{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DAVINA   W KING","gend":1,"add":"107 MYTILENE DR","city":"NEWPORT NEWS","state":"VA","zip":"23605-9998","dob":"1987-07-10","age":"","mstatus":"","insh":"2465337*01","cliId":"","pno":"757\/594-6461","cno":"","email":"","ename":"","eno":"","pphy":"EMECHEBE, NONSO S MD","ppno":"757\/827-2025","pcpadd":"4001 COLISEUM DR STE 300","pcpcity":"HAMPTON","pcpstate":"VA","pcpzip":23666,"pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Family & Internal Medicine Physicians - CarePlex West","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/275-9802","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I34.0","I51.7","I16.1","I50.21","J45.909","E66.01","I50.9","I42.0","N92.0","Z68.42","R06.02","R09.02","I50.42","I48.0","Z87.891","I42.9","I10.","Z20.828","R00.0","R50.9","J45.41","I50.41","I47.1","I42.8","Z20.822","I11.0","E28.2","Z79.899","Z88.5","Z83.3","Z82.5","Z82.3","Z82.49","S61.012A","V58.89","Z01.419","Z30.09","Z11.3","J18.9","A41.9","J10.1","J45.21","R03.0","A41.89","J12.89","J45.901","B97.19","I50.23","R42.","Z09.","Z23.","I50.22","I50.32","H18.603","H18.51","N89.8","A59.9","R10.31","N92.3","Z32.02","H18.613","H52.223","H52.13"],"date":["2021-03-08","2021-03-08","2021-03-12","2021-03-11","2021-03-10","2021-07-08","2021-03-12","2021-05-17","2020-08-18","2021-07-08","2021-03-08","2021-03-08","2021-03-30","2021-07-08","2021-03-11","2021-03-11","2021-07-08","2021-08-19","2020-12-19","2020-12-19","2020-12-28","2021-07-08","2021-03-08","2021-03-19","2021-03-08","2021-03-08","2021-03-08","2021-03-08","2021-03-08","2021-03-08","2021-03-08","2021-03-08","2021-03-08","2021-08-17","2021-08-23","2020-07-17","2020-07-17","2020-07-17","2020-12-21","2020-12-21","2020-03-09","2020-03-09","2021-03-08","2020-12-19","2020-12-19","2021-03-08","2020-12-19","2021-03-08","2021-03-08","2021-03-19","2021-03-19","2021-03-19","2021-03-19","2019-02-11","2019-02-11","2019-07-24","2019-10-23","2019-10-23","2019-10-23","2019-10-23","2019-01-04","2019-01-04","2019-01-04"],"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":[["","00003089421","ELIQUIS","TAB 5MG","60","Select","Select",""],["","00378021610","FUROSEMIDE","TAB 40MG","30","Select","Select",""],["","68180051703","LISINOPRIL","TAB 40MG","30","Select","Select",""],["","00378363405","CARVEDILOL","TAB 25MG","60","Select","Select",""],["","","ALBUTEROL"," ALBUTEROL ","18","Select","Select",""],["","53746051101","SPIRONOLACT","TAB 25MG","30","Select","Select",""],["","","PROAIR"," PROAIR ","8","Select","Select",""],["","","WIXELA","AER 100\/50","","Select","Select",""],["","00085113201","PROVENTIL","AER HFA","7","Select","Select",""],["","","VENTOLIN"," VENTOLIN ","18","Select","Select",""],["","","NORETH\/ETHIN"," NORETH\/ETHIN ","28","Select","Select",""],["","","DOXYCYCL"," DOXYCYCL ","12","Select","Select",""],["","","METRONIDAZOL"," METRONIDAZOL ","70","Select","Select",""],["","","PROMETHAZINE"," PROMETHAZINE ","120","Select","Select",""],["","","FC2"," FC2 ","24","Select","Select",""],["","","MY"," MY ","2","Select","Select",""],["","","NORETHINDRON"," NORETHINDRON ","28","Select","Select",""],["","","BENZONATATE"," BENZONATATE ","30","Select","Select",""],["","","MICROGESTIN"," MICROGESTIN ","28","Select","Select",""],["","","PREDNISONE","TAB 20MG","","Select","Select",""],["","","BREO","INH 100-25","","Select","Select",""],["","","AZITHROMYCIN","TAB 500MG","","Select","Select",""],["","","OSELTAMIVIR","CAP 75MG","","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":""}]}]}