{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CRYSTAL  A SHERWOOD","gend":1,"add":"1419 PICADILLY ST","city":"NORFOLK","state":"VA","zip":"23513-9998","dob":"1982-07-18","age":"","mstatus":"","insh":"9522778*01","cliId":"","pno":7574503256,"cno":7574503256,"email":"","ename":"","eno":"","pphy":"KEMENI, ROSINE NP","ppno":7573126797,"pcpadd":"648 GRASSFIELD PKWY STE 1,","pcpcity":"CHESAPEAKE","pcpstate":"VA","pcpzip":"23322-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7574100390,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F41.9","F98.8","R05.9","F34.0","I26.99","I82.522","F31.9","S82.831A","O26.891","R10.9","Z3A.09","N12.","A49.8","Z16.12","O23.00","R82.81","M54.9","Z3A.20","O09.523","O88.219","Z3A.28","Z23.","I82.409","O36.8121","O30.002","O99.891","O09.522","O21.9","O99.342","F90.9","Z87.891","Z88.2","Z86.711","Z3A.17","Z86.718","O36.8120","R05.1","R53.81","Z20.822","Z34.92","O98.512","U07.1","R09.81","Z3A.26","R09.89","R53.83","Z81.8","O99.332","F17.210","O99.352","G89.29","O99.512","J45.909","F70.","S82.61XA","S92.321A","S92.331A","S92.341A","NO DATA","I82.423","R07.89","O23.41","N39.0","B96.29","O43.193","V23.9","Z3A.35","Z11.52","M25.531","M77.8","S92.334A","M54.2","R51.9","M25.571","S40.211A","Z79.899","I82.411","I82.431","E66.9","I82.441","I82.532","S93.431A","S82.841A","I51.7","E87.6","T40.2X5A","T42.4X5A","K21.9","J96.01","I82.4Y3","S92.301A","J96.00","R31.9","R82.90","F17.200","Z76.89","Z98.890","S82.842A","I27.82","R07.9","I82.592","Z95.828","M67.833","M46.1","I36.1","O36.8190","O88.213","Z72.0","M19.90","L73.2","J45.998","M51.36","D23.9","Z71.9","M51.26","I26.09","V54.16","F31.10","M12.9","Z87.59","Z79.891","Z79.01","O23.01","D68.59","O98.811","O99.111","B37.3","B96.20","F17.290","O99.341","O99.511","O21.0","O99.331","Z3A.25","R39.9","G89.4","E86.0","R11.10","O67.9","O99.343","O99.333","O90.89","Z3A.30","J06.9","S92.333A","S92.323A","R52.","O88.211","O22.31","Z3A.34","I82.220","L02.611","R50.9","R00.0","R11.0","O99.340","Z3A.37","O60.14X0","Z39.1","Z34.82","Z34.83","R10.2","M25.559","O36.8330","O22.33","Z3A.36","O36.8130","O36.5930","Z37.0","O26.853","O23.03","O72.0","O76.","Z86.16","Z82.5","Z83.3"],"date":["2023-04-14","2023-04-14","2023-02-17","2023-04-14","2023-06-07","2022-06-07","2023-01-16","2022-06-19","2022-09-19","2022-09-19","2022-09-23","2023-03-28","2022-09-23","2022-09-23","2023-02-01","2022-12-06","2023-01-16","2022-12-06","2023-03-30","2023-03-21","2023-02-03","2023-02-01","2023-02-01","2022-11-05","2022-11-05","2023-01-15","2023-01-16","2022-11-05","2023-01-16","2023-03-28","2023-01-15","2023-02-17","2023-02-17","2022-11-05","2023-01-16","2023-01-16","2022-12-27","2023-01-16","2022-12-27","2022-12-27","2023-01-16","2023-01-16","2023-01-15","2023-01-16","2023-01-15","2023-01-15","2023-01-15","2023-01-16","2023-03-28","2023-01-16","2023-01-16","2023-01-16","2023-01-16","2021-04-05","2022-06-16","2022-06-05","2022-06-05","2022-06-05","2023-01-15","2022-06-20","2022-06-20","2022-09-23","2022-09-23","2022-09-23","2023-03-21","2023-03-22","2023-03-22","2021-10-22","2022-01-04","2022-01-04","2022-05-28","2022-05-28","2023-02-17","2022-05-28","2022-05-28","2023-02-17","2022-06-04","2022-06-04","2022-06-04","2022-06-04","2022-06-04","2022-06-04","2022-06-20","2022-06-04","2022-06-04","2022-06-04","2022-06-04","2022-06-04","2022-06-17","2022-06-17","2022-06-28","2022-06-28","2022-06-28","2022-06-28","2022-06-28","2022-06-28","2022-06-28","2022-06-28","2023-03-16","2023-02-03","2021-08-30","2023-03-28","2021-11-27","2022-04-12","2022-06-04","2023-03-22","2023-04-01","2021-02-08","2021-