{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SONYA PARSON","gend":1,"add":"116 DOOLITTLE RD APT 14","city":"HAMPTON","state":"VA","zip":"23669-9998","dob":"1975-06-17","age":"","mstatus":"","insh":"20033156*01","cliId":"","pno":"757\/604-9951","cno":"757\/897-2368","email":"","ename":"","eno":"","pphy":"GLAVE, KRISTLE M NP","ppno":"757\/736-3700","pcpadd":"2104 EXECUTIVE DR","pcpcity":"HAMPTON","pcpstate":"VA","pcpzip":23666,"pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Family Medicine Physicians - Peninsula Towne","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/827-9978","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F31.78","F31.60","U07.1","F31.62","Z01.419","Z12.31","R35.0","R19.00","D25.1","N95.1","E11.9","Z13.89","Z68.36","E66.9","Z12.4","Z12.39","R93.89","N88.2","D25.9","N92.1","F31.9","N39.41","R31.29","R82.90","Z01.812","Z20.828","K60.3","R06.00","R00.0","J30.89","R09.81","J02.9","Z03.818","L30.9","L21.9","K60.2","F41.9","F32.9","Z01.810","L81.4","F31.32","Z11.59","D41.10","K14.0","E11.65","K21.9","E66.01","Z13.220","M35.00","R76.8","M47.816","L24.9","F31.30","M25.551","R10.9","I36.1","Z00.00","N30.01","R39.15","R68.2","R30.0","R11.0","Z68.38","R45.89","R45.0","R73.9","F40.10","R14.0","J30.2","Z76.89","N39.0","Z71.3","M54.17","N89.8","M54.32","M54.16","M54.5","M51.36","G89.29","K59.00","H61.23","M54.9","B37.3","L02.411","L03.90","L03.91","Z79.899","Z79.84","R19.09","N39.498","Z90.710","N94.89","J00.","Z20.822","D25.0","D25.2","R10.31"],"date":["2022-10-26","2020-09-20","2020-07-27","2022-01-25","2021-08-31","2021-08-31","2021-11-03","2021-11-03","2022-01-11","2022-03-17","2022-08-10","2020-01-27","2020-01-27","2020-01-27","2020-07-06","2020-07-06","2022-01-11","2022-01-11","2022-01-11","2021-11-18","2022-08-10","2021-12-22","2021-12-22","2021-12-22","2020-11-16","2020-11-16","2020-11-19","2020-12-17","2020-12-17","2021-08-27","2021-08-27","2022-07-13","2020-08-12","2020-09-03","2020-09-03","2020-11-19","2022-08-10","2020-11-19","2021-12-16","2020-02-05","2020-03-27","2020-08-12","2020-03-06","2021-06-30","2021-11-23","2022-08-10","2021-11-23","2021-11-23","2021-12-20","2021-12-20","2021-12-20","2020-01-17","2020-01-02","2020-03-02","2020-03-02","2020-05-15","2021-07-22","2021-07-22","2021-07-22","2021-07-22","2020-02-12","2020-02-12","2020-03-06","2021-04-30","2021-04-30","2021-04-30","2021-06-30","2021-06-30","2021-06-30","2021-06-30","2021-09-15","2019-03-11","2019-07-18","2022-08-10","2019-07-16","2019-09-09","2019-08-09","2019-09-09","2019-09-09","2019-09-16","2019-01-10","2019-04-24","2019-08-03","2019-01-09","2019-01-21","2019-01-21","2022-08-10","2022-08-10","2022-08-10","2022-03-17","2022-03-17","2022-09-01","2022-07-13","2022-07-13","2022-01-11","2022-01-11","2022-01-11"],"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":[["","60505384901","CELECOXIB","CAP 200MG","2","Select","Select",""],["","50742050504","SCOPOLAMINE","DIS 1MG\/3DAY","1","Select","Select",""],["","51991029301","OXCARBAZEPIN","TAB 300MG","62","Select","Select",""],["","00093816501","QUETIAPINE","TAB 400MG","31","Select","Select",""],["","23155013525","DOXYCYC","TAB 100MG","14","Select","Select",""],["","69097094312","GABAPENTIN","CAP 300MG","30","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","15","Select","Select",""],["","45802065078","LORATADINE","TAB 10MG","30","Select","Select",""],["","45802048678","DOCUSATE","CAP 100MG","60","Select","Select",""],["","69097083412","SERTRALINE","TAB 50MG","31","Select","Select",""],["","75826011410","PHENAZOPYRID","TAB 100MG","1","Select","Select",""],["","65862039110","ONDANSETRON","TAB 8MG ODT","10","Select","Select",""],["","69452015020","VALPROIC","CAP 250MG","155","Select","Select",""],["","51672130406","TERCONAZOLE","CRE 0.004","45","Select","Select",""],["","55111015810","OMEPRAZOLE","CAP 20MG","90","Select","Select",""],["","70377002811","ATORVASTATIN","TAB 20MG","30","Select","Select",""],["","67877056110","METFORMIN","TAB 500MG","30","Select","Select",""],["","00781716783","ESTRADIOL","DIS 0.1MG","8","Select","Select",""],["","67877032005","IBUPROFEN","TAB 600MG","21","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","6","Select","Select",""],["","70710113908","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","57599000101","FREESTYLE    KIT SENSOR","KIT SENSOR","6","Select","Select",""],["","80777027399","MODERNA","INJ COVID-19","0","Select","Select",""],["","00135061503","FLONASE","SUS 27.5MCG","18","Select","Select",""],["","","TRIAMCINOLON","CRE 0.001","","Select","Select",""],["","","KETOCONAZOLE","CRE 0.02","","Select","Select",""],["","55299060104","MOI-STIR","SOL ","240","Select","Select",""],["","66689000816","NYSTATIN","SUS 100000","100","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","59762500801","MISOPROSTOL","TAB 200MCG","2","Select","Select",""],["","57599000200","FREESTYLE    MIS READER","MIS READER","1","Select","Select",""],["","00074364103","LUPRON","INJ 3.75MG","1","Select","Select",""],["","59651022401","PILOCARPINE","TAB 5MG","90","Select","Select",""],["","","CETIRIZINE","TAB 10MG","","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","14","Select","Select",""],["","","FLUTICASONE","SPR 50MCG","","Select","Select",""],["","","ROBIT","LIQ 20-200SF","","Select","Select",""],["","","BENZONATATE","CAP 100MG","","Select","Select",""],["","","OXYCOD\/APAP","TAB 5-325MG","","Select","Select",""],["","","FLUZONE","INJ 2020-21","","Select","Select",""],["","","FLUCLVX","INJ 2020-21","","Select","Select",""],["","74300049254","BENGAY","GEL THERAPY","113","Select","Select",""],["","00603188016","LIDOCAINE","PAD 0.05","15","Select","Select",""],["","59779010112","PAIN","TAB 500MG","30","Select","Select",""],["","00172392670","DIAZEPAM","TAB 5MG","2","Select","Select",""],["","00591565810","CYCLOBENZAPR","TAB 10MG","15","Select","Select",""],["","50742018921","METHYLPRED","TAB 4MG","21","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":""}]}]}