{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"AVIS  L FRAZIER","gend":1,"add":"1221 KIRBY ST PO BOX 1564","city":"WEST POINT","state":"VA","zip":"23181-9998","dob":"1971-03-22","age":"","mstatus":"","insh":"2316611*01","cliId":"","pno":7575619636,"cno":7575619636,"email":"","ename":"","eno":"","pphy":"PATEL, SHRADDHA R MD","ppno":7572344285,"pcpadd":"12652 JEFFERSON AVE","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":"23602-9998","pcpcounty":"","pcpid":"","pcpname":"Riverside Internal Medicine of Denbigh","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7572344260,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M65.4","Z47.89","Z98.890","J45.50","J30.1","J30.81","J30.89","R10.11","K59.09","R13.10","K21.9","R11.11","J47.9","L20.9","R13.19","K31.84","I10.","J45.51","G47.33","Z79.51","F51.12","J44.9","R10.9","N93.9","Z32.02","R10.2","D25.9","D25.1","R19.09","D25.2","E66.01","Z68.41","R93.89","R59.0","J38.3","NO DATA","F41.1","N95.1","J98.4","R11.2","Z23.","D84.9","J45.40","Z91.09","Z79.52","G47.10","R19.4","R10.30","G56.01","M65.311","R06.02","T18.128A","R11.10","R11.0","R10.10","K44.9","Z71.89","R07.9","R10.13","V58.89","E73.9","R05.","M62.89","M25.471","J20.9","N92.0","Z68.39","N72.","N39.3","J06.9","D31.32","H26.9","H04.123","K59.00","Q43.8","N13.5","F41.9","Z91.81","Z88.5","R49.0","K22.2","R06.00","H52.203","H25.13","H52.4","E78.2","R73.03","H53.8","J45.909","L91.8","D48.5","H01.139","D22.9","L82.1","Z71.9","R07.89","Z99.89"],"date":["2021-06-16","2021-06-16","2021-06-16","2023-04-19","2023-04-25","2023-04-25","2023-04-25","2022-09-08","2023-02-09","2021-07-07","2023-02-09","2021-09-02","2023-03-24","2022-02-14","2022-02-02","2023-02-09","2023-02-21","2022-08-15","2023-04-19","2023-03-24","2022-06-24","2022-11-18","2022-07-04","2022-11-18","2022-08-05","2022-08-05","2022-11-11","2022-12-27","2022-09-08","2022-12-27","2023-02-09","2023-02-09","2022-12-14","2022-12-14","2022-12-14","2023-04-06","2023-04-06","2023-04-06","2021-03-30","2021-06-30","2023-03-24","2021-05-18","2021-09-10","2023-03-24","2023-03-24","2021-07-19","2021-09-02","2021-10-07","2021-01-22","2021-01-22","2021-02-03","2021-03-25","2021-06-30","2021-03-25","2021-03-25","2021-06-30","2021-03-25","2021-05-29","2021-05-29","2022-05-03","2021-01-05","2021-09-13","2021-09-21","2022-05-27","2023-01-31","2022-11-18","2022-11-18","2022-11-18","2021-07-19","2021-07-25","2022-09-19","2021-09-07","2022-09-19","2021-10-07","2022-11-18","2022-11-18","2022-11-18","2022-11-18","2022-11-18","2023-03-24","2021-06-30","2022-05-03","2022-09-19","2022-09-19","2022-09-19","2023-04-06","2023-04-06","2021-01-18","2021-04-19","2021-05-10","2021-05-10","2021-05-10","2021-05-10","2021-05-10","2021-05-10","2023-03-24","2023-04-06"],"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":[["","49035044301","NASAL ALLRGY","SPR 55MCG\/AC","17","Select","Select",""],["","65162067684","AZELASTINE","SPR 0.001","30","Select","Select",""],["","16729044416","BUPROPN HCL","TAB 300MG XL","90","Select","Select",""],["","00093220401","METOCLOPRAM","TAB 5MG","120","Select","Select",""],["","29300022019","MONTELUKAST","TAB 10MG","90","Select","Select",""],["","68645051654","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","00487950103","ALBUTEROL","NEB 0.00083","360","Select","Select",""],["","63402051001","XOPENEX HFA","AER ","15","Select","Select",""],["","00168014630","HYDROCORT","OIN 0.025","28","Select","Select",""],["","43547033803","BENAZEPRIL","TAB 40MG","90","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","00456120130","LINZESS","CAP 145MCG","30","Select","Select",""],["","00904645780","DOK","CAP 100MG","40","Select","Select",""],["","31722094101","HYDROCO\/APAP","TAB 5-325MG","10","Select","Select",""],["","49035023814","EQ STOOL","CAP SOFTENER","40","Select","Select",""],["","65862018730","ONDANSETRON","TAB 