{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BRITTANY   N TAYLOR","gend":1,"add":"222 BRONTE TRCE APT 203","city":"VIRGINIA BEACH","state":"VA","zip":"23462-9998","dob":"1996-06-14","age":"","mstatus":"","insh":"2284228*01","cliId":"","pno":"919\/841-8767","cno":"919\/841-8767","email":"","ename":"","eno":"","pphy":"TOZER, BETH L MD","ppno":"804\/288-4084","pcpadd":"SUITE 200 7611 FOREST AVE","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":23229,"pcpcounty":"","pcpid":"","pcpname":"Virginia Women's Center","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/288-3567","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F25.9","M79.602","S72.002A","Z87.81","N89.8","R10.2","R23.4","N30.00","N10.","S72.302A","S52.302A","S52.202A","S02.652A","S02.609A","S02.651A","S02.612A","T78.40XA","V54.19","V54.12","V54.15","V58.89","Z79.01","E34.9","S02.601A","M25.532","V23.4XXA","M79.605","M25.552","S72.352A","S52.502A","S52.92XA","S52.609A","F64.9","Z20.822","F60.3","G47.33","G47.00","Z01.419","N89.6","F41.8","K08.89","K03.81","Z88.8","H66.92","H92.02"],"date":["2021-04-06","2021-05-03","2022-02-24","2022-01-11","2020-03-20","2020-03-20","2020-03-20","2020-12-22","2021-01-06","2021-01-15","2021-01-15","2021-01-15","2021-01-14","2021-01-18","2021-01-18","2021-01-18","2021-01-18","2021-02-23","2021-02-23","2021-03-03","2021-02-23","2021-02-23","2020-06-03","2021-01-14","2021-01-14","2021-01-14","2021-09-22","2021-09-22","2021-01-14","2021-01-14","2021-01-14","2021-01-14","2021-01-14","2021-01-14","2021-01-14","2021-05-20","2021-07-07","2021-06-11","2021-06-11","2022-02-24","2022-07-17","2022-07-17","2022-07-17","2020-11-24","2020-11-24"],"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":[["","57237002801","AMOXICILLIN","TAB 500MG","21","Select","Select",""],["","16714020030","ONDANSETRON","TAB 4MG ODT","20","Select","Select",""],["","00406055201","OXYCODONE","TAB 5MG","28","Select","Select",""],["","00904679480","ASPIRIN","CHW 81MG","28","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","20","Select","Select",""],["","00406012305","HYDROCO\/APAP","TAB 5-325MG","12","Select","Select",""],["","64380080707","IBUPROFEN","TAB 800MG","20","Select","Select",""],["","50383007916","APAP\/CODEINE","SOL 120-12\/5","150","Select","Select",""],["","42806040021","METHYLPRED","TAB 4MG","21","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","20","Select","Select",""],["","29300011201","LAMOTRIGINE","TAB 100MG","135","Select","Select",""],["","67877024601","QUETIAPINE","TAB 200MG","90","Select","Select",""],["","11917009215","FERROUS","TAB 325MG","60","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","15","Select","Select",""],["","00904759080","FEROSUL","TAB 325MG","60","Select","Select",""],["","00955100410","ENOXAPARIN","INJ 40\/0.4ML","12","Select","Select",""],["","00116200116","CHLORHEX","SOL 0.0012","473","Select","Select",""],["","00363876020","SENNA-S","TAB 8.6-50MG","60","Select","Select",""],["","00363033601","ACETAMINOPHE","TAB 650MG ER","60","Select","Select",""],["","00406051205","OXYCOD\/APAP","TAB 5-325MG","20","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","21","Select","Select",""],["","00121072104","FLUOXETINE","SOL 20MG\/5ML","150","Select","Select",""],["","68084077725","ACETAMIN","TAB 650MG","60","Select","Select",""],["","17478071130","LIDOCAINE","GEL 2% JELLY","30","Select","Select",""],["","00093354143","ESTRADIOL","CRE 0.0001","42","Select","Select",""],["","00574082001","TESTOST","INJ 200MG\/ML","2","Select","Select",""],["","42571016242","AMOX\/K","TAB 875-125","20","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":""}]}]}