{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"  YELHSASMADA J ","gend":1,"add":"NUDREV 01922 TPA EVA ","city":"NORFOLK","state":"VA","zip":"23509-9998","dob":"1985-04-16","age":"","mstatus":"","insh":"5189110*19","cliId":"","pno":"13\/7579626-5","cno":"","email":"","ename":"","eno":"","pphy":"HAGGERTY, MARK DO","ppno":"757\/395-1300","pcpadd":"2859 VIRGINIA BEACH BLVD","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":23452,"pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Family Medicine Physicians - Little Neck","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":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["D55.0","R16.1","F90.0","F41.9","F32.9","N64.4","N30.01","Z20.828","K04.7","F17.210","N20.0","R31.0","N23.","R10.9","R39.15","N39.0","N12.","Z72.0","R53.83","R06.00","E66.9","Z68.36","O20.0","O99.331","Z3A.11","O26.90","N13.2","R31.9","O26.891","Z3A.01","Z33.1"],"date":["2020-05-27","2020-05-27","2021-09-13","2021-09-13","2021-09-13","2021-02-04","2020-05-10","2020-05-10","2020-11-19","2020-11-19","2019-06-19","2019-06-13","2019-06-13","2019-08-14","2019-08-14","2019-08-14","2019-10-03","2019-07-28","2019-03-06","2019-03-06","2019-03-06","2019-03-06","2019-10-22","2019-10-22","2019-10-22","2019-10-22","2019-06-13","2019-06-13","2019-10-03","2019-10-03","2019-10-03"],"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":[["","","VENLAFAXINE"," VENLAFAXINE ","30","Select","Select",""],["","","AMPHET\/DEXTR"," AMPHET\/DEXTR ","60","Select","Select",""],["","","HYDROXYZ","CAP 25MG","","Select","Select",""],["","10370010150","BUPROPN","TAB 150MG XL","30","Select","Select",""],["","","DOXYCYCL"," DOXYCYCL ","20","Select","Select",""],["","51991029301","OXCARBAZEPIN","TAB 300MG","60","Select","Select",""],["","","CIPROFLOXACN"," CIPROFLOXACN ","14","Select","Select",""],["","","BUT\/APAP\/CAF"," BUT\/APAP\/CAF ","10","Select","Select",""],["","","METRONIDAZOL"," METRONIDAZOL ","14","Select","Select",""],["","","NITROFURANTN"," NITROFURANTN ","14","Select","Select",""],["","","FLUOXETINE"," FLUOXETINE ","30","Select","Select",""],["","","HYDROCO\/APAP"," HYDROCO\/APAP ","12","Select","Select",""],["","","CEFDINIR"," CEFDINIR ","20","Select","Select",""],["","","VALACYCLOVIR"," VALACYCLOVIR ","42","Select","Select",""],["","","ONDANSETRON"," ONDANSETRON ","20","Select","Select",""],["","","FLUCONAZOLE"," FLUCONAZOLE ","1","Select","Select",""],["","","AZITHROMYCIN"," AZITHROMYCIN ","4","Select","Select",""],["","","BUSPIRONE"," BUSPIRONE ","60","Select","Select",""],["","","OXYCOD\/APAP"," OXYCOD\/APAP ","15","Select","Select",""],["","","TAMSULOSIN"," TAMSULOSIN ","30","Select","Select",""],["","","NARCAN"," NARCAN ","2","Select","Select",""],["","","CEPHALEXIN"," CEPHALEXIN ","28","Select","Select",""],["","","AMOX\/K"," AMOX\/K ","14","Select","Select",""],["","","CLINDAMYCIN","CAP 150MG","","Select","Select",""],["","","KETOROLAC","TAB 10MG","","Select","Select",""],["","","AMOXICILLIN","CAP 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":""}]}]}