{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"S ENIMSAJNILREDNA","gend":1,"add":"T93 W 9041B TPA TS H","city":"NORFOLK","state":"VA","zip":"23508-9998","dob":"1990-01-13","age":"","mstatus":"","insh":"3425410*56","cliId":"","pno":"17\/7577627-4","cno":"757\/803-0639","email":"","ename":"","eno":"","pphy":"WHITE, BRITTNEY N NP","ppno":"757\/583-2181","pcpadd":"2203 E LITTLE CREEK RD","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23518,"pcpcounty":"","pcpid":"","pcpname":"BAYVIEW PHYSICIAN SERVICES PC","plan":"OHP","program":"MEDICAID","lob":"M4","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":["N89.8","N72.","Z68.20","V23.41","O23.591","B96.89","R07.9","R10.9","Z86.16","Z3A.01","O46.92","O47.02","Z3A.27","O36.8330","Z3A.31","J09.X2","K29.00","R00.1","S06.0X9A","K08.89","R68.84","V23.87","O26.891","R10.2","Z3A.19","R10.11","N92.5","Z32.01","Z3A.00","R19.7","Z20.822","O26.892","O23.32","N30.01","R10.30","R10.10","K44.9","R74.8","K76.0","R82.90","Z34.83","S20.362A","O77.0","O72.1","Z37.0","Z3A.38","Z82.49","Z83.3","Z82.0","Z28.21","O80.","O99.893","R51.9","O86.20","N39.0","O16.5","R41.0","R79.89","R53.83","R42.","R10.13","Z88.8","N92.6","J06.9","Z20.828","O23.593","O99.013","O46.93","D64.9","Z3A.35","Z88.6","Z87.51","Z79.899","Z30.09","R03.0","N73.0","Z23.","K80.20","F41.9","R00.2","R10.84","K29.70","R11.2","U07.1","R05.","S23.41XA","N76.0","Z11.3","R11.0","O26.852","Z3A.24","O26.90","O46.8X3","K21.9","Z13.220","Z34.82","O99.02","O99.354","D50.9","G43.909","O99.344","F32.9","Z82.61","NO DATA","Z38.00"],"date":["2019-04-30","2019-04-30","2019-07-16","2020-04-07","2021-03-05","2021-09-26","2021-11-18","2021-05-20","2021-03-05","2021-03-05","2021-08-03","2021-08-03","2021-08-03","2021-09-02","2021-09-02","2019-03-01","2019-04-24","2020-01-01","2019-07-28","2019-08-26","2019-07-28","2019-09-29","2019-10-05","2019-10-05","2020-01-09","2020-12-12","2021-03-31","2021-03-31","2021-03-31","2021-05-13","2021-11-18","2021-05-20","2021-05-20","2019-01-11","2019-01-11","2019-07-17","2019-07-17","2019-07-17","2019-07-17","2019-09-29","2020-05-20","2021-04-17","2021-10-15","2021-11-18","2021-10-15","2021-10-15","2021-11-18","2021-11-18","2021-11-18","2021-10-15","2021-10-15","2021-11-18","2021-11-18","2021-11-18","2021-11-18","2021-11-18","2021-11-18","2021-11-18","2021-11-18","2021-11-18","2021-11-18","2021-11-18","2019-11-06","2021-07-03","2021-07-03","2021-09-26","2021-09-26","2021-09-26","2021-09-26","2021-09-26","2021-09-26","2021-09-26","2021-09-26","2021-11-15","2021-11-18","2019-04-11","2019-11-21","2020-01-01","2020-10-10","2020-10-10","2020-11-20","2020-11-20","2020-11-20","2021-02-12","2021-02-12","2019-01-22","2019-08-17","2019-08-17","2019-10-28","2020-02-16","2020-02-16","2021-10-15","2021-09-26","2019-02-02","2019-07-16","2020-02-19","2020-05-25","2020-05-25","2020-05-25","2020-05-25","2020-05-25","2020-05-25","2020-05-25","2020-08-05","2021-10-15"],"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":[["","","NAPROXEN"," NAPROXEN ","20","Select","Select",""],["","","CEFUROXIME"," CEFUROXIME ","10","Select","Select",""],["","","DOXYCYC"," DOXYCYC ","28","Select","Select",""],["","","DOXYCYCL"," DOXYCYCL ","28","Select","Select",""],["","","METRONIDAZOL"," METRONIDAZOL ","14","Select","Select",""],["","","OXYCOD\/APAP"," OXYCOD\/APAP ","20","Select","Select",""],["","","IBUPROFEN"," IBUPROFEN ","30","Select","Select",""],["","","ONDANSETRON"," ONDANSETRON ","12","Select","Select",""],["","","ACETAMIN"," ACETAMIN ","80","Select","Select",""],["","","AMOXICILLIN"," AMOXICILLIN ","30","Select","Select",""],["","","FLUCONAZOLE","TAB 200MG","","Select","Select",""],["","","CVS","TAB 8.6MG","","Select","Select",""],["","","FERROUS","TAB 325MG","","Select","Select",""],["","","METHOCARBAM","TAB 750MG","","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":""}]}]}