02-08","2022-01-25","2021-02-08","2021-02-08","2022-01-25","2022-01-25","2022-02-09","2022-06-21","2022-06-21","2022-06-21","2022-06-21","2022-06-21","2022-06-21","2022-06-21","2022-09-19","2022-09-19","2022-09-19","2022-09-19","2022-09-19","2022-09-19","2022-09-19","2022-09-19","2022-09-19","2022-09-19","2022-09-19","2023-01-11","2022-07-07","2022-07-07","2022-12-27","2022-12-27","2023-02-17","2023-03-28","2023-03-28","2023-02-17","2023-02-17","2022-01-14","2022-06-01","2022-06-01","2022-06-04","2022-09-20","2022-09-20","2023-03-16","2022-06-06","2022-06-16","2022-06-20","2022-06-20","2022-06-20","2022-09-20","2023-04-03","2023-04-01","2023-04-07","2023-04-07","2023-04-07","2023-03-16","2023-03-16","2023-03-29","2023-04-01","2023-03-30","2023-03-30","2023-03-30","2023-04-01","2023-02-17","2023-03-28","2023-03-28","2023-03-28","2023-03-28","2023-03-28","2023-03-28"],"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":[["","62559099212","FLUCONAZOLE","150 MG","2","Select","Select",""],["","65862050301","AMOX\/K CLAV","TAB 875-125","20","Select","Select",""],["","00555097302","AMPHET\/DEXTR","TAB 20MG","90","Select","Select",""],["","53746011005","HYDROCO\/APAP","TAB 10-325MG","90","Select","Select",""],["","65862067905","ALPRAZOLAM","2 MG","60","Select","Select",""],["","65162046650","IBUPROFEN","800 MG","30","Select","Select",""],["","00781261305","AMOXICILLIN","CAP 500MG","15","Select","Select",""],["","68382014005","TOPIRAMATE","100 MG","60","Select","Select",""],["","00116200116","CHLORHEX GLU","SOL 0.0012","473","Select","Select",""],["","00904043004","DOXYCYCL HYC","TAB 100MG","20","Select","Select",""],["","33332042110","AFLURIA QUAD","INJ 2021-22","0","Select","Select",""],["","59746017310","PREDNISONE","TAB 10MG","25","Select","Select",""],["","69097084615","CYCLOBENZAPR","TAB 10MG","12","Select","Select",""],["","51672200202","CLOTRIMAZOLE","CRE 0.01","30","Select","Select",""],["","69315030630","NYSTATIN","POW 100000","30","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","67405082508","BENZOYL PER","LIQ 5% WASH","237","Select","Select",""],["","00168020360","CLINDAMYCIN","LOT 0.01","60","Select","Select",""],["","65862019399","FLUOXETINE","CAP 20MG","90","Select","Select",""],["","65862064163","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","47781026305","OXYCODONE","TAB 5MG","10","Select","Select",""],["","00781326869","ENOXAPARIN","INJ 100MG\/ML","60","Select","Select",""],["","65862039110","ONDANSETRON","TAB 8MG ODT","30","Select","Select",""],["","42858030101","HYDROMORPHON","TAB 2MG","40","Select","Select",""],["","00003089421","ELIQUIS","5 MG","60","Select","Select",""],["","47781019605","OXYCOD\/APAP","TAB 5-325MG","30","Select","Select",""],["","50458057990","XARELTO","TAB 20MG","30","Select","Select",""],["","00904699880","DOCUSATE SOD","CAP 100MG","14","Select","Select",""],["","00781717612","NALOXONE","SPR ","2","Select","Select",""],["","40985027062","VITAMIN D3","TAB 1000UNIT","30","Select","Select",""],["","80681013800","CALCIUM","600-VIT D3 600MG-5MCG","60","Select","Select",""],["","67877022005","CEPHALEXIN","CAP 250MG","20","Select","Select",""],["","70677002501","SLEEP AID","TAB 25MG","15","Select","Select",""],["","49884018601","DOXYL\/PYRID","TAB 10-10MG","30","Select","Select",""],["","41167000607","UNISOM","TAB 25MG","15","Select","Select",""],["","10702000310","PROMETHAZINE","TAB 25MG","30","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","10006070012","VITAMIN B-6","TAB 50MG","60","Select","Select",""],["","63044015005","PRENATAL VIT","TAB LOW