{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CHANTELLE   N OUTTEN","gend":1,"add":"925 BROOK AVE APT 169","city":"SUFFOLK","state":"VA","zip":"23434-9998","dob":"1987-09-02","age":"","mstatus":"","insh":"20063482*01","cliId":"","pno":"757\/972-4909","cno":"","email":"","ename":"","eno":"","pphy":"MORRISON, SARAI MD","ppno":"757\/983-2200","pcpadd":"3920A BRIDGE RD STE 207","pcpcity":"SUFFOLK","pcpstate":"VA","pcpzip":23435,"pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Family Medicine Physicians - Belle Harbour","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/983-2201","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["V23.87","Z3A.08","Z34.82","Z3A.15","Z36.1","V23.9","O99.019","Z3A.35","R32.","Z48.89","Z98.890","Q28.2","Z39.1","Z34.83","Z38.00","O14.95","Z39.2","Z30.09","D50.9","O99.344","Z37.0","F32.9","Z3A.39","F41.9","O99.02","D64.9","O99.334","F17.200","O14.15","O99.355","Z86.73","G44.209","Z87.891","F41.1","I10.","O03.9","R05.","Z20.828","R68.83","Z71.89","O20.0","N30.01","F17.210","Z3A.00","U07.1","Z87.74","Z3A.23","Z3A.38","O20.9","O99.330","N93.9","Z20.822","O80.","O99.335","Z87.728","Z79.899","O23.11","O23.591","Z3A.01","O99.011","Z3A.10","J01.00","R09.81","K08.89","K02.9","R10.2","G89.29","Z87.42","D21.9","R51.9","R06.2","K21.9","R09.89","Z01.89","O21.9","N89.8","B37.3","Z3A.18","R11.2","Z01.818","Z11.59","J06.9","R45.1","K04.7","NO DATA","Z00.00","O23.10","R50.9","Z34.81","Z3A.12","Z36.82","Z3A.31","Z3A.37","Z32.02","R05.9","S90.121A","M79.89","G89.18","R06.02","O26.891","O34.80"],"date":["2020-01-03","2020-01-03","2020-06-11","2020-02-18","2020-02-18","2020-07-27","2020-07-20","2020-07-07","2020-09-22","2020-02-10","2020-02-10","2020-02-10","2020-06-11","2020-06-11","2020-08-02","2020-09-29","2020-09-18","2021-08-10","2020-07-13","2020-08-02","2020-08-02","2020-12-10","2020-08-02","2020-08-02","2020-08-02","2020-08-02","2020-08-02","2020-08-02","2020-08-13","2020-08-13","2022-09-11","2020-08-13","2022-09-11","2020-12-10","2021-12-25","2022-11-11","2021-08-13","2020-11-14","2021-09-19","2020-11-14","2022-11-06","2021-12-14","2022-07-09","2022-11-11","2022-08-02","2021-09-19","2020-04-16","2020-07-27","2022-11-02","2021-12-15","2022-11-01","2022-08-22","2020-08-02","2020-08-14","2020-08-14","2020-08-14","2020-10-21","2020-10-21","2022-11-06","2020-01-15","2020-01-15","2020-09-16","2021-12-19","2022-07-09","2021-06-22","2022-11-01","2021-09-08","2021-09-08","2021-09-08","2021-09-19","2021-09-27","2021-09-27","2021-09-27","2021-12-19","2020-03-11","2020-03-11","2020-03-11","2020-03-11","2020-03-11","2020-07-29","2020-07-29","2022-08-02","2021-12-25","2021-06-22","2021-08-13","2021-12-06","2021-12-14","2021-12-25","2020-01-28","2020-02-07","2020-01-28","2020-06-12","2020-07-20","2021-08-10","2022-08-02","2022-09-11","2022-09-11","2022-07-09","2022-08-02","2022-11-01","2022-11-11"],"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":[["","00172392660","DIAZEPAM","TAB 5MG","2","Select","Select",""],["","31722099601","HYDROCO\/APAP","TAB 5-325MG","6","Select","Select",""],["","57237002801","AMOXICILLIN","TAB 500MG","21","Select","Select",""],["","","ONDANSETRON","TAB 4MG ODT","","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8","Select","Select",""],["","","BENZONATATE","CAP 100MG","","Select","Select",""],["","","MUCINEX","TAB 600MG ER","","Select","Select",""],["","00406048410","APAP\/CODEINE","TAB 300-30MG","15","Select","Select",""],["","","NAPROXEN","TAB 500MG","","Select","Select",""],["","68382004101","PROMETHAZINE","TAB 25MG","8","Select","Select",""],["","","IBUPROFEN","TAB 600MG","","Select","Select",""],["","65862037405","ESCITALOPRAM","TAB 10MG","180","Select","Select",""],["","00904699860","DOCUSATE","CAP 100MG","10","Select","Select",""],["","00406051201","OXYCOD\/APAP","TAB 5-325MG","12","Select","Select",""],["","70954044410","MISOPROSTOL","TAB 200MCG","8","Select","Select",""],["","00406055201","OXYCODONE","TAB 5MG","5","Select","Select",""],["","","ARTHRTS","TAB 650MG","","Select","Select",""],["","63304069301","CLINDAMYCIN","CAP 300MG","28","Select","Select",""],["","00116200116","CHLORHEX","SOL 0.0012","473","Select","Select",""],["","00093117401","PENICILLN","TAB 500MG","28","Select","Select",""],["","","CEPHALEXIN","CAP 500MG","","Select","Select",""],["","11822316500","RA","CAP 100MG","10","Select","Select",""],["","","METRONIDAZOL","TAB 500MG","","Select","Select",""],["","","TERCONAZOLE","CRE 0.004","","Select","Select",""],["","","PRENATAL","TAB 27-0.8MG","","Select","Select",""],["","","GNP","PAD 0.04","","Select","Select",""],["","","FERROUS","TAB 325MG","","Select","Select",""],["","","PREPLUS","TAB 27-1MG","","Select","Select",""],["","","FEROSUL","TAB 325MG","","Select","Select",""],["","","BUT\/APAP\/CAF","TAB ","","Select","Select",""],["","","CALCIUM","TAB 600MG","","Select","Select",""],["","","ACETAMIN","TAB 500MG","","Select","Select",""],["","","DOK","CAP 100MG","","Select","Select",""],["","","SERTRALINE","TAB 25MG","","Select","Select",""],["","","NIFEDIPINE","TAB 60MG ER","","Select","Select",""],["","","BUPROPN","TAB 150MG XL","","Select","Select",""],["","","ALPRAZOLAM","TAB 0.5MG","","Select","Select",""],["","","PROPRANOLOL","CAP 60MG ER","","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":""}]}]}