{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ROCHELLE BRYANT","gend":1,"add":"512 E LITTLE CREEK RD APT 1","city":"NORFOLK","state":"VA","zip":"23505-9998","dob":"1984-06-19","age":"","mstatus":"","insh":"20045902*01","cliId":"","pno":"757\/995-9051","cno":"","email":"","ename":"","eno":"","pphy":"GRANT JR, THOMAS R MD","ppno":"757\/446-5955","pcpadd":"825 FAIRFAX AVE STE 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":["O46.90","I10.","Z3A.01","N93.9","Z30.9","F33.0","F33.1","Z30.42","F39.","E11.8","F41.9","F32.9","Z30.09","R10.9","N39.0","Z20.2","A64.","O20.8","Z3A.00","Z68.35","K59.00","R11.2","R07.9","E05.90","R30.0","R10.84","R73.9","Z34.90","Z87.42","R35.0","R06.83","E66.9","Z36.9","O03.80","F17.200","T74.21XA","M25.562","F17.210","Z88.8","Z91.041","M25.462","Z30.013","S83.412A","N92.6","Z11.3","B37.3"],"date":["2019-01-23","2021-11-28","2019-02-13","2019-11-26","2020-05-07","2020-11-01","2020-08-18","2021-11-16","2021-12-22","2021-04-27","2020-08-24","2020-02-18","2019-09-10","2020-07-28","2021-11-01","2021-11-01","2020-08-24","2019-02-13","2019-02-05","2019-02-13","2019-08-25","2019-08-25","2021-07-16","2020-02-18","2020-02-18","2021-04-27","2021-04-27","2019-01-31","2019-11-21","2021-07-07","2021-10-21","2021-10-21","2019-01-23","2019-02-05","2019-03-11","2021-07-07","2021-11-28","2021-11-28","2021-11-28","2021-11-28","2021-11-28","2020-11-23","2021-12-02","2019-06-25","2021-06-14","2021-06-14"],"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":[["","","SERTRALINE"," SERTRALINE ","60","Select","Select",""],["","","FLUOXETINE"," FLUOXETINE ","30","Select","Select",""],["","","CLONAZEPAM"," CLONAZEPAM ","45","Select","Select",""],["","","ONDANSETRON"," ONDANSETRON ","20","Select","Select",""],["","","LABETALOL"," LABETALOL ","60","Select","Select",""],["","","CEPHALEXIN"," CEPHALEXIN ","21","Select","Select",""],["","","AMLODIPINE"," AMLODIPINE ","30","Select","Select",""],["","","PROPRANOLOL"," PROPRANOLOL ","60","Select","Select",""],["","","HYDROXYZ"," HYDROXYZ ","60","Select","Select",""],["","","BUSPIRONE"," BUSPIRONE ","60","Select","Select",""],["","","METOCLOPRAM"," METOCLOPRAM ","6","Select","Select",""],["","","MEDROXYPR"," MEDROXYPR ","10","Select","Select",""],["","","NAPROXEN"," NAPROXEN ","28","Select","Select",""],["","","DOXYCYCL","CAP 100MG","","Select","Select",""],["","","DICYCLOMINE","CAP 10MG","","Select","Select",""],["","","FAMOTIDINE","TAB 20MG","","Select","Select",""],["","","IBUPROFEN","TAB 400MG","","Select","Select",""],["","","NITROFURANTN","CAP 100MG","","Select","Select",""],["","","ARIPIPRAZOLE","TAB 5MG","","Select","Select",""],["","","AZITHROMYCIN","TAB 500MG","","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":""}]}]}