{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ASHLEY  N DOWTIN","gend":1,"add":"919 VIRGINIA BEACH BLVD","city":"NORFOLK","state":"VA","zip":23504,"dob":"1986-04-25","age":"","mstatus":"","insh":"20051031*01","cliId":"","pno":"757\/394-2209","cno":"","email":"","ename":"","eno":"","pphy":"Route,  barbara","ppno":"757\/446-5955","pcpadd":"5424 Discovery Park Blvd BLDB A STE 201","pcpcity":"WILLIAMSBURG","pcpstate":"VA","pcpzip":23504,"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":["F33.2","A41.9","U07.1","J12.82","E66.01","NO DATA","D50.9","E11.65","A41.89","Z68.42","I10.","K59.00","D50.0","R74.01","F32.9","Z79.84","Z79.899","Z83.3","Z82.49","Z86.16","N92.6","F33.1","Z48.02","F41.1","F41.0","F43.10","S01.81XA","F41.8","Z82.3","O26.891","R10.2","O21.9","O24.111","O10.911","Z3A.08","R63.0","R10.30","Z3A.01"],"date":["2020-07-02","2021-04-01","2022-03-02","2021-07-02","2022-03-02","2022-03-02","2021-03-28","2022-03-03","2021-03-28","2021-03-28","2022-07-19","2021-03-28","2021-03-28","2021-03-28","2021-03-28","2021-03-28","2021-03-28","2021-03-28","2022-07-19","2021-05-25","2021-03-09","2022-09-02","2022-07-25","2022-08-15","2022-08-15","2022-08-15","2022-07-19","2022-03-03","2022-07-19","2022-10-24","2022-10-24","2022-10-24","2022-10-24","2022-10-24","2022-10-24","2022-10-24","2022-10-24","2022-10-24"],"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":[["","62756014202","METFORMIN","TAB 500MG ER","360","Select","Select",""],["","69097083305","SERTRALINE","TAB 25MG","7","Select","Select",""],["","82607066026","FLOWFLEX","KIT TEST","8","Select","Select",""],["","00169430313","RYBELSUS","TAB 3MG","30","Select","Select",""],["","53885004601","ONETOUCH","KIT ULTRA 2","1","Select","Select",""],["","00054418625","DEXAMETHASON","TAB 6MG","5","Select","Select",""],["","00002771559","BASAGLAR","INJ 100UNIT","15","Select","Select",""],["","08290320122","BD  PEN NEEDL","MIS 32GX4MM","100","Select","Select",""],["","16714036004","MONO-LINYAH","TAB 0.25-35","84","Select","Select",""],["","00603254421","BUT\/APAP\/CAF","TAB ","12","Select","Select",""],["","42806071401","BENZONATATE","CAP 100MG","20","Select","Select",""],["","16714047802","AMOX\/K","TAB 875-125","4","Select","Select",""],["","00904759080","FEROSUL","TAB 325MG","60","Select","Select",""],["","70677004901","SM","TAB 600MG ER","14","Select","Select",""],["","00006008061","JANUMET","TAB 50-1000","60","Select","Select",""],["","56151146001","TRUE","TES GLUCOSE","200","Select","Select",""],["","13668013701","ESCITALOPRAM","TAB 20MG","14","Select","Select",""],["","50111043301","TRAZODONE","TAB 50MG","14","Select","Select",""],["","23155019101","BUPROPION","TAB 75MG","30","Select","Select",""],["","","MIRTAZAPINE","TAB 15MG","","Select","Select",""],["","13107008305","LORAZEPAM","TAB 0.5MG","60","Select","Select",""],["","69097012303","TOPIRAMATE","TAB 50MG","60","Select","Select",""],["","60505265601","TRIAMT\/HCTZ","TAB 37.5-25","90","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":{"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":""}]}]}