{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JESSICA   A WALKER","gend":1,"add":"213 PRESERVATION REACH","city":"CHESAPEAKE","state":"VA","zip":"23320-9998","dob":"1979-11-17","age":"","mstatus":"","insh":"1931698*01","cliId":"","pno":"757\/777-4780","cno":"","email":"","ename":"","eno":"","pphy":"CHOI, HINSING STEVEN MD","ppno":"757\/261-5910","pcpadd":"SUITE 200A 850 KEMPSVILLE RD","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23502,"pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Internal Medicine Physicians - Kempsville","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/275-9961","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M71.30","M54.17","R20.2","Z00.00","J45.21","Z12.11","J30.89","G43.709","K57.30","M67.471","I45.10","R00.2","R94.31","J34.3","J30.1","K21.9","F45.8","R13.19","R09.89","Z91.018","L30.4","M54.2","N62.","M25.519","M54.6","M54.9","M95.4","Z01.818","M79.671","M79.89","Z20.828","J30.2","R22.40","R53.82","R68.83","R11.0","J06.9","V58.89","J45.20","K59.01","J45.40","S43.015A","N94.10","Z01.419","Z12.39","R10.2","B37.2"],"date":["2020-07-08","2020-07-08","2020-07-08","2021-08-10","2021-07-23","2021-08-10","2020-07-17","2021-08-10","2021-08-10","2021-03-17","2020-09-24","2020-10-22","2020-09-24","2021-07-14","2021-08-10","2021-07-14","2021-07-14","2021-07-14","2021-07-14","2021-07-14","2021-11-04","2021-08-25","2021-12-10","2021-08-25","2021-08-25","2021-08-25","2021-08-25","2020-08-19","2021-03-17","2020-08-18","2021-02-24","2021-05-28","2020-08-12","2021-02-26","2021-02-26","2021-02-26","2021-02-26","2021-12-10","2021-12-10","2021-08-10","2021-08-10","2021-10-23","2019-05-30","2019-06-17","2019-06-17","2019-06-17","2019-12-09"],"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":[["","","MONTELUKAST"," MONTELUKAST ","90","Select","Select",""],["","","PROAIR"," PROAIR ","8","Select","Select",""],["","60505083001","MOMETASONE","SPR 50MCG","17","Select","Select",""],["","","KETOCONAZOLE"," KETOCONAZOLE ","30","Select","Select",""],["","","ALBUTEROL"," ALBUTEROL ","13","Select","Select",""],["","","ADVAIR"," ADVAIR ","60","Select","Select",""],["","59267100002","PFIZER","INJ COVID-19","0","Select","Select",""],["","62175011843","OMEPRAZOLE","CAP 20MG","60","Select","Select",""],["","65862014836","SUMATRIPTAN","TAB 100MG","9","Select","Select",""],["","68462015305","TOPIRAMATE","TAB 50MG","60","Select","Select",""],["","","HYDROCO\/APAP","TAB 5-325MG","","Select","Select",""],["","00472037915","CLOTRIM\/BETA","CRE DIPROP","45","Select","Select",""],["","","PARI","MIS NEBULIZR","","Select","Select",""],["","","VIOS","MIS SYSTEM","","Select","Select",""],["","","NYSTAT\/TRIAM","CRE ","","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":""}]}]}