{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DANA PARSON","gend":1,"add":"7459 OAKMONT DR","city":"NORFOLK","state":"VA","zip":"23513-9998","dob":"1980-07-01","age":"","mstatus":"","insh":"20044979*01","cliId":"","pno":"757\/857-0092","cno":"757\/785-7904","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":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F25.9","S91.349A","H60.90","E87.6","I10.","NO DATA","F14.90","F31.9","Z72.0","S63.501A","B37.3","H60.93","R19.7","Z20.828","M79.631","J42.","Z30.9","K12.1","T50.904A","L20.9","L81.0","T07.XXXA","J20.9","J30.9","J45.909","F30.9","F17.200","Z00.00","E78.5","Z11.3","F25.0","L03.213","L85.3","R21.","R22.42","N76.0","B96.89","R00.2","E83.59","M61.40","G89.18","M96.842","F17.210","F31.81","R03.0","F51.09","M79.604","R60.0","M54.9","B86.","F14.20","F10.20","F12.20","Z62.811","T78.40XA","R50.9","Z33.1","M79.609","F12.10","F14.10","F10.10","Z91.14","R22.40","L72.3","R22.41","L30.9","L29.9"],"date":["2021-08-29","2021-10-31","2021-10-31","2021-12-03","2021-12-03","2021-12-03","2021-12-03","2021-12-03","2021-12-03","2020-01-10","2020-01-10","2021-02-24","2021-02-24","2021-02-24","2020-02-05","2020-02-05","2020-02-05","2020-08-09","2021-12-03","2021-11-08","2020-01-17","2020-01-17","2020-01-20","2021-11-08","2021-11-08","2021-11-08","2021-11-08","2021-11-08","2021-11-08","2021-11-08","2021-03-17","2019-02-16","2019-03-21","2019-11-27","2019-03-22","2019-10-22","2019-03-22","2019-11-03","2019-04-29","2019-08-28","2019-09-08","2019-09-08","2019-01-14","2019-01-25","2019-01-05","2019-01-05","2019-09-08","2019-09-08","2019-11-03","2019-11-07","2019-01-14","2019-01-14","2019-01-14","2019-01-14","2019-02-16","2019-02-16","2019-10-22","2019-09-08","2019-01-04","2019-01-04","2019-01-04","2019-01-04","2019-04-15","2019-06-27","2019-08-28","2019-12-17","2019-12-17"],"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":[["","","NEO\/POLY\/HC","SUS 1% OTIC","","Select","Select",""],["","59148004013","REXULTI","TAB 4MG","30","Select","Select",""],["","43547040710","CLONAZEPAM","TAB 1MG","60","Select","Select",""],["","65862037401","ESCITALOPRAM","TAB 10MG","90","Select","Select",""],["","45802005535","TRIAMCINOLON","OIN 0.001","15","Select","Select",""],["","65162024709","CHLORTHALID","TAB 25MG","30","Select","Select",""],["","","PROAIR","AER ","","Select","Select",""],["","","ALBUTEROL","AER HFA","","Select","Select",""],["","55111012701","CIPROFLOXACN","TAB 500MG","10","Select","Select",""],["","","ETODOLAC","CAP 300MG","","Select","Select",""],["","","DOXYCYCL","TAB 100MG","","Select","Select",""],["","","LIDOCAINE","PAD 0.05","","Select","Select",""],["","","CIPRODEX","SUS 0.3-0.1%","","Select","Select",""],["","","VENTOLIN","AER ","","Select","Select",""],["","","NEBULIZER","MIS CMPRESSR","","Select","Select",""],["","","MELOXICAM","TAB 15MG","","Select","Select",""],["","67877021901","CEPHALEXIN","CAP 500MG","28","Select","Select",""],["","00406012301","HYDROCO\/APAP","TAB 5-325MG","4","Select","Select",""],["","67877032105","IBUPROFEN","TAB 800MG","20","Select","Select",""],["","29300022701","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","00591024110","LORAZEPAM","TAB 1MG","90","Select","Select",""],["","11822312760","LORATADINE","TAB 10MG","30","Select","Select",""],["","68462010340","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","60432026415","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","00168014630","HYDROCORT","OIN 0.025","28","Select","Select",""],["","65162062710","TRAMADOL","TAB 50MG","10","Select","Select",""],["","00093506001","HYDROXYZ","TAB 10MG","20","Select","Select",""],["","59746017506","PREDNISONE","TAB 20MG","18","Select","Select",""],["","00472024260","PERMETHRIN","CRE 0.05","120","Select","Select",""],["","75450028005","LICE","LOT 0.01","59","Select","Select",""],["","50111078710","AZITHROMYCIN","TAB 250MG","4","Select","Select",""],["","16714043901","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","53746027201","SMZ\/TMP","TAB 800-160","14","Select","Select",""],["","11822985580","RA","LIQ MAX ST","59","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":""}]}]}