{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SHAUNTE   N SCOTT","gend":1,"add":"4010 RIVER BREEZE CIR","city":"CHESAPEAKE","state":"VA","zip":"23321-9998","dob":"1981-08-22","age":"","mstatus":"","insh":"3577511*01","cliId":"","pno":"757\/776-5434","cno":"","email":"","ename":"","eno":"","pphy":"TYNES-MCCRAY, WANDA J NP","ppno":"757\/983-8600","pcpadd":"SUITE 200 114 N MAIN STREET","pcpcity":"SUFFOLK","pcpstate":"VA","pcpzip":23434,"pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Family Medicine Physicians - Belle Harbour","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/934-1660","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z48.812","Z95.828","Z45.2","T81.30XA","G47.30","Z85.72","C84.73","E86.0","R11.2","R20.0","R07.9","C85.90","Z51.12","T81.31XA","R11.0","R53.83","R56.9","Z51.11","J01.10","R05.","R06.09","D33.2","Z94.84","G40.109","Z79.899","Z11.1","E55.9","Z13.220","R73.09","E66.01","Z13.29","G47.33","Z91.14"],"date":["2019-07-15","2019-07-15","2020-02-06","2020-02-06","2020-02-06","2020-02-06","2021-07-12","2019-08-19","2019-08-19","2019-08-19","2019-11-20","2021-08-17","2019-10-07","2020-02-06","2019-07-08","2019-07-08","2021-05-25","2019-08-05","2021-08-17","2019-08-22","2019-08-22","2020-02-04","2020-02-04","2021-11-24","2021-07-08","2021-08-17","2021-08-17","2021-08-17","2021-08-17","2021-08-17","2021-08-17","2021-10-06","2021-11-24"],"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":{"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":[["","","FLUTICASONE"," FLUTICASONE ","16","Select","Select",""],["","","TOPIRAMATE"," TOPIRAMATE ","90","Select","Select",""],["","","ONDANSETRON"," ONDANSETRON ","50","Select","Select",""],["","","PROMETHAZINE"," PROMETHAZINE ","30","Select","Select",""],["","","CEPHALEXIN"," CEPHALEXIN ","28","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":""}]}]}