{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BARBARA   L MORRISETTE","gend":1,"add":"4200 THOROUGHGOOD DR","city":"VIRGINIA BEACH","state":"VA","zip":"23455-9998","dob":"1964-08-16","age":"","mstatus":"","insh":"2043976*01","cliId":"","pno":"757\/363-7092","cno":"757\/363-7092","email":"","ename":"","eno":"","pphy":"ANDERSON, ROBIN N MD","ppno":"757\/318-6900","pcpadd":"2017 PLEASURE HOUSE ROAD","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":23455,"pcpcounty":"","pcpid":300194,"pcpname":"SMG - Sentara Family Medicine Physicians - Thoroughgood","plan":"OHP","program":"ACA","lob":"Small Group","region":"TIDEWATER","aligned":"","ano":"757\/368-0117","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/275-9772","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J30.1","J30.81","J30.89","J45.30","Z12.11","L30.9"],"date":["2021-11-10","2021-11-10","2021-11-10","2020-11-18","2021-08-30","2021-09-15"],"priorHcc":[null,null,null,"",null,""]}},{"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":[["","49502010202","EPINEPHRINE","0.3MG","2","Select","Select",""],["","52536010503","ERYTHROMYCIN","500MG BS","14","Select","Select",""],["","68180015301","DESLORATADIN","5MG","-30","Select","Select",""],["","59310030240","QVAR","40MCG","-11","Select","Select",""],["","65862057490","MONTELUKAST","10MG","90","Select","Select",""],["","66993001968","ALBUTEROL","HFA","18","Select","Select",""],["","00173068220","VENTOLIN","","-18","Select","Select",""],["","59267100002","PFIZER","COVID-19","0","Select","Select",""],["","52536010503","ERYTHROMYCIN ","500MG BS","14","Select","Select",""],["","65862057490","MONTELUKAST ","10MG","90","Select","Select",""],["","49502010202","EPINEPHRINE ","0.3MG","2","Select","Select",""],["","59310030240","QVAR ","40MCG","11","Select","Select",""],["","00173068220","VENTOLIN ","","18","Select","Select",""],["","66993001968","ALBUTEROL ","HFA","18","Select","Select",""],["","68180015301","DESLORATADIN ","5MG","30","Select","Select",""],["","59267100002","PFIZER ","COVID-19","0","Select","Select",""],["","45802006435","TRIAMCINOLON","0.10%","465","Select","Select",""],["","59746017506","PREDNISONE","20MG","15","Select","Select",""],["","45802006435","TRIAMCINOLON ","CRE 0.001","-465","Select","Select",""],["","59746017506","PREDNISONE ","TAB 20MG","15","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":[[["No","Select","","","","","Select","",""],["No","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":""}]}]}