{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"COREY   A REDCROSS SR","gend":0,"add":"1616 OAK AVE","city":"NEWPORT NEWS","state":"VA","zip":"23607-9998","dob":"1983-09-15","age":"","mstatus":"","insh":"20033805*01","cliId":"","pno":"757\/247-6697","cno":"","email":"","ename":"","eno":"","pphy":"JORDAN, JASMINE A NP","ppno":"757\/594-1850","pcpadd":"11803 JEFFERSON AVE STE 100","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\/510-9223","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M86.19","B95.4","B96.20","Z16.12","L89.314","L89.154","M86.10","N30.00","D63.8","L89.94","I10.","R32.","R15.9","R39.81","F32.9","R41.82","L89.894","A41.51","E43.","M86.18","T83.511A","K59.2","G82.20","A41.59","B96.4","E83.42","E87.6","D50.9","N31.9","M86.8X0","Z76.89","Z78.9","L89.304","D64.9","Z13.1","E55.9","L89.219","F17.200","F17.210","R53.1","R53.83","F29.","L89.319","L08.9","Z72.0","Z79.2","L89.214","B96.89","B96.5","Z86.718","Z79.01","Z99.3","Z00.00","M25.512","N52.8","M62.838","G43.709","A41.9","T81.41XA","T83.518A","B96.29","R53.81","G43.909","M86.9","T14.8XXA","M86.651","M86.8X9"],"date":["2020-09-10","2020-09-11","2020-09-11","2020-09-10","2020-09-11","2020-09-24","2020-10-02","2020-09-30","2020-09-29","2020-09-30","2021-08-02","2021-12-28","2021-12-28","2021-12-28","2020-01-24","2020-01-22","2021-12-28","2020-09-01","2020-09-04","2020-09-11","2020-09-01","2020-09-01","2021-12-28","2020-09-01","2020-09-11","2020-10-05","2020-10-05","2020-09-01","2021-12-28","2021-12-28","2021-08-02","2021-08-02","2021-08-02","2021-08-02","2021-08-02","2021-08-02","2021-08-02","2020-04-05","2020-09-04","2020-09-01","2020-09-01","2020-01-22","2020-09-07","2020-09-07","2020-09-29","2020-09-11","2020-09-11","2020-09-11","2020-09-11","2020-10-01","2020-09-11","2020-09-11","2019-08-29","2019-08-29","2019-08-29","2020-01-29","2020-01-30","2020-09-11","2020-09-01","2020-09-11","2020-09-07","2020-10-02","2019-08-20","2020-10-05","2020-09-28","2020-09-28","2020-10-02"],"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":[]},{"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":[["","10939086944","VITAMIN","CAP 5000UNIT","12","Select","Select",""],["","00591565810","CYCLOBENZAPR","TAB 10MG","30","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","43547036009","LOSARTAN","TAB 25MG","30","Select","Select",""],["","16252051605","CIPROFLOXACN","TAB 750MG","28","Select","Select",""],["","65162055310","METAXALONE","TAB 800MG","20","Select","Select",""],["","00093534156","SILDENAFIL","TAB 25MG","10","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":""}]}]}