{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SHELLY  M DANZY","gend":1,"add":"453 N CHALICE CT","city":"NEWPORT NEWS","state":"VA","zip":"23608-9998","dob":"1975-04-05","age":"","mstatus":"","insh":"3583783*01","cliId":"","pno":7579447242,"cno":7579447242,"email":"","ename":"","eno":"","pphy":"WHITE, SHARONEE MARSHELLE FNP","ppno":7573808709,"pcpadd":"4714 MARSHALL AVE","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":"23607-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7579521345,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R07.89","R09.02","F41.9","R05.","Z20.822","R14.0","R13.10","K31.84","K21.9","R63.4","R11.0","R93.3","K59.00","R06.09","K31.89","B37.81","K22.2","NO DATA","Q61.3","Z21.","R80.9","J98.8","B97.89","I12.9","Z79.899","Z87.891","J45.909","R10.13","F17.200","R10.9","K08.89","R52.","I10.","R07.9","Z72.0","Z86.59","M54.9","R06.2","R00.2","Z23.","Z32.02","R12.","B20.","Z11.3","R42.","J30.2","R10.30","L29.9","F17.210","G89.29","R51.9","J06.9","R09.81","H92.03","G44.85","J32.8","R49.0","R06.83","F31.9","R11.10","Z12.11","J18.9","R06.02","M54.6","B34.9","H93.13","G43.809","G47.00","Q61.9","Z80.1","Z84.89","Z84.1","F43.9","R10.84","L84.","M20.12","M20.11","M79.671","M79.672","K52.9","R11.2","R19.7","R53.81","R53.83","Z82.49","R13.12","F45.8","D21.9","N83.201","R10.2","Z00.00","L28.2","R68.81","R05.1","Z13.31","N28.9","Z11.59","H81.393","J30.5","R20.2","Z12.39","Z13.9","Z68.29","Z13.89","N94.6","E66.9","R06.00","F41.1","R10.32","R10.31","Z97.2","R10.33","R35.0","Z98.51","G43.019","F14.10","I20.8","L85.3","D23.71","D23.72","M77.41","M77.42","M67.01","M67.02"],"date":["2023-03-27","2021-01-14","2021-12-30","2021-01-22","2022-06-05","2022-05-27","2023-02-10","2022-05-27","2023-02-10","2023-02-10","2023-02-10","2022-05-27","2022-05-27","2021-04-07","2021-06-24","2022-05-27","2022-05-27","2023-03-27","2023-01-17","2023-02-16","2023-01-17","2021-12-30","2021-12-30","2023-03-27","2023-01-28","2023-02-10","2023-01-28","2022-03-03","2022-12-22","2022-03-03","2021-01-02","2021-03-09","2023-01-17","2023-02-16","2023-03-27","2021-06-29","2021-08-23","2021-05-03","2021-05-12","2022-12-22","2022-03-03","2023-02-10","2023-03-27","2022-12-22","2023-02-16","2022-03-15","2022-09-06","2022-10-15","2023-01-28","2023-01-07","2023-01-07","2022-06-05","2022-06-05","2023-01-11","2023-02-14","2023-01-11","2023-01-11","2021-04-13","2022-09-06","2021-07-07","2023-02-16","2021-12-27","2021-12-26","2021-02-23","2021-08-07","2021-04-13","2021-04-13","2023-01-28","2021-11-19","2021-12-27","2021-11-19","2021-11-19","2021-11-19","2022-02-14","2023-01-24","2023-01-24","2023-01-24","2023-03-13","2023-03-13","2021-05-31","2023-01-28","2021-11-24","2021-11-24","2021-11-24","2021-12-27","2022-01-19","2022-01-19","2022-02-13","2022-02-13","2022-04-27","2022-04-27","2022-10-15","2021-02-09","2022-06-05","2022-12-22","2022-12-22","2022-12-22","2023-01-18","2023-02-14","2023-02-16","2023-02-16","2023-02-16","2023-02-16","2023-02-16","2021-01-04","2021-02-11","2021-05-11","2021-05-14","2022-08-30","2022-08-30","2022-08-30","2022-09-06","2022-09-06","2023-01-28","2023-04-26","2021-04-23","2021-04-27","2023-03-13","2023-03-13","2023-03-13","2023-03-13","2023-03-13","2023-03-13","2023-03-13"],"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":[["","68180045001","QUETIAPINE","TAB 400MG","60","Select","Select",""],["","61958210101","ODEFSEY","200-25-25","30","Select","Select",""],["","46122017460","GNP