{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SHAYLA   R KNIGHT","gend":1,"add":"400 W 26TH ST APT C","city":"NORFOLK","state":"VA","zip":23507,"dob":"1989-01-26","age":"","mstatus":"","insh":"2966336*01","cliId":"","pno":"757\/738-8609","cno":"757\/738-8609","email":"","ename":"","eno":"","pphy":"WHALEN, RICHARD M MD","ppno":"757\/446-5955","pcpadd":"SUITE 118 825 FAIRFAX AVE","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23507,"pcpcounty":"","pcpid":100070,"pcpname":"EVMS Ghent Family Medicine","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/446-5242","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F31.9","F41.1","F90.0","F33.1","R51.","F41.9","F32.9","J45.909","M25.512","M54.2","G44.89","S16.1XXA","R56.9","S29.019A","M54.12","M54.6","R41.3","Z00.00"],"date":["2021-09-23","2020-09-23","2020-09-23","2020-06-13","2020-08-13","2021-09-23","2021-09-23","2020-06-02","2020-08-13","2020-08-13","2021-05-17","2021-05-17","2020-12-17","2021-03-25","2021-03-25","2021-05-17","2021-05-17","2021-09-23"],"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":[["","31722082030","ARIPIPRAZOLE ","5MG","30","Select","Select",""],["","45802005911","NYSTATIN ","100000","30","Select","Select",""],["","00093101042","MUPIROCIN ","2%","22","Select","Select",""],["","68180044101","CEPHALEXIN ","250\/5ML","100","Select","Select",""],["","68462022301","LITHIUM ","300MG ER","60","Select","Select",""],["","51672413001","LAMOTRIGINE ","25MG","42","Select","Select",""],["","16714079801","SUMATRIPTAN ","100MG","20","Select","Select",""],["","60432026415","FLUTICASONE ","50MCG","16","Select","Select",""],["","68462019001","NAPROXEN ","500MG","60","Select","Select",""],["","11822312760","LORATADINE ","10MG","30","Select","Select",""],["","59746017306","PREDNISONE ","10MG","42","Select","Select",""],["","16714069801","VALACYCLOVIR ","500MG","90","Select","Select",""],["","55111015430","ONDANSETRON ","8MG","40","Select","Select",""],["","69097012203","TOPIRAMATE ","25MG","30","Select","Select",""],["","65162046510","IBUPROFEN ","600MG","60","Select","Select",""],["","59746021106","CYCLOBENZAPR ","5MG","20","Select","Select",""],["","68462022301","LITHIUM","300MG ER","60","Select","Select",""],["","45802005935","NYSTATIN","100000","30","Select","Select",""],["","31722082030","ARIPIPRAZOLE","5MG","30","Select","Select",""],["","00093101042","MUPIROCIN","2%","22","Select","Select",""],["","67877054588","CEPHALEXIN","250\/5ML","100","Select","Select",""],["","51672413001","LAMOTRIGINE","25MG","42","Select","Select",""],["","16714069801","VALACYCLOVIR","500MG","90","Select","Select",""],["","68462019001","NAPROXEN","500MG","60","Select","Select",""],["","60432026415","FLUTICASONE","50MCG","16","Select","Select",""],["","00781317007","SUMATRIPTAN","4MG\/0.5","5","Select","Select",""],["","11822312760","LORATADINE","10MG","30","Select","Select",""],["","55111015430","ONDANSETRON","8MG","40","Select","Select",""],["","69097012203","TOPIRAMATE","25MG","30","Select","Select",""],["","65162046510","IBUPROFEN","600MG","60","Select","Select",""],["","59746017306","PREDNISONE","10MG","42","Select","Select",""],["","59746021106","CYCLOBENZAPR","5MG","20","Select","Select",""],["","31722099601","HYDROCO\/APAP","5-325MG","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","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["No","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":""}]}]}