{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DEIDRA   M COOPER","gend":1,"add":"1777 CAMPOSTELLA ST","city":"NORFOLK","state":"VA","zip":"23523-9998","dob":"1994-11-09","age":"","mstatus":"","insh":"20058186*01","cliId":"","pno":"757\/354-9743","cno":"757\/354-9743","email":"","ename":"","eno":"","pphy":"GUNTHER, ALTHEA O 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":["F90.2","NO DATA","V62.84","F41.9","U07.1","I10.","E66.01","Z68.41","Z28.310","Z28.9","R50.9","N76.0","N89.8","L73.2","Z79.899","M54.5","F32.9","Z30.09","Z20.2","E28.2","B37.3","N30.00","R63.5","Z13.31","Z68.42","Z32.02","B96.89","R10.2","H04.123","Z98.890","R73.03","Z76.89","R79.89","J06.9","Z20.828","L72.0","R51.9","Z86.16","K21.9","R19.7","R53.83","N93.8","N92.6","L68.0","N91.5","Z78.9","E11.8","R31.0","E66.9","G89.29","E22.1","Z20.822","L30.4","L29.2","G47.00","G56.00","F33.1","M79.669"],"date":["2020-05-29","2022-10-21","2022-10-21","2022-08-05","2022-08-21","2022-09-01","2022-09-01","2022-09-01","2022-08-21","2022-08-21","2022-08-21","2022-09-01","2022-09-01","2022-09-16","2022-09-16","2021-01-25","2021-01-25","2021-08-12","2021-08-12","2022-05-19","2022-05-16","2022-02-02","2022-05-19","2022-10-21","2020-05-28","2020-10-22","2022-02-02","2021-09-13","2022-07-25","2022-07-25","2022-05-19","2020-01-03","2020-04-30","2021-04-04","2020-09-09","2021-01-06","2021-04-27","2021-04-27","2022-02-02","2022-02-02","2022-05-16","2020-11-25","2020-11-25","2021-06-22","2022-01-07","2022-03-24","2022-08-15","2020-02-28","2020-10-12","2020-10-27","2020-12-21","2022-08-21","2020-10-07","2022-02-18","2022-08-05","2020-04-24","2020-04-24","2020-04-24"],"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":[]},{"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":[["","68645058459","METFORMIN","TAB 1000MG","180","Select","Select",""],["","69238110002","DOXYCYCL","CAP 100MG","14","Select","Select",""],["","51862086806","MICROGESTIN","TAB 43831","63","Select","Select",""],["","68645051654","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","00002318280","TRULICITY","INJ 4.5\/0.5","2","Select","Select",""],["","00074055402","HUMIRA","INJ 40\/0.4ML","4","Select","Select",""],["","00143924920","AMOX\/K","TAB 875-125","20","Select","Select",""],["","00234057504","HIBICLENS","LIQ 0.04","236","Select","Select",""],["","68462015713","ONDANSETRON","TAB 4MG ODT","10","Select","Select",""],["","68645055854","LISINOP\/HCTZ","TAB 20-25MG","30","Select","Select",""],["","63736044180","MONISTAT","KIT 1200\/2%","1","Select","Select",""],["","00078091112","XIIDRA","DRO 0.05","120","Select","Select",""],["","70700015010","OMEPRAZOLE","CAP 20MG","20","Select","Select",""],["","10702000709","CYCLOBENZAPR","TAB 10MG","30","Select","Select",""],["","49035019900","MICONAZOLE","KIT ","9","Select","Select",""],["","59746021801","SPIRONOLACT","TAB 100MG","30","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","68645056354","IBUPROFEN","TAB 800MG","90","Select","Select",""],["","68645052254","SERTRALINE","TAB 50MG","30","Select","Select",""],["","55111014512","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","20555003601","MELATONIN","TAB 3MG","15","Select","Select",""],["","50111056001","TRAZODONE","TAB 50MG","30","Select","Select",""],["","42806071401","BENZONATATE","CAP 100MG","30","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","62542030117","HYD","SUS 10-8\/5ML","25","Select","Select",""],["","00121077516","GG\/CODEINE","SOL 100-10\/5","120","Select","Select",""],["","65162019011","NAPROXEN","TAB 500MG","30","Select","Select",""],["","00378727453","NORETH\/ETHIN","TAB 1.5\/30","21","Select","Select",""],["","51285012797","LOESTRIN","TAB 1.5\/30","21","Select","Select",""],["","16729017217","AMITRIPTYLIN","TAB 25MG","90","Select","Select",""],["","54738005001","PRENATAL","TAB MINERALS","20","Select","Select",""],["","67877022310","GABAPENTIN","CAP 300MG","60","Select","Select",""],["","65162027250","SMZ\/TMP","TAB 800-160","30","Select","Select",""],["","64380073706","VITAMIN","CAP 50000UNT","4","Select","Select",""],["","10702025301","BUT\/APAP\/CAF","TAB ","20","Select","Select",""],["","00555077902","MEDROXYPR","TAB 10MG","10","Select","Select",""],["","63304061650","DOXYCYC","CAP 100MG","14","Select","Select",""],["","13668048450","MINOCYCLINE","CAP 100MG","60","Select","Select",""],["","45802012801","CLINDAMYCIN","LOT 0.01","120","Select","Select",""],["","67877021905","CEPHALEXIN","CAP 500MG","14","Select","Select",""],["","00536406301","CL","TAB 28-0.8MG","30","Select","Select",""],["","00116106104","DYNA-HEX","SOL 0.04","118","Select","Select",""],["","51672130200","TERCONAZOLE","CRE 0.008","20","Select","Select",""],["","43547028111","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","00168016260","CLOBETASOL","OIN 0.0005","60","Select","Select",""],["","45802001405","HYDROCORT","OIN 0.025","454","Select","Select",""],["","16714008210","HYDROXYZ","TAB 25MG","30","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":""}]}]}