{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CIERRA GREGORY","gend":1,"add":"3584 ARGONNE AVE TRLR 19C","city":"NORFOLK","state":"VA","zip":"23509-9998","dob":"1989-08-21","age":"","mstatus":"","insh":"6932231*01","cliId":"","pno":7573891477,"cno":7573891477,"email":"","ename":"","eno":"","pphy":"MALIK, KIRAN MD","ppno":7579355310,"pcpadd":"3060 GODWIN BLVD,","pcpcity":"SUFFOLK","pcpstate":"VA","pcpzip":"23434-9998","pcpcounty":"","pcpid":"","pcpname":"Nowcare Godwin","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7579355311,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.2","M79.7","E55.9","F43.10","F32.9","F41.9","Z79.899","F33.1","F43.12","Z03.89","F31.9","M25.561","Z20.822","N92.1","N94.6","R93.5","M79.645","Z72.0","F60.9","F90.0","N30.01","E66.9","I73.00","F90.9","K21.9","K80.50","K80.20","R10.32","Z71.6","N60.01","F17.210","NO DATA","S19.9XXA","S29.9XXA","R07.81","M62.81","R26.89","K80.80","Z88.5","Z88.8","R31.9","Z76.89","F41.8","N20.0","R31.29","Q62.5","N28.89","E28.2","E78.2","Z68.32","M62.561","M62.562","R05.","N93.9","J20.9","Z88.6","R07.9","F34.1","R51.9","H53.9","J45.909","F41.0","G89.29","M54.9","M54.2","M25.531","G62.9","R53.83","M54.5","R53.1","J32.9","R00.0","Q62.8","N13.4","K44.9","R42.","J45.20","G43.909","N92.6","J30.9","R21.","G47.00","F51.5","L73.2","L70.0","D22.9","Z71.9","R20.2","Z65.8","U07.1","Z79.1","M25.532","R79.89","S31.109A","Z90.49","Z98.890","R50.9","R07.89","S69.90XA","N92.0","R10.9","G89.18","J02.9","R19.7","R09.89","Z98.51","D72.829","R23.2","N39.0","Z00.00","N64.4","Z68.31","Z01.818","J01.90"],"date":["2022-04-04","2023-06-20","2021-07-07","2023-08-16","2021-07-07","2022-11-08","2021-10-19","2022-09-13","2022-04-04","2022-04-04","2021-08-18","2021-08-23","2022-09-20","2021-12-27","2021-12-27","2021-12-27","2022-02-15","2022-02-15","2022-09-23","2022-04-04","2022-07-31","2023-02-28","2022-08-29","2022-08-30","2023-02-28","2022-09-13","2022-09-13","2023-02-20","2023-02-20","2023-03-17","2023-06-20","2023-03-17","2023-06-20","2023-06-20","2023-06-20","2021-03-03","2021-03-03","2022-07-31","2022-09-20","2022-09-20","2023-05-12","2022-11-08","2023-04-17","2023-05-22","2023-05-05","2023-03-22","2023-03-22","2023-07-17","2023-07-17","2023-07-17","2022-02-26","2022-02-26","2021-09-25","2021-09-22","2022-09-20","2021-09-25","2021-09-14","2022-09-23","2023-04-17","2023-04-17","2023-04-17","2023-04-17","2023-04-17","2023-05-12","2023-06-20","2021-01-14","2021-04-02","2022-08-30","2021-02-02","2021-02-02","2021-07-21","2022-09-20","2023-02-28","2023-02-28","2023-02-28","2023-04-17","2023-05-22","2023-05-22","2021-12-09","2021-07-21","2021-07-21","2021-07-21","2021-07-21","2021-07-21","2021-08-13","2021-08-13","2021-08-13","2021-04-02","2021-04-02","2022-01-08","2022-02-15","2022-02-15","2022-09-20","2022-09-20","2022-09-20","2022-09-20","2022-09-20","2021-09-15","2021-10-17","2021-12-27","2021-12-28","2021-12-28","2022-01-08","2022-01-08","2022-01-08","2022-01-08","2022-08-30","2022-08-30","2022-08-30","2022-08-30","2023-03-17","2021-02-10","2021-12-09","2023-09-27"],"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":[["","64380071207","BENZONATATE CAP","100MG","30","Select","Select",""],["","49483060450","IBUPROFEN