{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ANTHONY   G ZOLLO","gend":0,"add":"1846 E LITTLE CREEK RD LOT 20","city":"NORFOLK","state":"VA","zip":"23518-9998","dob":"1962-07-06","age":"","mstatus":"","insh":"20038406*01","cliId":"","pno":"757\/502-5336","cno":"","email":"","ename":"","eno":"","pphy":"LAYNE, MICHAEL MD","ppno":"757\/446-5955","pcpadd":"825 FAIRFAX AVE SUITE 118","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23507,"pcpcounty":"","pcpid":"","pcpname":"EVMS Ghent Family Medicine","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/446-5196","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["C20.","L60.3","R51.","Z23.","Z93.3","M79.89","F41.9","F10.10","Z85.038","K94.09","R10.32","R19.01","M25.551","F17.210","Z92.21","Z86.73","Z87.19","Z88.1","Z88.5","Z91.09","K59.00","Z43.3","R06.02","Z20.828","R05.","Z20.822","NO DATA","Z91.048","Z88.8","K43.5","Z82.49","Z80.9","Z83.3","Z85.048","M54.16","Z72.0","R10.9","R14.0","Z01.810","Z01.812","I45.10","M79.651","K56.600","G89.29","R22.41","R11.2","E66.9","L57.0","S06.0X9A","G44.329","R41.2","E87.6","K56.609","Z13.31","K90.9","G47.00","G57.00","K21.9","M19.90","H54.7","K66.8","Z80.3","Z79.82","Z79.899","F17.200","D17.23"],"date":["2019-08-26","2019-02-15","2019-02-15","2021-09-20","2021-12-21","2019-11-20","2021-12-28","2021-12-28","2019-11-05","2019-08-13","2021-06-12","2019-08-19","2019-11-05","2021-12-13","2019-11-05","2021-12-13","2019-11-05","2021-12-13","2021-12-13","2021-12-13","2020-05-19","2020-05-19","2020-05-19","2020-05-19","2021-04-06","2021-04-06","2021-12-13","2021-06-09","2021-06-09","2021-06-12","2021-12-13","2021-06-09","2021-12-13","2021-12-13","2021-11-18","2021-11-18","2021-10-31","2021-06-10","2021-12-09","2021-12-09","2021-12-09","2019-11-11","2021-06-08","2021-10-31","2020-01-09","2021-06-09","2021-09-20","2021-09-20","2019-02-13","2019-02-13","2019-02-13","2019-03-01","2021-06-12","2019-07-24","2019-07-24","2021-03-23","2021-03-23","2021-12-13","2021-12-13","2021-12-13","2021-12-13","2021-12-13","2021-12-13","2021-12-13","2019-08-26","2020-01-09"],"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":[["","60505265401","TRAZODONE","TAB 100MG","30","Select","Select",""],["","70700026390","LANSOPRAZOLE","CAP 30MG DR","180","Select","Select",""],["","65162006205","SUCRALFATE","SUS 1GM\/10ML","1800","Select","Select",""],["","75834002012","VITAMIN","CAP 50000UNT","12","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","60505006501","OMEPRAZOLE","CAP 20MG","90","Select","Select",""],["","69097014260","ALBUTEROL","AER HFA","7","Select","Select",""],["","70954005920","PREDNISONE","TAB 10MG","30","Select","Select",""],["","","OXYCODONE","TAB 5MG","","Select","Select",""],["","00363193112","MILK","SUS 400\/5ML","710","Select","Select",""],["","43598044556","NICOTINE","KIT TRANSDER","56","Select","Select",""],["","00363023820","STOOL","CAP 100MG","60","Select","Select",""],["","00904699860","DOCUSATE","CAP 100MG","60","Select","Select",""],["","42806071501","BENZONATATE","CAP 200MG","30","Select","Select",""],["","00085113204","PROVENTIL","AER HFA","7","Select","Select",""],["","37864087006","SIMETHICONE","CHW 125MG","90","Select","Select",""],["","","AMOXICILLIN","CAP 500MG","","Select","Select",""],["","","HYDROCO\/APAP","TAB 7.5-325","","Select","Select",""],["","","CLINDAMYCIN","CAP 150MG","","Select","Select",""],["","","OXYCOD\/APAP","TAB 5-325MG","","Select","Select",""],["","","TRAMADOL","TAB 50MG","","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":""}]}]}