOLONE ACETONIDE OIL","0.01 %","20","Select","Select",""],["","68462063945","NITROGLYCERIN","0.4 MG","25","Select","Select",""],["","00173089310","TRELEGY ELLIPTA","200-62.5","60","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":""}]}]}