{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MONIQUE   S SAWYER","gend":1,"add":"337 N FIFTH ST","city":"SUFFOLK","state":"VA","zip":"23434-9998","dob":"1987-09-04","age":"","mstatus":"","insh":"1908608*01","cliId":"","pno":"757\/353-1562","cno":"","email":"","ename":"","eno":"","pphy":"WILLIAMS, LINDSEY M PA","ppno":"757\/983-8650","pcpadd":"2760 GODWIN BLVD STE 100","pcpcity":"SUFFOLK","pcpstate":"VA","pcpzip":23434,"pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Family Medicine & Walk-In - Suffolk","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/983-8673","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G43.019","O99.891","N85.9","O30.003","Z3A.35","R58.","R53.81","O26.891","R10.9","Z3A.01","O34.211","V23.5","Z3A.37","Z37.2","L70.0","J06.9","Z32.01","Z20.822","O20.9","R10.10","Z87.59","Z91.048","Z88.2","Z88.8","Z91.041","R10.30","O32.1XX0","V91.03","Z01.812","O34.219","O99.214","Z37.9","E66.01","B97.89","G47.33","G43.009","E66.9","G47.00","O23.592","O26.892","R07.9","Z3A.18","M54.89","O99.519","Z3A.00","Z88.6","J02.9","S01.112A","G60.3","O23.591","B96.89","O30.001","R10.2","Z82.49","Z83.3","M54.16","F41.1","O21.0","O99.011","Z3A.10","M79.604","Z36.9","F32.9","N92.6","K21.9","M79.652","M79.651","D50.9","Z11.4","Z11.3","J30.9","R52.","G44.219","M62.838","F41.9","O23.599","O26.899","Z23.","Z3A.32","V23.89","R07.81","R51.9","Z72.820","O26.851"],"date":["2020-01-16","2021-10-01","2021-03-11","2021-03-11","2021-03-11","2021-10-01","2021-10-01","2020-08-18","2020-08-18","2021-10-01","2021-03-22","2021-03-22","2021-03-22","2021-03-22","2021-06-02","2021-09-20","2021-09-28","2021-09-20","2021-10-01","2021-10-01","2021-10-01","2021-10-01","2021-10-01","2021-10-01","2021-10-01","2021-10-01","2021-03-22","2021-03-22","2021-03-22","2021-03-22","2021-03-22","2021-03-22","2021-03-22","2019-09-19","2020-02-19","2020-02-19","2020-02-19","2020-02-19","2020-11-10","2020-11-10","2020-11-10","2020-11-10","2021-01-12","2021-09-20","2021-09-20","2021-09-20","2021-09-20","2021-12-02","2020-01-16","2020-08-18","2020-08-18","2020-08-18","2020-08-18","2020-08-18","2020-08-18","2020-01-21","2020-01-21","2020-09-14","2020-09-14","2020-09-14","2020-11-10","2021-09-28","2019-08-14","2019-03-08","2019-03-08","2019-03-08","2019-03-08","2019-03-08","2019-03-08","2019-03-08","2019-03-08","2019-04-25","2019-08-14","2019-08-14","2019-08-14","2020-08-17","2020-08-17","2021-02-17","2021-02-17","2021-02-17","2021-06-15","2021-06-15","2021-06-15","2021-10-01"],"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":[]},{"a":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"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":[["","","FEROSUL"," FEROSUL ","30","Select","Select",""],["","","PRENATAL","TAB 27-0.8MG","","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","24","Select","Select",""],["","57896044305","BISACODYL","SUP 10MG","16","Select","Select",""],["","","CETIRIZINE","TAB 10MG","","Select","Select",""],["","","VALACYCLOVIR"," VALACYCLOVIR ","30","Select","Select",""],["","00642747001","SLYND","TAB 4MG","28","Select","Select",""],["","00045044902","TYLENOL","TAB 500MG","20","Select","Select",""],["","63323060788","ENOXAPARIN","INJ 60\/0.6ML","8","Select","Select",""],["","","FERROUS"," FERROUS ","30","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","45802065087","LORATADINE","TAB 10MG","28","Select","Select",""],["","","METRONIDAZOL"," METRONIDAZOL ","14","Select","Select",""],["","","ONDANSETRON"," ONDANSETRON ","30","Select","Select",""],["","00904645780","DOK","CAP 100MG","60","Select","Select",""],["","00378808220","TRETINOIN","CRE 0.00025","20","Select","Select",""],["","","DOXYCYCL","CAP 100MG","","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8","Select","Select",""],["","65862050220","AMOX\/K","TAB 500-125","20","Select","Select",""],["","","MONTELUKAST"," MONTELUKAST ","30","Select","Select",""],["","76282021318","SERTRALINE","TAB 50MG","30","Select","Select",""],["","","GABAPENTIN","TAB 600MG","","Select","Select",""],["","","DOXYL\/PYRID","TAB 10-10MG","","Select","Select",""],["","","PNV","TAB PLUS","","Select","Select",""],["","","PROMETHAZINE","TAB 12.5MG","","Select","Select",""],["","","DICLEGIS","TAB 10-10MG","","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":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"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":""}]}]}