{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"QUATISHA   R WHITEHURST","gend":1,"add":"1129 GREEN ST APT 7","city":"NORFOLK","state":"VA","zip":"23513-9998","dob":"1986-12-18","age":"","mstatus":"","insh":"20041477*01","cliId":"","pno":"757\/930-9973","cno":"","email":"","ename":"","eno":"","pphy":"SANTACRUZ, NESTOR D MD","ppno":"757\/583-2181","pcpadd":"2203 E LITTLE CREEK RD","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23518,"pcpcounty":"","pcpid":"","pcpname":"Roosevelt Family Practice","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/480-6482","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M17.10","N30.00","G47.33","E66.01","F32.9","F31.32","F33.1","F17.200","F31.9","K02.9","F41.9","N76.0","B96.89","R10.2","M79.89","R06.02","M79.671","M79.672","N91.1","N93.9","F60.89","M54.5","V49.50XA","T14.90XA","R69.","N91.2","Z20.2","Z12.72","R60.0","Z53.21","R25.2","M79.604","M79.605","Z87.891","Z20.828","N73.9","R52.","E66.9","Z68.43","NO DATA","K04.7","K08.89","Z11.59","A59.01","M62.838","R60.9","J01.90","R05.1","Z01.419","Z11.3","Z32.02","H92.09"],"date":["2020-03-05","2020-08-18","2021-12-17","2021-12-17","2020-03-05","2021-04-22","2021-08-24","2021-07-01","2022-03-08","2022-06-30","2021-08-24","2020-08-18","2020-08-18","2020-08-18","2020-10-11","2020-10-11","2020-10-11","2020-10-11","2021-10-21","2022-05-11","2020-07-20","2021-02-24","2021-02-24","2021-02-24","2021-02-24","2021-08-11","2022-03-26","2021-08-11","2022-03-09","2022-03-08","2022-03-09","2022-03-08","2022-03-08","2022-10-15","2022-09-02","2022-09-15","2022-03-08","2022-03-09","2022-03-09","2022-03-09","2022-06-30","2022-10-15","2022-09-23","2022-08-16","2022-03-09","2022-03-09","2022-04-16","2022-04-16","2022-05-11","2022-05-11","2022-05-11","2022-10-15"],"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":[["","62756052169","SUMATRIPTAN","TAB 50MG","10","Select","Select",""],["","00591565810","CYCLOBENZAPR","TAB 10MG","12","Select","Select",""],["","68180065208","DOXYCYC","CAP 100MG","28","Select","Select",""],["","68180016106","AZITHROMYCIN","TAB 500MG","2","Select","Select",""],["","43547040111","FUROSEMIDE","TAB 20MG","15","Select","Select",""],["","64380071307","BENZONATATE","CAP 200MG","42","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","50111033401","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","20","Select","Select",""],["","00093117410","PENICILLN","TAB 500MG","28","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","8","Select","Select",""],["","53489011905","DOXYCYCL","CAP 100MG","28","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","20","Select","Select",""],["","70710113908","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","49483060450","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","00573021825","ANBESOL","GEL 0.1","9","Select","Select",""],["","00116200116","CHLORHEX","SOL 0.0012","473","Select","Select",""],["","69097083412","SERTRALINE","TAB 50MG","90","Select","Select",""],["","42571017701","PIROXICAM","CAP 20MG","30","Select","Select",""],["","00115180401","HYDROXYZ","CAP 50MG","90","Select","Select",""],["","00832105410","BACLOFEN","TAB 10MG","30","Select","Select",""],["","69097012203","TOPIRAMATE","TAB 25MG","90","Select","Select",""],["","65862050220","AMOX\/K","TAB 500-125","21","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0","Select","Select",""],["","69452023420","PROGESTERONE","CAP 200MG","36","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","12","Select","Select",""],["","49483034010","ACETAMIN","TAB 325MG","30","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","14","Select","Select",""],["","00555077902","MEDROXYPR","TAB 10MG","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":""}]}]}