{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MASHANDA JONES","gend":1,"add":"4116 GRIFFIN ST","city":"PORTSMOUTH","state":"VA","zip":"23707-9998","dob":"1976-06-05","age":"","mstatus":"","insh":"3956253*01","cliId":"","pno":7579142602,"cno":7579142602,"email":"","ename":"","eno":"","pphy":"STRONG, WILLIAM P MD","ppno":7574883333,"pcpadd":"3925 PORTSMOUTH BLVD,","pcpcity":"CHESAPEAKE","pcpstate":"VA","pcpzip":"23321-9998","pcpcounty":"","pcpid":"","pcpname":"Family Medicine Healthcare, PLLC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7574880007,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G47.33","I48.91","Z12.31","Z12.11","R73.01","Z23.","NO DATA","R73.9","B96.81","E55.9","I49.3","R11.0","F41.9","F32.9","E78.5","M25.561","M25.562","M54.6","Z79.899","I48.0","R07.9","J44.9","R73.03","J30.9","E11.9","T30.0","G89.29","U09.9","R10.9","R14.0","E53.8","R00.8","I49.8","J01.90","B37.9","R07.89","K76.0","Z79.01","Z86.711","E88.81","Z68.42","F17.200","A04.8","R10.32","K62.89","M54.9","R06.02","I10.","Z87.891","N28.1","K75.9"],"date":["2021-06-23","2022-03-11","2022-03-11","2022-12-09","2022-11-29","2022-03-11","2023-04-08","2021-02-10","2021-03-02","2022-11-29","2023-03-07","2021-04-16","2021-01-25","2021-01-25","2022-11-29","2021-06-10","2021-06-10","2023-04-08","2021-06-10","2023-01-17","2021-03-30","2021-04-29","2021-04-29","2022-04-29","2021-06-15","2021-06-15","2021-06-15","2022-03-29","2022-09-29","2022-09-29","2022-09-29","2021-06-22","2021-06-22","2022-04-29","2021-03-02","2023-04-08","2022-12-09","2023-04-08","2023-04-08","2022-12-09","2022-12-09","2022-12-09","2021-04-16","2021-04-16","2021-04-16","2023-04-08","2023-04-08","2023-04-08","2023-04-08","2023-01-26","2022-11-29"],"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":[["","68382004110","PROMETHAZINE","TAB 25MG","90","Select","Select",""],["","75834025801","ATORVASTATIN","TAB 80MG","30","Select","Select",""],["","67877024910","QUETIAPINE","TAB 50MG","60","Select","Select",""],["","65862056099","PANTOPRAZOLE","TAB 40MG","28","Select","Select",""],["","68462011944","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","43547028211","ESCITALOPRAM","TAB 20MG","30","Select","Select",""],["","65862022660","CLARITHROMYC","TAB 500MG","28","Select","Select",""],["","64380073706","VITAMIN D","2 1250 MCG","12","Select","Select",""],["","00093310905","AMOXICILLIN","CAP 500MG","28","Select","Select",""],["","57237010199","METOPROL TAR","TAB 50MG","60","Select","Select",""],["","67877056105","METFORMIN","TAB 500MG","30","Select","Select",""],["","50458057930","XARELTO","20 MG","30","Select","Select",""],["","00093220405","METOCLOPRAM","TAB 5MG","2","Select","Select",""],["","29300022701","METRONIDAZOL","TAB 500MG","28","Select","Select",""],["","00186037020","SYMBICORT","160-4.5MCG","30.6","Select","Select",""],["","50383070016","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","52817033110","CYCLOBENZAPR","TAB 7.5MG","90","Select","Select",""],["","00310737020","BUDES\/FORMOT","AER 160-4.5","10","Select","Select",""],["","67877012450","SILVER SULFA","CRE 0.01","50","Select","Select",""],["","00597007541","SPIRIVA","CAP HANDIHLR","90","Select","Select",""],["","59310057922","PROAIR HFA","AER ","17","Select","Select",""],["","00904759180","FEROSUL","325(65) MG","30","Select","Select",""],["","72511077001","REPATHA PUSH","INJ 420\/3.5","4","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","17","Select","Select",""],["","00169413212","OZEMPIC","INJ 2\/1.5ML","2","Select","Select",""],["","62756035664","ONDANSETRON","TAB 8MG ODT","15","Select","Select",""],["","00904699880","DOCUSATE SOD","CAP 100MG","30","Select","Select",""],["","82607066026","FLOWFLEX","KIT TEST","8","Select","Select",""],["","72733590102","PRALUENT","INJ 75MG\/ML","2","Select","Select",""],["","00002143480","TRULICITY","1.5 MG\/0.5","2","Select","Select",""],["","16714001401","AMOX\/K CLAV","TAB 875-125","14","Select","Select",""],["","65702071110","ACCU-CHEK","TES GUIDE","50","Select","Select",""],["","67877021905","CEPHALEXIN","CAP 500MG","10","Select","Select",""],["","51991045758","POLYETH GLYC","POW 3350 NF","255","Select","Select",""],["","50924097110","SOFTCLIX","MIS