NICOTINE","GUM 4MG ORIG","160","Select","Select",""],["","29300011316","LAMOTRIGINE","150 MG","30","Select","Select",""],["","65862086099","FAMOTIDINE","40 MG","60","Select","Select",""],["","16714008310","HYDROXYZ HCL","TAB 50MG","120","Select","Select",""],["","00591036901","LOXAPINE","5 MG","30","Select","Select",""],["","49035048490","ACETAMINOPHN","TAB 500MG","50","Select","Select",""],["","00121074740","SUCRALFATE","1 G\/10 ML","1200","Select","Select",""],["","00904673080","ACETAMIN","TAB 500MG","50","Select","Select",""],["","55111015330","ONDANSETRON","TAB 4MG","60","Select","Select",""],["","13107008401","LORAZEPAM","TAB 1MG","5","Select","Select",""],["","00904699880","DOCUSATE SOD","CAP 100MG","30","Select","Select",""],["","55111014512","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","11523726803","MIRALAX","POW 3350 NF","30","Select","Select",""],["","63868093510","MAG CITRATE","SOL LEMON","296","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","12843003520","STOOL SOFTNR","CAP 100MG","30","Select","Select",""],["","59746012106","MECLIZINE","TAB 25MG","30","Select","Select",""],["","55111064530","OMEPRAZOLE","CAP 40MG","90","Select","Select",""],["","50383070016","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","68645055154","LISINOPRIL","5 MG","90","Select","Select",""],["","00093220401","METOCLOPRAM","TAB 5MG","240","Select","Select",""],["","00406051201","OXYCOD\/APAP","TAB 5-325MG","21","Select","Select",""],["","68645056259","IBUPROFEN","TAB 600MG","30","Select","Select",""],["","65162019011","NAPROXEN","500 MG","30","Select","Select",""],["","00113043262","NASAL DECONG","TAB 30MG","30","Select","Select",""],["","11822145760","RA NASAL 12H","SPR 0.0005","30","Select","Select",""],["","68382080701","TRAZODONE","TAB 150MG","15","Select","Select",""],["","49035019502","EQ NICOTINE","DIS 14MG\/24H","30","Select","Select",""],["","29300041519","CYCLOBENZAPR","TAB 10MG","12","Select","Select",""],["","00093005805","TRAMADOL HCL","50 MG","12","Select","Select",""],["","59746017310","PREDNISONE","10 MG","18","Select","Select",""],["","68462015713","ONDANSETRON ODT","4 MG","12","Select","Select",""],["","00310737020","BUDESONIDE-FORMOTEROL FUMARATE","160-4.5MCG","10.2","Select","Select",""],["","44523061701","UREA","40 %","195.517","Select","Select",""],["","66993001968","ALBUTEROL SULFATE HFA","90 MCG","18","Select","Select",""],["","65862017260","TOPIRAMATE","50 MG","60","Select","Select",""],["","16714008310","HYDROXYZINE HCL","50 MG","120","Select","Select",""],["","00054327099","FLUTICASONE PROPIONATE","50 MCG","16","Select","Select",""],["","55111015330","ONDANSETRON HCL","4 MG","60","Select","Select",""],["","00093220401","METOCLOPRAMIDE HCL","5 MG","240","Select","Select",""],["","42806071401","BENZONATATE","100 MG","30","Select","Select",""],["","68382080701","TRAZODONE HCL","150 MG","30","Select","Select",""],["","00186037020","SYMBICORT","160-4.5MCG","10.2","Select","Select",""],["","00143924920","AMOXICILLIN-CLAVULANATE POTASS","875-125 MG","28","Select","Select",""],["","49035053112","ACETAMINOPHEN","500 MG","56","Select","Select",""],["","00406051201","OXYCODONE-ACETAMINOPHEN","5 MG-325MG","10","Select","Select",""],["","00378827052","ALBUTEROL SULFATE","2.5 MG\/3ML","225","Select","Select",""],["","65162047810","NITROFURANTOIN MONO-MACRO","100 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":""}]}]}