{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"   SEMAJNONNAC A","gend":0,"add":"LUC 4205DAOR NEL","city":"VIRGINIA BEACH","state":"VA","zip":"23455-9998","dob":"1958-01-30","age":"","mstatus":"","insh":"18300210*05","cliId":"","pno":"09\/7574520-5","cno":"","email":"","ename":"","eno":"","pphy":"BOGNER, KATHRYN NP","ppno":"757\/395-2500","pcpadd":"1024 FIRST COLONIAL RD","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":23454,"pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Family Medicine Physicians - First Colonial","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":["I25.10","I10.","R00.2","E78.2","I25.2","Z98.890","R73.01","NO DATA","M54.2","J45.20","R06.2","G89.29","N45.2","R07.9","Z87.891","R06.09","Z20.822","Z00.00","N50.812","I48.91","N50.819","N45.1","R39.9","E78.5","N50.89","T23.252A","T23.032A","T31.0","I50.9","J44.9","Z79.899","Z88.6","Z88.0","Z91.09","T23.022A","Z01.810","I47.1","L98.9","M25.561","R20.0","I49.3","I49.1","M79.651","R22.41","M79.9","D17.23","E78.00","L72.9","R20.2","M79.604","R00.0"],"date":["2021-04-26","2021-04-26","2021-04-26","2021-04-26","2021-02-10","2021-02-10","2021-02-10","2021-02-10","2021-03-02","2021-02-10","2021-02-10","2021-02-10","2020-08-11","2020-08-11","2021-05-14","2021-02-24","2021-12-31","2020-08-05","2020-08-11","2020-08-05","2021-03-30","2021-03-30","2021-03-30","2020-04-28","2020-08-11","2021-05-14","2021-05-14","2021-05-14","2021-05-14","2021-05-14","2021-05-14","2021-05-14","2021-05-14","2021-05-14","2021-05-14","2019-01-14","2019-05-07","2019-03-07","2019-03-07","2019-03-07","2019-06-13","2019-06-13","2019-07-18","2019-01-22","2019-01-14","2019-01-22","2019-04-15","2019-03-26","2019-06-07","2019-06-07","2019-05-07"],"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":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"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":[["","80777027399","MODERNA","INJ COVID-19","0","Select","Select",""],["","49483060450","IBUPROFEN","TAB 800MG","12","Select","Select",""],["","","HYDROCO\/APAP"," HYDROCO\/APAP ","10","Select","Select",""],["","00093310905","AMOXICILLIN","CAP 500MG","21","Select","Select",""],["","69097014260","ALBUTEROL","AER HFA","7","Select","Select",""],["","67877012485","SILVER","CRE 0.01","85","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","59651005290","EZETIMIBE","TAB 10MG","90","Select","Select",""],["","00527133850","DOXYCYC","TAB 100MG","20","Select","Select",""],["","","ATORVASTATIN"," ATORVASTATIN ","30","Select","Select",""],["","","GABAPENTIN"," GABAPENTIN ","30","Select","Select",""],["","","SMZ\/TMP","TAB 800-160","","Select","Select",""],["","","ALFUZOSIN","TAB 10MG ER","","Select","Select",""],["","","FAMOTIDINE","TAB 20MG","","Select","Select",""],["","","LEVOFLOXACIN","TAB 500MG","","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":""}]}]}