{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LIZA FIGARI","gend":1,"add":"3306 HORNSEA ROAD","city":"CHESAPEAKE","state":"VA","zip":"23325-9998","dob":"1981-10-11","age":"","mstatus":"","insh":"1934059*01","cliId":"","pno":"757\/404-5800","cno":"","email":"","ename":"","eno":"","pphy":"BELARDO, BETYSHIA J MD","ppno":"757\/413-7600","pcpadd":"STE 301 5320 PROVIDENCE RD","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":23464,"pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Family Medicine Physicians - Providence Road","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/413-7601","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["L70.0","L23.9","D48.5","Z01.419","Z30.41","N81.4","N81.10","N81.6","F34.1","F41.1","R10.31","R16.0","K76.0","K42.9","S05.90XA","D22.39","L70.5","D49.2","Z00.00","Z23.","Z76.89","G81.90","R42.","R55.","M51.26","NO DATA","Z91.81","E66.01","E78.5","N64.4","S00.83XA","S05.12XA","L20.9","L81.2","D22.5","J40.","L57.8","L40.0","F44.4","J45.30","L50.0","J30.89","J30.81","J30.1","R20.2","W19.XXXD","F43.10","S01.302A","R40.4","S01.312A","Z48.02","M79.672"],"date":["2021-06-01","2021-06-01","2021-04-07","2021-04-30","2021-04-30","2021-04-30","2021-04-30","2021-04-30","2021-11-22","2021-11-22","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2020-02-03","2021-06-01","2021-06-01","2021-06-01","2021-10-13","2021-10-13","2021-10-13","2021-10-13","2021-10-13","2021-10-13","2021-10-13","2021-10-13","2021-10-13","2021-10-13","2021-10-13","2021-10-13","2020-02-03","2020-02-03","2021-01-06","2021-01-06","2021-01-06","2020-03-05","2020-09-08","2020-09-08","2019-01-02","2019-01-04","2019-01-04","2019-01-04","2019-01-04","2019-01-04","2019-05-17","2019-05-17","2019-06-07","2019-01-08","2019-04-24","2019-01-04","2019-01-04","2021-07-19"],"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":[["","59762374401","CLINDAMYCIN","LOT 10MG\/ML","60","Select","Select",""],["","16729017001","ESCITALOPRAM","TAB 20MG","30","Select","Select",""],["","16714040604","LARIN","TAB 44581","84","Select","Select",""],["","80777027398","MODERNA","INJ COVID-19","0","Select","Select",""],["","50222021160","PROTOPIC","OIN 0.001","60","Select","Select",""],["","68462060965","PIMECROLIMUS","CRE 0.01","60","Select","Select",""],["","68462053465","TACROLIMUS","OIN 0.001","60","Select","Select",""],["","72647033104","METHYLPRED","TAB 4MG","21","Select","Select",""],["","65162003310","APAP\/CODEINE","TAB 300-30MG","24","Select","Select",""],["","51672129802","KETOCONAZOLE","CRE 0.02","30","Select","Select",""],["","16714043901","NITROFURANTN","CAP 100MG","20","Select","Select",""],["","70010077001","METHOCARBAM","TAB 750MG","30","Select","Select",""],["","67877021901","CEPHALEXIN","CAP 500MG","14","Select","Select",""],["","","CLOBETASOL","OIN 0.0005","","Select","Select",""],["","00472011745","TRETINOIN","CRE 0.00025","45","Select","Select",""],["","65162046650","IBUPROFEN","TAB 800MG","21","Select","Select",""],["","","HYDROCO\/APAP","TAB 5-325MG","","Select","Select",""],["","","DOXYCYCL","CAP 100MG","","Select","Select",""],["","","PREDNISONE","TAB 20MG","","Select","Select",""],["","","FLUCLVX","INJ 2020-21","","Select","Select",""],["","58160089652","FLUARIX","INJ 2019-20","0","Select","Select",""],["","43547034506","LEVETIRACETA","TAB 500MG ER","30","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":""}]}]}