TAB","800MG","21","Select","Select",""],["","45802043262","PSEUDOEPHEDR TAB","30MG","24","Select","Select",""],["","70954001910","PRAZOSIN HCL CAP","1MG","30","Select","Select",""],["","49483070210","FLUOXETINE CAP","20MG","30","Select","Select",""],["","50111045001","TRAZODONE TAB","150MG","30","Select","Select",""],["","45802065078","LORATADINE TAB","10MG","90","Select","Select",""],["","00228306011","AMPHET\/DEXTR CAP","20MG ER","30","Select","Select",""],["","54092038701","ADDERALL XR CAP","20MG","30","Select","Select",""],["","59417010310","VYVANSE CAP","30MG","30","Select","Select",""],["","69842000003","FLUTICASONE SPR","50MCG","10","Select","Select",""],["","16571020106","DICLOFENAC TAB","75MG DR","40","Select","Select",""],["","65862039010","ONDANSETRON TAB","4MG ODT","30","Select","Select",""],["","67877054360","CEFDINIR CAP","300MG","20","Select","Select",""],["","70710113908","FLUCONAZOLE TAB","150MG","2","Select","Select",""],["","00378668910","PANTOPRAZOLE TAB","40MG","30","Select","Select",""],["","00093310905","AMOXICILLIN CAP","500MG","15","Select","Select",""],["","42858010201","OXYCOD\/APAP TAB","5-325MG","20","Select","Select",""],["","43598056601","FLUOXETINE TAB","20MG","30","Select","Select",""],["","49483070210","FLUOXETINE HCL","20 MG","30","Select","Select",""],["","70710113908","FLUCONAZOLE","150 MG","2","Select","Select",""],["","60505004001","ETODOLAC","300 MG","60","Select","Select",""],["","70436005901","BUPROPION HCL SR","150 MG","84","Select","Select",""],["","70954000520","OXYBUTYNIN CHLORIDE","5 MG","21","Select","Select",""],["","68180012202","CEPHALEXIN","500 MG","7","Select","Select",""],["","00172392670","DIAZEPAM","5 MG","12","Select","Select",""],["","67877041401","METFORMIN HCL ER","750 MG","90","Select","Select",""],["","57237001401","TAMSULOSIN HCL","0.4 MG","30","Select","Select",""],["","65862050320","AMOXICILLIN-CLAVULANATE POTASS","875-125 MG","20","Select","Select",""],["","00406012301","HYDROCODONE-ACETAMINOPHEN","5 MG-325MG","8","Select","Select",""],["","64380071207","BENZONATATE","100 MG","30","Select","Select",""],["","49483060450","IBUPROFEN","TAB 800MG","21","Select","Select",""],["","45802043262","PSEUDOEPHEDR","TAB 30MG","24","Select","Select",""],["","50111045001","TRAZODONE","TAB 150MG","30","Select","Select",""],["","45802065078","LORATADINE","TAB 10MG","30","Select","Select",""],["","65862019405","FLUOXETINE","CAP 40MG","30","Select","Select",""],["","70954001910","PRAZOSIN HCL","CAP 1MG","30","Select","Select",""],["","69842000003","FLUTICASONE","SPR 50MCG","10","Select","Select",""],["","54092038701","ADDERALL XR","CAP 20MG","30","Select","Select",""],["","00115148901","AMPHET\/DEXTR","CAP 20MG ER","30","Select","Select",""],["","59417010310","VYVANSE","CAP 30MG","30","Select","Select",""],["","67877054360","CEFDINIR","CAP 300MG","20","Select","Select",""],["","00093310905","AMOXICILLIN","CAP 500MG","15","Select","Select",""],["","16571020106","DICLOFENAC","TAB 75MG DR","40","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","30","Select","Select",""],["","00378668910","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","20","Select","Select",""],["","68180086111","AZITHROMYCIN","250 MG","6","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":""}]}]}