{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ANNAYTSIRKRENRUT L ","gend":1,"add":"DOOW 885NL ENIB","city":"VIRGINIA BEACH","state":"VA","zip":"23452-9998","dob":"1979-08-15","age":"","mstatus":"","insh":"0583210*06","cliId":"","pno":"0775706395","cno":7577059360,"email":"","ename":"","eno":"","pphy":"WATSON, NICOLE M NP","ppno":7573951300,"pcpadd":"1975 GLENN MITCHELL DR STE 202","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":"23456-9998","pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Family Medicine Physicians - Little Neck","plan":"OHP","program":"ACA","lob":"Small Group","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.9","M06.4","F32.5","M05.79","G43.009","E78.00","K21.9","M50.20","M54.12","L71.0","L23.89","M06.00","M25.562","M54.2","Z79.899","R20.0","R20.2","R10.2","I73.00","D22.5","L90.5","R35.0","R10.32","J01.01","J30.9","D48.5","L82.1","I78.1","D22.9","L81.4","Z12.83","Z71.9","Z13.29","M50.022","M50.122","G43.909","K76.0","E28.2","K59.04","M06.9","Z88.8","Z88.0","Z98.890","Z83.3","Z79.4","Z79.1","R11.0","K64.9","I73.01","J30.2","J34.2","J34.3"],"date":["2023-04-06","2022-02-28","2023-04-18","2022-02-28","2022-02-28","2023-04-18","2023-04-18","2021-04-19","2021-04-19","2021-04-19","2021-04-19","2023-04-21","2023-04-21","2023-04-21","2022-06-17","2022-02-23","2022-02-23","2023-02-27","2022-02-04","2022-02-08","2022-02-08","2023-04-18","2022-05-27","2023-04-17","2023-04-18","2022-01-14","2022-01-14","2022-01-14","2022-01-14","2022-01-14","2022-01-14","2022-01-14","2023-04-06","2021-06-21","2021-06-21","2021-06-21","2021-06-21","2021-06-21","2022-03-03","2021-06-21","2021-06-21","2021-06-21","2021-06-21","2021-06-21","2021-06-21","2021-06-21","2022-03-03","2022-03-03","2023-04-21","2023-04-17","2023-04-17","2023-04-17"],"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":[["","70700015010","OMEPRAZOLE","20 MG","90","Select","Select",""],["","55513084301","AIMOVIG INJ","140MG\/ML","1","Select","Select",""],["","68462049833","ZOLMITRIPTAN","5 MG","6","Select","Select",""],["","00093505998","ATORVASTATIN CALCIUM","20 MG","90","Select","Select",""],["","00169413013","OZEMPIC","1\/0.75 (3)","3","Select","Select",""],["","65862014836","SUMATRIPTAN SUCCINATE","100 MG","27","Select","Select",""],["","63304069301","CLINDAMYCIN HCL","300 MG","30","Select","Select",""],["","00169413212","OZEMPIC INJ","2\/1.5ML","2","Select","Select",""],["","68462049833","ZOLMITRIPTAN TAB","5MG","6","Select","Select",""],["","68462015713","ONDANSETRON TAB","4MG ODT","30","Select","Select",""],["","65862014836","SUMATRIPTAN TAB","100MG","9","Select","Select",""],["","00093505998","ATORVASTATIN TAB","20MG","90","Select","Select",""],["","65862017360","TOPIRAMATE TAB","100MG","90","Select","Select",""],["","55111064530","OMEPRAZOLE CAP","40MG","180","Select","Select",""],["","00126007292","PREVDNT","5000 PST 1.1%","100","Select","Select",""],["","59746017210","PREDNISONE TAB","5MG","10","Select","Select",""],["","43598016430","OLANZAPINE TAB","5MG","30","Select","Select",""],["","65862017360","TOPIRAMATE","100 MG","90","Select","Select",""],["","68180087773","JENCYCLA","0.35 MG","84","Select","Select",""],["","60219204301","DEXAMETHASONE","4 MG","6","Select","Select",""],["","55513084301","AIMOVIG AUTOINJECTOR","140 MG\/ML","1","Select","Select",""],["","55111014512","FLUCONAZOLE","150 MG","1","Select","Select",""],["","16729044310","BUPROPION XL","150 MG","180","Select","Select",""],["","65862022660","CLARITHROMYCIN","500 MG","30","Select","Select",""],["","00603533815","PREDNISONE","10 MG","21","Select","Select",""],["","00054327099","FLUTICASONE PROPIONATE","50 MCG","48","Select","Select",""],["","00093101042","MUPIROCIN","2 %","22","Select","Select",""],["","68462015713","ONDANSETRON ODT","4 MG","30","Select","Select",""],["","68645056354","IBUPROFEN","800 MG","15","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":""}]}]}