IRON","30","Select","Select",""],["","57896020110","PAIN RELIEF","TAB 500MG","30","Select","Select",""],["","42192080201","PHENAZOPYRID","TAB 200MG","6","Select","Select",""],["","00904673080","ACETAMIN","TAB 500MG","30","Select","Select",""],["","43386058131","METOCLOPRAM","TAB 5MG ODT","30","Select","Select",""],["","47781030301","NITROFURANTOIN MONO-MACRO","100 MG","14","Select","Select",""],["","39328010610","PRENATAL VITAMIN PLUS LOW IRON","27 MG-1 MG","30","Select","Select",""],["","00781326869","ENOXAPARIN SODIUM","100 MG\/ML","60","Select","Select",""],["","00555097402","DEXTROAMPHETAMINE-AMPHETAMINE","30 MG","60","Select","Select",""],["","42806071405","BENZONATATE","100 MG","30","Select","Select",""],["","72888001400","CYCLOBENZAPRINE HCL","10 MG","10","Select","Select",""],["","00904759080","FEROSUL","325(65) MG","30","Select","Select",""],["","00904699880","DOCUSATE SODIUM","100 MG","30","Select","Select",""],["","65862019399","FLUOXETINE HCL","20 MG","90","Select","Select",""],["","49348013534","TUSSIN MUCUS-CHEST CONGESTION","100 MG\/5ML","236","Select","Select",""],["","82607066027","FLOWFLEX COVID-","19 AG HOME TEST ","8","Select","Select",""],["","00555097302","AMPHET\/DEXTR TAB","20MG","90","Select","Select",""],["","65862064163","AZITHROMYCIN TAB","250MG","6","Select","Select",""],["","65862019399","FLUOXETINE CAP","20MG","90","Select","Select",""],["","65862067905","ALPRAZOLAM TAB","2MG","60","Select","Select",""],["","59746000103","METHYLPRED TAB","4MG","21","Select","Select",""],["","00168020360","CLINDAMYCIN LOT","1%","60","Select","Select",""],["","67405082508","BENZOYL PER LIQ","5% WASH","237","Select","Select",""],["","68382014005","TOPIRAMATE TAB","100MG","60","Select","Select",""],["","47781019605","OXYCOD\/APAP TAB","5-325MG","30","Select","Select",""],["","47781026305","OXYCODONE TAB","5MG","10","Select","Select",""],["","00904699880","DOCUSATE SOD CAP","100MG","14","Select","Select",""],["","65862050301","AMOX\/K CLAV TAB","875-125","20","Select","Select",""],["","65862039110","ONDANSETRON TAB","8MG ODT","30","Select","Select",""],["","00781717612","NALOXONE SPR","","2","Select","Select",""],["","50458057990","XARELTO TAB","20MG","30","Select","Select",""],["","00003089421","ELIQUIS TAB","5MG","60","Select","Select",""],["","42858030101","HYDROMORPHON TAB","2MG","30","Select","Select",""],["","47781030301","NITROFURANTN CAP","100MG","28","Select","Select",""],["","00781326869","ENOXAPARIN INJ","100MG\/ML","60","Select","Select",""],["","53746011005","HYDROCO\/APAP TAB","10-325MG","90","Select","Select",""],["","70677002501","SLEEP AID TAB","25MG","15","Select","Select",""],["","67877022005","CEPHALEXIN CAP","250MG","20","Select","Select",""],["","63044015005","PRENATAL VIT TAB LOW IRON","","30","Select","Select",""],["","10006070012","VITAMIN B-","6 TAB 50MG","60","Select","Select",""],["","10702000310","PROMETHAZINE TAB","25MG","30","Select","Select",""],["","00904673080","ACETAMIN TAB","500MG","30","Select","Select",""],["","49884018601","DOXYL\/PYRID TAB","10-10MG","30","Select","Select",""],["","57896074606","CALCIUM TAB","600MG","30","Select","Select",""],["","57896020110","PAIN RELIEF TAB","500MG","30","Select","Select",""],["","41167000607","UNISOM TAB","25MG","15","Select","Select",""],["","40985027062","VITAMIN D","3 TAB 1000UNIT","30","Select","Select",""],["","42192080201","PHENAZOPYRID TAB","200MG","6","Select","Select",""],["","62559099212","FLUCONAZOLE TAB","150MG","2","Select","Select",""],["","43386058131","METOCLOPRAM TAB","5MG ODT","30","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":""}]}]}