{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JENIPHER WARNER","gend":1,"add":"108 W 28TH ST APT B","city":"NORFOLK","state":"VA","zip":"23504-9998","dob":"1976-01-14","age":"","mstatus":"","insh":"20039797*01","cliId":"","pno":"434\/546-7954","cno":"757\/217-7715","email":"","ename":"","eno":"","pphy":"HUMADI, SAHIRA 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":["F32.9","R23.2","Z30.09","L30.4","G89.4","M43.06","H40.033","H35.09","D31.32","H25.13","H16.223","L91.8","L81.4","I83.93","I50.9","D50.9","I10.","Z23.","G47.00","G43.909","G25.81","Z01.419","Z11.3","Z97.5","M17.12","F32.1","F41.9","F43.22","R63.4","E55.9","J45.909","Z30.46","M50.20","M47.26","G43.109","N93.9","M47.814","M62.830","R07.89","M51.26","M54.16","M54.5","M54.2","M25.562","Z79.899","M54.12","M47.816","NO DATA","Z30.2","M53.3","M51.36","G47.9","Z01.818","L30.9","Z01.810","I42.8","I50.22","J45.20","E66.01","Z68.36","N31.9","I42.9","M79.7","Z86.718","D53.9","E07.9","Z68.41","M19.90","Z90.3","Z87.891","Z79.890","Z01.812","Z20.828","Z98.84","M94.262","M17.0","N39.46","R35.0","F41.8","M54.17","M46.1","J02.9","R05.","J30.9","M47.817","M54.81","H92.09","J11.1","J06.9","R07.9","N81.10","K59.09","K91.2"],"date":["2021-08-09","2020-01-21","2021-03-16","2020-12-01","2021-12-06","2020-08-27","2021-10-04","2020-10-01","2021-10-04","2021-10-04","2021-10-04","2020-12-01","2020-12-01","2020-12-01","2021-12-06","2021-05-20","2020-12-04","2021-09-20","2021-01-08","2021-01-08","2021-01-08","2021-02-18","2021-02-18","2021-02-18","2021-10-01","2021-11-30","2021-12-14","2020-02-28","2020-03-04","2021-09-20","2021-12-06","2021-03-16","2021-07-13","2021-12-06","2021-04-23","2020-03-06","2021-12-06","2021-02-04","2021-02-04","2021-11-15","2021-11-15","2021-09-13","2021-11-15","2021-11-15","2021-11-15","2021-11-15","2021-12-06","2021-12-06","2020-02-20","2020-03-17","2020-03-17","2020-07-24","2021-11-22","2021-11-22","2020-08-21","2021-10-08","2021-08-27","2021-08-27","2021-12-06","2020-08-21","2021-05-12","2021-12-06","2021-12-06","2021-12-06","2021-12-06","2021-12-06","2021-12-06","2021-12-06","2021-12-06","2021-12-06","2021-12-06","2020-08-15","2020-08-15","2021-01-22","2021-10-01","2020-02-10","2021-03-01","2021-03-01","2021-06-07","2019-07-12","2019-10-15","2019-12-05","2019-12-05","2019-07-09","2019-03-29","2019-03-29","2019-07-09","2019-12-16","2019-12-16","2019-07-31","2019-02-13","2019-04-29","2019-05-28"],"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":[["","00469260230","MYRBETRIQ","TAB 50MG","30","Select","Select",""],["","51672300302","HYDROCORT","CRE 0.025","28","Select","Select",""],["","50428027684","MELATONIN","TAB 5MG","30","Select","Select",""],["","","UBRELVY","TAB 50MG","","Select","Select",""],["","00168084401","DICLOFENAC","GEL 0.03","100","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","120","Select","Select",""],["","00002143611","EMGALITY","INJ 120MG\/ML","1","Select","Select",""],["","00071101368","LYRICA","CAP 50MG","60","Select","Select",""],["","75834002001","VITAMIN","CAP 50000UNT","4","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","71093014105","METHOCARBAM","TAB 750MG","90","Select","Select",""],["","00378021610","FUROSEMIDE","TAB 40MG","30","Select","Select",""],["","50742061510","METOPROL","TAB 25MG ER","90","Select","Select",""],["","69097096507","NABUMETONE","TAB 500MG","90","Select","Select",""],["","69097012303","TOPIRAMATE","TAB 50MG","270","Select","Select",""],["","43598029290","PREGABALIN","CAP 50MG","60","Select","Select",""],["","52565000814","LIDOCAINE","OIN 0.05","35","Select","Select",""],["","50111056001","TRAZODONE","TAB 50MG","90","Select","Select",""],["","53191036201","D3-50","CAP 50000UNT","4","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","00093321992","KETOCONAZOLE","CRE 0.02","60","Select","Select",""],["","","ESCITALOPRAM","TAB 10MG","","Select","Select",""],["","","NARCAN","SPR ","","Select","Select",""],["","","PROVENTIL","AER HFA","","Select","Select",""],["","64380078706","BUSPIRONE","TAB 7.5MG","60","Select","Select",""],["","65862048901","QUETIAPINE","TAB 25MG","30","Select","Select",""],["","00115169449","EPINEPHRINE","INJ 0.3MG","2","Select","Select",""],["","59779030602","CVS","POW 3350","238","Select","Select",""],["","76385011150","CARVEDILOL","TAB 6.25MG","45","Select","Select",""],["","00781711783","CALCIPOTRIEN","CRE 0.00005","240","Select","Select",""],["","","CEPHALEXIN","CAP 500MG","","Select","Select",""],["","00187099445","ZOVIRAX","CRE 0.05","5","Select","Select",""],["","00173068220","VENTOLIN","AER ","18","Select","Select",""],["","13811071530","VENLAFAXINE","TAB 225MG ER","30","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","","EPIPEN","INJ 0.3MG","","Select","Select",""],["","","ACYCLOVIR","CRE 0.05","","Select","Select",""],["","60505317007","OMEGA-3-ACID","CAP 1GM","360","Select","Select",""],["","45802048678","DOCUSATE","CAP 100MG","30","Select","Select",""],["","68308015260","NYSTATIN","POW 100000","30","Select","Select",""],["","00536100901","FERROUS","TAB 325MG","30","Select","Select",""],["","68134020116","NAPROXEN","SUS 125\/5ML","1000","Select","Select",""],["","40085071645","DOXEPIN","CRE 0.05","45","Select","Select",""],["","68462018135","CLOTRIMAZOLE","CRE 0.01","30","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","10","Select","Select",""],["","10702001150","HYDROXYZ","TAB 25MG","30","Select","Select",""],["","00832046530","NYAMYC","POW 100000","30","Select","Select",""],["","23155005901","VERAPAMIL","TAB 40MG","90","Select","Select",""],["","43386031208","GAVILAX","POW ","238","Select","Select",""],["","70710113908","FLUCONAZOLE","TAB 150MG","5","Select","Select",""],["","67877057505","BENZONATATE","CAP 200MG","60","Select","Select",""],["","68462050535","FLUOCINONIDE","CRE 0.001","120","Select","Select",""],["","70512003350","HALOBETASOL","OIN 0.0005","100","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":""}]}]}