{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SOPHIEA   MIHYANG YI","gend":1,"add":"508 TABB LAKES DR","city":"YORKTOWN","state":"VA","zip":"23693-9998","dob":"1971-10-30","age":"","mstatus":"","insh":"1721055*02","cliId":"","pno":"757\/753-5047","cno":"757\/753-5047","email":"","ename":"","eno":"","pphy":"MOORE, CHARLOTTE DO","ppno":"757\/369-5784","pcpadd":"SUITE K 1405 KILN CREEK PKWY","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":23602,"pcpcounty":"","pcpid":157546,"pcpname":"KILN CREEK FAMILY MEDICINE","plan":"OHP","program":"ACA","lob":"Individual","region":"TIDEWATER","aligned":"","ano":"757\/753-5047","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/369-5785","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E04.9","I10.","N30.01","E78.2","E03.9","E06.3","E55.9","D50.9","N39.0","K76.0","Z87.440","R30.0","L20.9","J30.1","J30.89","J30.81","A05.9","K92.1","R10.84","R11.2","R19.7","H10.13","N20.1","M54.9","R10.9","E11.65","I11.0","N23.","R31.9","N20.0","L30.9","Z68.28","M06.9","Z68.27","K52.9","R17.","D50.0","Z23.","E03.8"],"date":["2020-03-17","2021-09-27","2020-11-09","2021-04-26","2021-08-18","2020-07-30","2021-11-08","2021-08-18","2021-04-19","2020-11-11","2021-02-06","2021-07-06","2021-02-08","2021-02-08","2021-02-08","2021-02-08","2020-05-29","2020-05-29","2020-05-29","2020-05-29","2020-05-29","2021-02-08","2020-11-11","2020-11-11","2020-11-30","2021-04-26","2021-01-07","2020-11-11","2020-11-19","2020-11-19","2020-11-19","2020-11-19","2020-02-18","2020-02-18","2020-05-20","2021-08-18","2021-11-08","2021-11-08","2021-11-08"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}},{"a":[]}]},{"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":[]}]},{"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":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","00093720110","PRAVASTATIN","20MG","30","Select","Select",""],["","00024591401","DUPIXENT","300\/2ML","-4","Select","Select",""],["","64380073706","VITAMIN","50000UNT","12","Select","Select",""],["","00781518692","LEVOTHYROXIN","125MCG","30","Select","Select",""],["","68645055254","LISINOPRIL","10MG","30","Select","Select",""],["","00093031101","LOPERAMIDE","2MG","30","Select","Select",""],["","00527128201","DICYCLOMINE","20MG","30","Select","Select",""],["","61314063305","GENTAMICIN","0.3% OP","5","Select","Select",""],["","72305011230","EUTHYROX","112MCG","-30","Select","Select",""],["","00406012301","HYDROCO\/APAP","5-325MG","-12","Select","Select",""],["","51293081101","PHENAZOPYRID","200MG","-10","Select","Select",""],["","68180012101","CEPHALEXIN","250MG","28","Select","Select",""],["","68382005105","MELOXICAM","15MG","30","Select","Select",""],["","55724021121","EUCRISA","2%","60","Select","Select",""],["","00074929690","SYNTHROID","112MCG","30","Select","Select",""],["","00185012201","NITROFURANTN","100MG","10","Select","Select",""],["","45802006335","TRIAMCINOLON","0.03%","15","Select","Select",""],["","31722070190","LOSARTAN","50MG","30","Select","Select",""],["","00093720110","PRAVASTATIN ","20MG","30","Select","Select",""],["","00024591401","DUPIXENT ","300\/2ML","4","Select","Select",""],["","00781518692","LEVOTHYROXIN ","125MCG","30","Select","Select",""],["","64380073706","VITAMIN ","50000UNT","4","Select","Select",""],["","68645055254","LISINOPRIL ","10MG","30","Select","Select",""],["","00527128201","DICYCLOMINE ","20MG","30","Select","Select",""],["","00093031101","LOPERAMIDE ","2MG","30","Select","Select",""],["","72305011230","EUTHYROX ","112MCG","30","Select","Select",""],["","61314063305","GENTAMICIN ","0.3% OP","5","Select","Select",""],["","00406012301","HYDROCO\/APAP ","5-325MG","-12","Select","Select",""],["","51293081101","PHENAZOPYRID ","200MG","10","Select","Select",""],["","00185012201","NITROFURANTN ","100MG","10","Select","Select",""],["","45802006335","TRIAMCINOLON ","0.03%","15","Select","Select",""],["","68180012101","CEPHALEXIN ","250MG","28","Select","Select",""],["","55724021121","EUCRISA ","2%","60","Select","Select",""],["","68382005105","MELOXICAM ","15MG","30","Select","Select",""],["","65162027250","SMZ\/TMP ","800-160","10","Select","Select",""],["","00074929690","SYNTHROID ","112MCG","30","Select","Select",""],["","31722070190","LOSARTAN ","50MG","30","Select","Select",""],["","65162027250","SMZ\/TMP","800-160","10","Select","Select",""],["","59267100003","PFIZER ","INJ COVID-19","0","Select","Select",""],["","80777027398","MODERNA ","INJ COVID-19","0","Select","Select",""],["","89634800272",""," ","4","Select","Select",""]]}},{"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":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[[["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""]]]},{"t":"Mini-Cog","q":[{"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":""}]}]}