{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"A   KRAMNERRAF ","gend":0,"add":"OTSREHTAEF 025101 TPA TC EN","city":"VIRGINIA BEACH","state":"VA","zip":"23462-9998","dob":"1960-05-07","age":"","mstatus":"","insh":"17200210*76","cliId":"","pno":"32\/7575717-5","cno":"","email":"","ename":"","eno":"","pphy":"KIMES, CAROLYN M NP","ppno":"757\/363-6800","pcpadd":"816 INDEPENDENCE BLVD STE 100","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":23455,"pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Family Medicine Physicians - Independence","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I21.4","I10.","R79.89","F17.210","Z53.29","Z79.82","Z79.899","R06.02","H16.011","NO DATA","H25.13","E87.1","H16.001","H16.071","H16.031","L20.82","R04.0","I20.0","I73.9","Z95.820","F10.10","Z20.822","I25.10","Z95.5","Z79.02","E87.6","I25.119","I25.84","I77.810","F12.90","E78.5","I25.5","Z86.72","L28.0","R07.9","I25.110","I83.813","R07.89","I51.7","H18.221","H17.89","H16.221","I87.2","L90.9","I83.90","Z71.9","S05.30XA","I70.90","I74.5","I70.1","L85.3","H57.11","Z74.3","H53.9"],"date":["2022-02-11","2022-11-08","2022-02-08","2022-10-18","2022-02-08","2022-10-18","2022-10-18","2022-02-08","2022-06-04","2022-06-04","2022-06-02","2022-06-06","2022-11-09","2022-06-05","2022-11-04","2022-11-03","2021-09-30","2022-02-10","2022-11-02","2022-06-05","2022-06-05","2022-06-05","2022-10-18","2022-06-05","2022-10-18","2021-09-30","2022-02-09","2022-02-09","2022-02-10","2022-02-09","2022-02-10","2022-02-10","2022-10-18","2021-05-10","2022-02-10","2022-02-11","2022-10-05","2022-10-18","2022-02-10","2021-11-12","2021-11-12","2021-11-12","2022-11-03","2022-09-02","2022-09-02","2022-09-02","2022-11-08","2022-10-27","2022-10-27","2022-10-27","2022-11-03","2022-11-08","2022-11-08","2022-11-08"],"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":[["","00536100836","ASPIRIN","CHW 81MG","90","Select","Select",""],["","65862035705","CLOPIDOGREL","TAB 75MG","30","Select","Select",""],["","55111012105","ATORVASTATIN","TAB 10MG","30","Select","Select",""],["","45963070911","METOPROL","TAB 25MG ER","60","Select","Select",""],["","00406012305","HYDROCO\/APAP","TAB 5-325MG","18","Select","Select",""],["","68180072003","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","12843013105","BAYER","CHW 81MG","30","Select","Select",""],["","65862020399","LOSARTAN","TAB 100MG","30","Select","Select",""],["","00574402435","ERYTHROMYCIN","OIN 5MG\/GM","4","Select","Select",""],["","70069013101","TOBRAMYCIN","SOL 0.3% OP","5","Select","Select",""],["","65862084003","MOXIFLOXACIN","SOL HCL 0.5%","3","Select","Select",""],["","61314063710","PREDNISOLONE","SUS 1% OP","10","Select","Select",""],["","69238138003","DIFLUPREDNAT","EMU 0.0005","5","Select","Select",""],["","23155050105","HYDROXYZ","TAB 25MG","60","Select","Select",""],["","00065924007","DUREZOL","EMU 0.0005","5","Select","Select",""],["","61314062810","POLYMYXIN","SOL TRIMETHP","10","Select","Select",""],["","00536589553","NICOTINE","DIS 14MG\/24H","7","Select","Select",""],["","00591544305","PREDNISONE","TAB 20MG","180","Select","Select",""],["","45802006405","TRIAMCINOLON","CRE 0.001","454","Select","Select",""],["","31722052001","HYDRALAZINE","TAB 25MG","30","Select","Select",""],["","70756020111","AMITRIPTYLIN","TAB 10MG","30","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","4","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":""}]}]}