{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KEISHA S TURNER","gend":1,"add":"801 BOUSH ST STE 302","city":"NORFOLK","state":"VA","zip":"23510-9998","dob":"1981-11-22","age":"","mstatus":"","insh":"900040314*01","cliId":"","pno":"757\/625-6161","cno":"","email":"","ename":"","eno":"","pphy":"GRANT JR, THOMAS R MD","ppno":"757\/446-5955","pcpadd":"825 FAIRFAX AVE STE 118","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23507,"pcpcounty":"","pcpid":"","pcpname":"EVMS Ghent Family Medicine","plan":"OHP","program":"MEDICARE","lob":"DSNP","region":"TIDEWATER","aligned":"Y","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/446-5196","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["A53.9","I89.0","E66.9","I10.","Z68.42","Z91.030","Z91.040","Z96.642","M79.89","M25.552","F63.2","H40.053","H10.45","F25.0","F41.1","Z79.899","Z11.3","Z12.4","F43.21","F71.","M70.62","G47.33","L20.9","L21.9","Z23.","E66.01","E03.9","I82.403","R53.83","R39.81","J45.901","I87.2","G47.14","Z00.00","F70.","Z13.31","J20.9","Z20.828","R05.","R50.9","R07.0","N92.3","Z12.9","Z30.46","F25.9","F79.","Z87.2","K05.5"],"date":["2021-02-23","2021-11-15","2021-05-26","2021-05-26","2021-05-26","2021-05-26","2021-05-26","2021-05-26","2021-05-26","2021-09-24","2021-12-06","2021-10-08","2021-10-08","2021-10-25","2021-10-25","2021-10-25","2021-01-20","2021-01-20","2021-11-15","2021-11-15","2021-06-18","2021-10-19","2021-07-30","2021-07-30","2021-11-15","2021-11-15","2020-11-02","2021-05-26","2021-08-23","2020-10-30","2020-11-02","2021-06-07","2020-09-25","2020-11-06","2020-11-06","2020-11-06","2020-10-25","2020-10-25","2020-10-25","2020-10-25","2020-10-25","2021-01-15","2021-01-15","2021-02-23","2020-09-01","2020-10-30","2021-03-12","2021-03-12"],"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":[]}]},{"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":[["","69097012815","AMLODIPINE BESYLATE ","10MG","28","Select","Select",""],["","43547035411","LISINOPRIL ","20MG","56","Select","Select",""],["","16729020216","BUSPIRONE HYDROCHLORIDE ","10MG","84","Select","Select",""],["","00378181377","LEVOTHYROXINE SODIUM ","125MCG","28","Select","Select",""],["","61442012110","FAMOTIDINE ","20MG","28","Select","Select",""],["","13668000905","CITALOPRAM HYDROBROMIDE ","10MG","28","Select","Select",""],["","00054001925","PREDNISONE ","50MG","-5","Select","Select",""],["","01234567891"," ","","2","Select","Select",""],["","70727052925","ROCKLATAN ","","2","Select","Select",""],["","68382011505","RISPERIDONE ","2MG","28","Select","Select",""],["","00143314205","DOXYCYCLINE HYCLATE ","100MG","20","Select","Select",""],["","61314022710","TIMOLOL MALEATE ","0.5% OP","10","Select","Select",""],["","55111072510","MONTELUKAST SODIUM ","10MG","28","Select","Select",""],["","00168000616","TRIAMCINOLONE ACETONIDE ","0.10%","454","Select","Select",""],["","49502010202","EPINEPHRINE ","0.3MG","2","Select","Select",""],["","00168014616","HYDROCORTISONE ","2.50%","454","Select","Select",""],["","66993001968","ALBUTEROL SULFATE HFA ","HFA","18","Select","Select",""],["","47335093890","AZELASTINE HCL ","0.05%","6","Select","Select",""],["","00173071920","FLOVENT HFA ","110MCG","12","Select","Select",""],["","00173068220","VENTOLIN HFA ","","18","Select","Select",""],["","00832046515","NYAMYC ","100000","15","Select","Select",""],["","23155050110","HYDROXYZINE HYDROCHLORIDE ","25MG","30","Select","Select",""],["","63646001004","KETOCONAZOLE ","2%","120","Select","Select",""],["","00378022201","CHLORTHALIDONE ","25MG","28","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":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"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":""}]}]}