{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"STEPHANIE MORALES-SOLER","gend":1,"add":"701 QUEENS WAY","city":"VIRGINIA BEACH","state":"VA","zip":"23454-9998","dob":"1991-09-07","age":"","mstatus":"","insh":"20040316*01","cliId":"","pno":"757\/625-4175","cno":"757\/625-4175","email":"","ename":"","eno":"","pphy":"SNELLINGS, JOHN E MD","ppno":"757\/446-5955","pcpadd":"825 FAIRFAX AVE SUITE 118","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23507,"pcpcounty":"","pcpid":100070,"pcpname":"EVMS Ghent Family Medicine","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"757-480-2755","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N91.2","Z32.01","N31.9","Q05.9","G82.20","Z3A.12","Z99.3","J45.20","Z96.0","D50.9","Q05.7","Z87.74","Z3A.20","Q76.49","Q21.3","Z3A.31","O62.9","NO DATA","K62.6","Z3A.32","Z37.0","Q05.8","O75.89","O99.52","Z87.440","O99.02","Z79.899","Z91.040","N39.0","Z3A.34","Z34.90","L98.8","K61.0","M72.6","O86.04","A41.9","E87.6","E87.2","O86.89","I96.","L02.31","Z16.11","O99.893","B95.2","B96.1","O99.03","O99.53","Z20.828","Z48.01","S31.000A","O28.3","M54.5","R26.1","G82.22","Q25.6","I47.1","Z83.1","O60.03","R31.0","Z3A.33","S31.819A","M79.89","O26.892","R00.2","Z3A.14","I37.0","Z33.1","O60.14X0","Z00.129","O99.413","Q24.9","V23.9","Z3A.30","Z3A.35","S31.829A","A49.8","S31.809A","L89.153","L89.213","L89.891","Z48.00","D64.9","G89.29","Z79.01","Z91.81","R07.89","Z46.89","O99.89","O99.419","O99.019","Z3A.00","N73.6","R50.9","Z33.3","O35.2XX0","Q21.1","L89.154","I07.1","I37.2","R42.","Z98.890","O99.412","Z3A.22","O26.899","R10.9","O32.1XX0","Z39.0","R62.51","R68.12","P07.38","Z23.","Z3A.29","O26.93","Z38.01","P07.17","P03.4","P04.0","P22.8","Z30.017","P92.9"],"date":["2020-04-14","2020-04-14","2020-11-05","2020-11-05","2020-06-25","2020-06-25","2020-11-05","2020-11-05","2020-11-05","2020-09-15","2020-09-29","2020-09-29","2020-07-13","2020-11-05","2020-09-15","2020-09-09","2020-09-15","2020-09-15","2020-09-15","2020-09-19","2020-10-04","2020-10-04","2020-09-15","2020-09-15","2020-09-15","2020-09-15","2020-09-15","2020-09-15","2020-09-23","2020-10-02","2020-10-01","2020-11-02","2020-10-12","2020-10-23","2020-10-12","2020-10-12","2020-10-12","2020-10-12","2020-10-12","2020-10-12","2020-11-16","2020-10-12","2020-10-12","2020-10-12","2020-10-12","2020-10-12","2020-10-12","2020-10-12","2020-10-19","2020-10-19","2020-06-08","2020-06-23","2020-06-30","2020-06-30","2020-09-15","2020-09-15","2020-09-15","2020-10-04","2020-09-19","2020-09-25","2020-11-02","2020-10-22","2020-05-10","2020-05-12","2020-05-10","2020-09-15","2020-09-15","2020-10-04","2020-10-20","2020-09-04","2020-09-11","2020-09-04","2020-09-04","2020-10-04","2020-10-18","2020-10-17","2020-10-21","2020-11-05","2020-11-05","2020-11-05","2020-11-05","2020-11-05","2020-11-05","2020-11-05","2020-11-05","2020-05-12","2020-06-30","2020-09-14","2020-09-11","2020-09-14","2020-09-14","2020-10-04","2020-10-18","2020-04-28","2020-07-06","2020-07-28","2020-10-30","2020-05-12","2020-05-12","2020-05-12","2020-05-12","2020-07-06","2020-07-06","2020-08-30","2020-08-30","2020-09-15","2020-10-06","2020-10-14","2020-10-12","2020-10-14","2020-08-25","2020-08-25","2020-09-15","2020-10-04","2020-10-04","2020-10-04","2020-10-04","2020-10-04","2020-10-07","2020-10-14"],"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":[["","68180012202","CEPHALEXIN ","500MG","14","Select","Select",""],["","00904531360","PRENATAL ","27-0.8MG","30","Select","Select",""],["","16714043901","NITROFURANTN ","100MG","10","Select","Select",""],["","61748009230","PYRIDOXINE ","25MG","30","Select","Select",""],["","59310057922","PROAIR ","","8","Select","Select",""],["","00121053005","FERROUS ","300\/5ML","300","Select","Select",""],["","00904645780","DOK ","100MG","30","Select","Select",""],["","69543025850","PREPLUS ","27-1MG","30","Select","Select",""],["","50111078810","AZITHROMYCIN ","500MG","2","Select","Select",""],["","75854031230","PRENATE ","","30","Select","Select",""],["","10702001850","OXYCODONE ","5MG","15","Select","Select",""],["","66993001968","ALBUTEROL ","HFA","18","Select","Select",""],["","00536440601","VITAMIN ","25MG","30","Select","Select",""],["","00093078701","ATENOLOL ","25MG","180","Select","Select",""],["","49035044164","SLEEP ","25MG","30","Select","Select",""],["","55111014512","FLUCONAZOLE ","150MG","2","Select","Select",""],["","42858010250","OXYCOD\/APAP ","5-325MG","30","Select","Select",""],["","74300000301","DESITIN ","13%","113","Select","Select",""],["","80681013800","CALCIUM\/D3 ","600MG","60","Select","Select",""],["","00904759080","FEROSUL ","325MG","30","Select","Select",""],["","76385012350","METHOCARBAM ","500MG","20","Select","Select",""],["","71288041081","ENOXAPARIN ","30\/0.3ML","2","Select","Select",""],["","65162046650","IBUPROFEN ","800MG","30","Select","Select",""],["","31604002766","PRENATAL","","30","Select","Select",""],["","69543025850","PREPLUS","27-1MG","30","Select","Select",""],["","50111078810","AZITHROMYCIN","500MG","2","Select","Select",""],["","16714043901","NITROFURANTN","100MG","10","Select","Select",""],["","00536440601","VITAMIN","25MG","30","Select","Select",""],["","49035044164","SLEEP","25MG","30","Select","Select",""],["","61748009230","PYRIDOXINE","25MG","30","Select","Select",""],["","68180012202","CEPHALEXIN","500MG","14","Select","Select",""],["","00093078701","ATENOLOL","25MG","180","Select","Select",""],["","75854031230","PRENATE","","30","Select","Select",""],["","55111014512","FLUCONAZOLE","150MG","2","Select","Select",""],["","66993001968","ALBUTEROL","HFA","18","Select","Select",""],["","59310057922","PROAIR","","8","Select","Select",""],["","00245010811","FERROUS","325MG EC","30","Select","Select",""],["","80681013800","CALCIUM\/D3","600MG","60","Select","Select",""],["","00904645780","DOK","100MG","30","Select","Select",""],["","74300000301","DESITIN","13%","113","Select","Select",""],["","76385012350","METHOCARBAM","500MG","20","Select","Select",""],["","10702001850","OXYCODONE","5MG","15","Select","Select",""],["","71288041081","ENOXAPARIN","30\/0.3ML","2","Select","Select",""],["","42858010250","OXYCOD\/APAP","5-325MG","30","Select","Select",""],["","00904759080","FEROSUL","325MG","30","Select","Select",""],["","65162046650","IBUPROFEN","800MG","30","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","",""],["No","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["Yes","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":""}]}]}