4MG","20","Select","Select",""],["","00173089310","TRELEGY","AER ELLIPTA","60","Select","Select",""],["","00310461612","BREZTRI AERO","AER SPHERE","11","Select","Select",""],["","00254101196","SUCRALFATE","SUS 1GM\/10ML","1200","Select","Select",""],["","00597010061","SPIRIVA","SPR 2.5MCG","4","Select","Select",""],["","00310737020","BUDES\/FORMOT","AER 160-4.5","10","Select","Select",""],["","75834011001","CHLORTHALID","TAB 50MG","90","Select","Select",""],["","59267100001","PFIZER VACC","INJ COVID-19","0","Select","Select",""],["","00487900360","SODIUM CHLOR","NEB 0.03","240","Select","Select",""],["","69452014430","BENZONATATE","200 MG","42","Select","Select",""],["","68645059459","FAMOTIDINE","20 MG","90","Select","Select",""],["","70700015010","OMEPRAZOLE","CAP 20MG","180","Select","Select",""],["","68682011203","PIMECROLIMUS","CRE 0.01","100","Select","Select",""],["","65649000330","TRULANCE","TAB 3MG","90","Select","Select",""],["","00186037020","SYMBICORT","AER 160-4.5","10","Select","Select",""],["","00173068220","VENTOLIN HFA","90 MCG","18","Select","Select",""],["","00121077516","GG\/CODEINE","SOL 100-10\/5","105","Select","Select",""],["","50111078751","AZITHROMYCIN","250 MG","6","Select","Select",""],["","59762444002","METHYLPRED","TAB 4MG","21","Select","Select",""],["","59746017210","PREDNISONE","5 MG","60","Select","Select",""],["","16571030216","GUAIFENESIN","SYP 100-10\/5","105","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","64764024060","AMITIZA","24MCG","180","Select","Select",""],["","00173089201","NUCALA","INJ 100MG\/ML","1","Select","Select",""],["","31722052201","HYDRALAZINE","TAB 100MG","180","Select","Select",""],["","00527058601","DICYCLOMINE","CAP 10MG","24","Select","Select",""],["","54092054701","MOTEGRITY","TAB 2MG","90","Select","Select",""],["","00254302902","LUBIPROSTONE","24MCG","180","Select","Select",""],["","67618012006","SENOKOT EXTR","TAB 17.2MG","90","Select","Select",""],["","11877001140","BINAXNOW COV","KIT HOME TES","2","Select","Select",""],["","76204030003","SOD CHLORIDE","NEB 0.009","180","Select","Select",""],["","31722071390","PANTOPRAZOLE","TAB 40MG","60","Select","Select",""],["","00093005301","BUSPIRONE","TAB 5MG","180","Select","Select",""],["","00045020444","ZYRTEC ALLGY","CAP 10MG","30","Select","Select",""],["","00904699880","DOCUSATE SOD","CAP 100MG","60","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","20","Select","Select",""],["","00904759180","FEROSUL","TAB 325MG","30","Select","Select",""],["","68645051054","HYDROCHLOROT","TAB 25MG","30","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","00904672080","ACETAMIN","TAB 500MG","60","Select","Select",""],["","67877032101","IBUPROFEN","TAB 800MG","60","Select","Select",""],["","65162067684","AZELASTINE HCL","137 MCG","30","Select","Select",""],["","13668001001","CITALOPRAM HBR","20 MG","30","Select","Select",""],["","16729044416","BUPROPION XL","300 MG","90","Select","Select",""],["","29300022019","MONTELUKAST SODIUM","10 MG","90","Select","Select",""],["","68645051654","AMLODIPINE BESYLATE","10 MG","90","Select","Select",""],["","49035007860","STOOL SOFTENER","100 MG","180","Select","Select",""],["","00378827052","ALBUTEROL SULFATE","2.5 MG\/3ML","300","Select","Select",""],["","00054327099","FLUTICASONE PROPIONATE","50 MCG","16","Select","Select",""],["","43547033803","BENAZEPRIL HCL","40 MG","90","Select","Select",""],["","00487930103","SODIUM CHLORIDE","0.9 %","300","Select","Select",""],["","55111015330","ONDANSETRON HCL","4 MG","30","Select","Select",""],["","00045020444","ZYRTEC","10 MG","30","Select","Select",""],["","31722052201","HYDRALAZINE HCL","100 MG","270","Select","Select",""],["","29300046801","CLONIDINE HCL","0.1 MG","60","Select","Select",""],["","00093005301","BUSPIRONE HCL","5 MG","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":""}]}]}