{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"RENEE D COOPER","gend":1,"add":"320 E MERCURY BLVD APT 2","city":"HAMPTON","state":"VA","zip":"23663-9998","dob":"1964-05-20","age":"","mstatus":"","insh":"3632105*01","cliId":"","pno":7579152366,"cno":7579152366,"email":"","ename":"","eno":"","pphy":"SUTTON, THADDEUS MD","ppno":7572512170,"pcpadd":"850 ENTERPRISE PARKWAY SUITE 2200,","pcpcity":"HAMPTON","pcpstate":"VA","pcpzip":"23666-9998","pcpcounty":"","pcpid":"","pcpname":"Riverside Center for Internal & Family Medicine","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7572512185,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J98.01","E87.6","Z72.0","I10.","K42.9","I87.2","E53.8","E55.9","D64.9","R73.03","E66.9","R49.0","Z87.09","F17.210","K43.2","R93.89","E27.8","M25.512","G89.29","M75.102","M25.612","M75.82","Z87.891","Z11.52","L98.9","F10.29","E11.65","M62.81","R05.","Z13.220","R06.89","R47.9","J38.1","J38.3","Z01.810","Z76.89","N30.00","B96.89","I82.812","R21.","Z79.84","D50.8","R82.90","B07.8","NO DATA","M67.922","M19.019","M25.812","Z01.818","Z71.6","Z12.2","Z20.822","Z23.","H25.813","H43.22","H52.4","Z98.890","F17.219","M75.122","R94.31","R91.1","R91.8","I28.8","R94.39","M66.322","M25.712","S43.432A","I51.7","I51.89"],"date":["2021-03-20","2023-06-01","2022-02-23","2023-08-25","2021-07-26","2022-12-19","2023-08-01","2023-08-01","2022-10-26","2022-05-13","2021-05-26","2021-09-16","2021-09-16","2023-08-09","2021-12-02","2021-10-18","2022-05-13","2023-04-19","2023-04-19","2023-05-26","2023-04-19","2023-03-17","2022-01-05","2022-02-23","2022-07-25","2023-03-30","2023-08-01","2023-03-27","2021-03-25","2021-10-27","2021-03-25","2021-03-25","2023-08-01","2023-02-16","2023-08-15","2021-07-26","2022-10-26","2022-10-26","2022-06-07","2022-06-07","2023-03-30","2023-08-01","2023-02-20","2023-02-20","2022-08-31","2023-05-26","2023-05-26","2023-09-25","2023-08-25","2021-04-26","2023-07-26","2023-01-14","2022-10-26","2022-06-21","2022-06-21","2022-06-21","2023-02-16","2023-02-16","2023-09-25","2023-08-25","2023-08-01","2023-07-26","2023-07-26","2023-09-07","2023-09-25","2023-09-25","2023-09-25","2023-09-05","2023-09-05"],"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":[["","68180072003","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","00054429731","FUROSEMIDE","TAB 20MG","30","Select","Select",""],["","00185012201","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","00173068220","VENTOLIN HFA","AER ","18","Select","Select",""],["","67877025130","TRIAMCINOLON","CRE 0.001","30","Select","Select",""],["","68382032001","POT CHLORIDE","TAB 10MEQ ER","30","Select","Select",""],["","59267030402","PFIZER BIVAL","INJ BA4\/BA5","0","Select","Select",""],["","00591046005","GLIPIZIDE","5 MG","180","Select","Select",""],["","00574050801","FERROUS GLUCONATE","324(38)MG","90","Select","Select",""],["","29300039810","AMLODIPINE BESYLATE","10 MG","90","Select","Select",""],["","00185012201","NITROFURANTOIN MONO-MACRO","100 MG","14","Select","Select",""],["","00378456105","POTASSIUM CHLORIDE","10 MEQ","90","Select","Select",""],["","68180072103","AMLODIPINE TAB","10MG","30","Select","Select",""],["","00173068220","VENTOLIN HFA AER","","18","Select","Select",""],["","00185012201","NITROFURANTN CAP","100MG","14","Select","Select",""],["","67877025130","TRIAMCINOLON CRE","0.1%","30","Select","Select",""],["","00054429731","FUROSEMIDE TAB","20MG","30","Select","Select",""],["","68382032001","POT CHLORIDE TAB","10MEQ ER","30","Select","Select",""],["","59267030402","PFIZER BIVAL INJ BA","4\/BA5","0","Select","Select",""],["","31722088290","ROSUVASTATIN CALCIUM","5 MG","90","Select","Select",""],["","57237007710","ONDANSETRON ODT","4 MG","20","Select","Select",""],["","00406012305","HYDROCODONE-ACETAMINOPHEN","5 MG-325MG","20","Select","Select",""],["","00904728060","DOCUSATE SODIUM","100 MG","20","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":""}]}]}