{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DEAUDREY MYERS","gend":1,"add":"1123 QUASH ST","city":"HAMPTON","state":"VA","zip":"23669-9998","dob":"1955-08-26","age":"","mstatus":"","insh":"20032619*01","cliId":"","pno":"757\/265-4320","cno":"","email":"","ename":"","eno":"","pphy":"HUSEN, SRIE D MD","ppno":"757\/594-1850","pcpadd":"STE 100 11803 JEFFERSON AVE","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":23606,"pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Family Medicine Physicians - Port Warwick","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/594-1841","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R07.9","R06.09","I34.0","M54.16","M51.36","G89.29","Z20.828","D86.9","M25.531","I10.","E78.2","G56.03","E55.9","M25.532","K21.9","R13.10","E66.9","J45.909","M65.4","M18.0","M19.031","M19.032","Z71.3","Z00.00","J98.4","Z13.220","Z11.59","G56.01","J45.40","J10.1","M79.652","S76.111A","R06.02","Z79.51","Z79.899","R09.89","M25.512","M54.42","I34.1","J20.9"],"date":["2020-03-24","2020-03-24","2020-03-24","2021-05-17","2021-04-30","2021-04-30","2021-09-30","2021-03-29","2019-05-09","2021-02-24","2021-02-24","2019-05-09","2021-02-24","2019-05-09","2020-06-05","2020-06-05","2021-03-29","2020-06-05","2020-02-25","2019-05-29","2019-05-29","2019-05-29","2020-02-25","2021-02-24","2021-03-29","2021-02-24","2019-10-01","2019-10-01","2021-03-30","2020-02-25","2021-07-29","2021-07-29","2019-02-25","2019-02-25","2019-02-25","2021-02-24","2021-02-24","2021-09-07","2020-03-10","2021-09-30"],"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":[["","69097052444","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","","AMLODIPINE"," AMLODIPINE ","30","Select","Select",""],["","","SIMVASTATIN"," SIMVASTATIN ","30","Select","Select",""],["","52817033010","CYCLOBENZAPR","TAB 5MG","30","Select","Select",""],["","","OMEPRAZOLE"," OMEPRAZOLE ","30","Select","Select",""],["","","DULERA"," DULERA ","13","Select","Select",""],["","","LIDOCAINE"," LIDOCAINE ","30","Select","Select",""],["","","POT  CHLORIDE"," POT  CHLORIDE","30","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0","Select","Select",""],["","42806071401","BENZONATATE","CAP 100MG","28","Select","Select",""],["","","ACETAMINOPHE","TAB 650MG ER","","Select","Select",""],["","","MONTELUKAST"," MONTELUKAST ","30","Select","Select",""],["","68382091634","METHYLPRED","TAB 4MG","21","Select","Select",""],["","43598081115","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","","VITAMIN"," VITAMIN ","4","Select","Select",""],["","","PROAIR"," PROAIR ","8","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","","NITROGLYCERN"," NITROGLYCERN ","100","Select","Select",""],["","","OSELTAMIVIR","CAP 75MG","","Select","Select",""],["","","TYLENOL","TAB 650MG","","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":""}]}]}