LANCETS","100","Select","Select",""],["","66758095985","PROVENTIL","AER HFA","7","Select","Select",""],["","43598044674","NICOTINE TD","DIS 7MG\/24HR","14","Select","Select",""],["","65702073110","ACCU-CHECK","KIT GUIDE ME","1","Select","Select",""],["","37000074117","METAMUCIL","POW 0.63","575","Select","Select",""],["","43386009019","GAVILYTE-G","236-22.74G","4000","Select","Select",""],["","00904699880","DOCUSATE SODIUM","100 MG","30","Select","Select",""],["","53885004401","ONETOUCH VERIO FLEX METER","","1","Select","Select",""],["","43547028211","ESCITALOPRAM OXALATE","20 MG","90","Select","Select",""],["","00597015230","JARDIANCE","10 MG","30","Select","Select",""],["","53885001110","ONETOUCH DELICA PLUS LANCET","30 GAUGE","100","Select","Select",""],["","65702010110","ACCU-CHEK AVIVA PLUS","","1","Select","Select",""],["","69097012215","TOPIRAMATE","25 MG","120","Select","Select",""],["","57237010199","METOPROLOL TARTRATE","50 MG","60","Select","Select",""],["","67877056110","METFORMIN HCL","500 MG","30","Select","Select",""],["","72511076002","REPATHA SURECLICK","140 MG\/ML","2","Select","Select",""],["","75834025801","ATORVASTATIN CALCIUM","80 MG","90","Select","Select",""],["","43598044674","NICOTINE PATCH","7MG\/24HR","14","Select","Select",""],["","53885027150","ONETOUCH VERIO TEST STRIP","","50","Select","Select",""],["","68382004110","PROMETHAZINE HCL","25 MG","90","Select","Select",""],["","67877024910","QUETIAPINE FUMARATE","50 MG","60","Select","Select",""],["","65702071110","ACCU-CHEK GUIDE TEST STRIP","","50","Select","Select",""],["","70756060915","OFLOXACIN","0.3 %","10","Select","Select",""],["","55111064505","OMEPRAZOLE","40 MG","30","Select","Select",""],["","00904759180","FEROSUL TAB","325MG","30","Select","Select",""],["","00904699880","DOCUSATE SOD CAP","100MG","30","Select","Select",""],["","59310057922","PROAIR HFA AER","","8","Select","Select",""],["","57237010099","METOPROL TAR TAB","25MG","60","Select","Select",""],["","00310737020","BUDES\/FORMOT AER","160-4.5","10","Select","Select",""],["","75834025801","ATORVASTATIN TAB","80MG","30","Select","Select",""],["","68382004110","PROMETHAZINE TAB","25MG","90","Select","Select",""],["","51224000760","METFORMIN TAB","500MG ER","30","Select","Select",""],["","50458057990","XARELTO TAB","20MG","30","Select","Select",""],["","67877024910","QUETIAPINE TAB","50MG","60","Select","Select",""],["","43547028211","ESCITALOPRAM TAB","20MG","30","Select","Select",""],["","00169413212","OZEMPIC INJ","2\/1.5ML","2","Select","Select",""],["","72511077001","REPATHA PUSH INJ","420\/3.5","4","Select","Select",""],["","00186037020","SYMBICORT AER","160-4.5","10","Select","Select",""],["","57237007810","ONDANSETRON TAB","8MG ODT","15","Select","Select",""],["","68462011944","FLUCONAZOLE TAB","150MG","2","Select","Select",""],["","50383070016","FLUTICASONE SPR","50MCG","16","Select","Select",""],["","64380073706","VITAMIN D CAP","50000UNT","4","Select","Select",""],["","68180096301","ALBUTEROL AER HFA","","8","Select","Select",""],["","16714001401","AMOX\/K CLAV TAB","875-125","14","Select","Select",""],["","82607066026","FLOWFLEX KIT TEST","","8","Select","Select",""],["","72733590102","PRALUENT INJ","75MG\/ML","2","Select","Select",""],["","00002143380","TRULICITY INJ","0.75\/0.5","2","Select","Select",""],["","66758095985","PROVENTIL AER HFA","","7","Select","Select",""],["","65702071110","ACCU-CHEK TES GUIDE","","50","Select","Select",""],["","50924097110","SOFTCLIX MIS LANCETS","","100","Select","Select",""],["","65702010110","ACCU-CHEK KIT AVIVA PL","","1","Select","Select",""],["","37000074117","METAMUCIL POW","63%","575","Select","Select",""],["","51991045758","POLYETH GLYC POW","3350 NF","255","Select","Select",""],["","65702073110","ACCU-CHECK KIT GUIDE ME","","1","Select","Select",""],["","43598044674","NICOTINE TD DIS","7MG\/24HR","14","Select","Select",""],["","67877021905","CEPHALEXIN CAP","500MG","10","Select","Select",""],["","43386009019","GAVILYTE-G SOL","","4000","Select","Select",""],["","00456202001","LEXAPRO","20 MG","90","Select","Select",""],["","55111068305","IBU","600 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":""}]}]}