{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MARNAY   L SYLVESTER","gend":1,"add":"4901 GRAND STRAND DR APT 104","city":"WILLIAMSBURG","state":"VA","zip":"23188-9998","dob":"1969-11-16","age":"","mstatus":"","insh":"20040182*01","cliId":"","pno":"757\/660-2847","cno":"","email":"","ename":"","eno":"","pphy":"NURU, YASMIN NP","ppno":"757\/345-4600","pcpadd":"STE 450 400 SENTARA CIR","pcpcity":"WILLIAMSBURG","pcpstate":"VA","pcpzip":"23188","pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Family & Internal Medicine Physicians - Williamsburg","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/345-4601","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G47.33","J44.9","E66.01","E11.40","F43.10","M48.02","M47.892","F39.","E11.42","E78.5","G43.829","M43.02","M47.816","M25.50","Z79.4","K04.7","R51.","E11.49","E11.65","L72.0","R91.8","Z23.","K21.9","Z12.11","Z20.828","D64.9","D72.829","D75.9","R06.02","J01.00","J45.40","NO DATA","Z12.31","F32.2","I51.89","I87.8","E11.9","F41.0","L24.89","L75.0","Q82.5","L82.1","D22.9","Z12.83","Z71.9","Z28.21","J98.11","E55.9","J30.9","A60.00","Z11.59","R94.2","J45.20","J30.89","G47.52","M54.12","Z00.00","K43.9","D72.820","F32.1","L72.3","R21.","L98.9"],"date":["2021-08-02","2021-08-02","2021-11-12","2021-04-14","2021-10-08","2020-05-27","2020-05-27","2021-11-29","2021-10-08","2021-08-05","2021-11-12","2021-08-05","2021-08-05","2021-11-12","2021-10-08","2020-04-21","2020-04-21","2021-08-02","2021-08-02","2020-07-01","2020-08-11","2021-10-08","2020-10-20","2020-10-20","2021-09-16","2020-03-02","2021-10-08","2020-03-02","2020-03-16","2021-06-10","2021-10-08","2021-10-08","2021-10-08","2021-01-21","2020-03-16","2020-03-16","2021-10-21","2020-01-21","2020-08-13","2020-08-13","2020-08-13","2020-08-13","2020-08-13","2020-08-13","2020-08-13","2020-08-13","2021-08-02","2021-08-02","2021-08-02","2021-04-14","2021-04-14","2021-08-02","2021-08-02","2021-08-02","2021-08-02","2020-04-09","2021-01-21","2021-01-21","2020-06-23","2020-06-23","2020-06-23","2020-06-23","2020-06-23"],"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":[["","45802000403","HYDROCORT","CRE 0.025","28","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","80777027398","MODERNA","INJ COVID-19","0","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","67877056310","METFORMIN","TAB 1000MG","60","Select","Select",""],["","68382003616","VENLAFAXINE","CAP 150MG ER","30","Select","Select",""],["","65862057490","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","70954001910","PRAZOSIN","CAP 1MG","30","Select","Select",""],["","68180016013","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","08290320550","BD  PEN NEEDL","MIS 32GX5\/32","100","Select","Select",""],["","08214090723",""," ","28","Select","Select",""],["","59651000305","OMEPRAZOLE","CAP 40MG","30","Select","Select",""],["","00185067405","HYDROXYZ","CAP 25MG","60","Select","Select",""],["","00093727098","PRAVASTATIN","TAB 80MG","30","Select","Select",""],["","00169406013","VICTOZA","INJ 18MG\/3ML","9","Select","Select",""],["","67877026218","RIZATRIPTAN","TAB 10MG","12","Select","Select",""],["","70710122501","AMITRIPTYLIN","TAB 10MG","30","Select","Select",""],["","00378932132","WIXELA","AER 250\/50","60","Select","Select",""],["","00173069600","ADVAIR","AER 250\/50","60","Select","Select",""],["","60505384901","CELECOXIB","CAP 200MG","30","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","48","Select","Select",""],["","53885027210","ONETOUCH","TES VERIO","300","Select","Select",""],["","70700011685","ALTAVERA","TAB ","28","Select","Select",""],["","31722070530","VALACYCLOVIR","TAB 1GM","10","Select","Select",""],["","68180051303","LISINOPRIL","TAB 5MG","30","Select","Select",""],["","71205026260","FLUTIC\/SALME","AER 250\/50","60","Select","Select",""],["","69097012303","TOPIRAMATE","TAB 50MG","30","Select","Select",""],["","00378064010","PREDNISONE","TAB 5MG","70","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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}