{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CHANITA KNIGHT","gend":1,"add":"3116 GASTON DR","city":"CHESAPEAKE","state":"VA","zip":"23323-9998","dob":"1975-08-06","age":"","mstatus":"","insh":"2815214*01","cliId":"","pno":7577148203,"cno":7577148203,"email":"","ename":"","eno":"","pphy":"SKINNER, ALISON C MD","ppno":7576865673,"pcpadd":"SUITE 102 3253 TAYLOR ROAD,","pcpcity":"CHESAPEAKE","pcpstate":"VA","pcpzip":"23321-9998","pcpcounty":"","pcpid":"","pcpname":"Bon Secours Western Branch Primary Care","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7576868694,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["U07.1","N39.0","N17.9","D72.829","E66.01","Z68.42","Z01.419","Z30.40","E11.9","L03.116","R78.81","B95.5","I10.","R82.71","E66.9","E78.5","G47.30","Z79.84","H40.053","H25.813","H04.123","F34.0","R35.0","F41.1","F33.0","F41.9","F54.","A41.81","E11.65","E78.00","R00.0","NO DATA","Z79.899","B95.2","Z20.828","K91.2","E55.9","Z11.59","Z01.810","Z01.818","R94.31","E88.81","K76.0","R16.0","G47.33","R11.0","Z68.41","Z98.84","I87.8","K21.9","M12.9","Z82.49","Z83.3","R50.9","A41.9","Z20.822","E11.29","F33.1"],"date":["2022-09-29","2022-09-16","2022-09-16","2022-09-16","2022-12-20","2022-10-25","2021-07-30","2021-07-30","2023-09-14","2022-09-15","2022-09-15","2022-09-15","2023-09-14","2022-09-15","2022-09-15","2022-09-15","2022-09-15","2022-09-12","2023-03-31","2023-03-31","2023-03-31","2023-09-13","2021-04-22","2022-11-18","2022-03-22","2022-09-29","2022-03-22","2022-09-12","2022-09-13","2022-10-25","2022-09-12","2022-09-12","2023-03-07","2022-09-12","2021-01-30","2022-12-20","2022-02-07","2022-02-07","2022-04-28","2022-04-28","2022-04-28","2022-10-25","2022-10-25","2022-10-25","2022-10-25","2022-12-20","2022-12-20","2022-12-20","2022-10-25","2022-10-25","2022-10-25","2022-10-25","2022-10-25","2022-09-12","2022-09-12","2022-09-12","2022-09-12","2023-09-12"],"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":[["","00093100301","BUSPIRONE","TAB 15MG","30","Select","Select",""],["","29300013601","CLONIDINE","TAB 0.2MG","30","Select","Select",""],["","29300012810","HYDROCHLOROT","TAB 25MG","30","Select","Select",""],["","57664016758","METOPROL TAR","TAB 100MG","60","Select","Select",""],["","31722070290","LOSARTAN POT","TAB 100MG","30","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","51672128202","TRIAMCINOLON","CRE 0.001","30","Select","Select",""],["","00378718505","METFORMIN","TAB 500MG","60","Select","Select",""],["","16729000417","SIMVASTATIN","10 MG","90","Select","Select",""],["","10702002501","PHENTERMINE","TAB 37.5MG","30","Select","Select",""],["","65862001705","AMOXICILLIN","CAP 500MG","56","Select","Select",""],["","62175011843","OMEPRAZOLE","CAP 20MG","28","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","42","Select","Select",""],["","00597015230","JARDIANCE","TAB 10MG","30","Select","Select",""],["","57237000511","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","00955100410","ENOXAPARIN","INJ 40\/0.4ML","3","Select","Select",""],["","68462016505","CARVEDILOL","TAB 25MG","60","Select","Select",""],["","00002143380","TRULICITY","INJ 0.75\/0.5","2","Select","Select",""],["","00781185220","AMOX\/K CLAV","TAB 875-125","10","Select","Select",""],["","65862046990","LOSARTAN\/HCT","TAB 100-12.5","30","Select","Select",""],["","57237007710","ONDANSETRON","TAB 4MG ODT","30","Select","Select",""],["","65162004710","OXYCODONE","TAB 5MG","10","Select","Select",""],["","00093100301","BUSPIRONE HCL","15 MG","60","Select","Select",""],["","29300011101","LAMOTRIGINE","25 MG","60","Select","Select",""],["","65862046990","LOSARTAN-HYDROCHLOROTHIAZIDE","100-12.5MG","60","Select","Select",""],["","57664016758","METOPROLOL TARTRATE","100 MG","180","Select","Select",""],["","65862015901","ZOLPIDEM TARTRATE","5 MG","30","Select","Select",""],["","29300013601","CLONIDINE HCL","0.2 MG","30","Select","Select",""],["","51672128202","TRIAMCINOLONE ACETONIDE","0.1 %","30","Select","Select",""],["","00378718505","METFORMIN HCL","500 MG","180","Select","Select",""],["","23155050001","HYDROXYZINE HCL","10 MG","120","Select","Select",""],["","68180031909","BUPROPION XL","150 MG","30","Select","Select",""],["","68180035202","SERTRALINE HCL","50 MG","90","Select","Select",""],["","57664016758","METOPROL TAR TAB","100MG","180","Select","Select",""],["","65862020399","LOSARTAN POT TAB","100MG","30","Select","Select",""],["","68180072103","AMLODIPINE TAB","10MG","30","Select","Select",""],["","00378718505","METFORMIN TAB","500MG","60","Select","Select",""],["","00093100301","BUSPIRONE TAB","15MG","60","Select","Select",""],["","16729000417","SIMVASTATIN TAB","10MG","30","Select","Select",""],["","00597015230","JARDIANCE TAB","10MG","30","Select","Select",""],["","29300012810","HYDROCHLOROT TAB","25MG","30","Select","Select",""],["","57237000511","FLUCONAZOLE TAB","150MG","1","Select","Select",""],["","29300013601","CLONIDINE TAB","0.2MG","30","Select","Select",""],["","51672128202","TRIAMCINOLON CRE","0.1%","30","Select","Select",""],["","10702002501","PHENTERMINE TAB","37.5MG","30","Select","Select",""],["","00955100410","ENOXAPARIN INJ","40\/0.4ML","3","Select","Select",""],["","00002143380","TRULICITY INJ","0.75\/0.5","2","Select","Select",""],["","68462016505","CARVEDILOL TAB","25MG","60","Select","Select",""],["","68462015713","ONDANSETRON TAB","4MG ODT","12","Select","Select",""],["","65162004710","OXYCODONE TAB","5MG","10","Select","Select",""],["","00781185220","AMOX\/K CLAV TAB","875-125","10","Select","Select",""],["","65862046990","LOSARTAN\/HCT TAB","100-12.5","30","Select","Select",""],["","29300039810","AMLODIPINE BESYLATE","10 MG","90","Select","Select",""],["","68180077901","ZOLPIDEM TARTRATE ER","6.25 MG","14","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":""}]}]}