{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"NAWASSA   T WILLIAMS","gend":1,"add":"113 LEXINGTON ST","city":"HAMPTON","state":"VA","zip":"23669-9998","dob":"1978-08-31","age":"","mstatus":"","insh":"3736059*01","cliId":"","pno":"757\/453-1184","cno":"757\/251-7119","email":"","ename":"","eno":"","pphy":"JOYNER, AERIAN K NP","ppno":"757\/827-2025","pcpadd":"STE 300 4001 COLISEUM DR","pcpcity":"HAMPTON","pcpstate":"VA","pcpzip":23666,"pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Senior Health Services","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/510-9223","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R09.81","R42.","H93.11","J30.89","L50.0","M25.561","M25.571","R07.89","F41.0","F41.1","M76.821","F17.210","Z71.3","R21.","M89.8X7","Y93.01","W10.1XXA","Y92.480","M25.50","M79.7","M47.817","M17.11","E55.9","N64.4","R20.0","R73.09","N64.89","R20.2","L29.9","L50.9","J30.1","E66.01","V58.89","Z01.419","Z11.51","Z12.31","M76.829","R00.2","R06.02","I49.1","I47.1","I49.3","G62.9","G89.29","M54.9","NO DATA","F41.9","D57.3","Z79.899","I42.2","J02.9","Z01.411","Z12.39","Z11.3","N76.0","B37.3","R10.9","R11.2","R35.0","Z00.00","R73.03","M54.42","M54.41","R19.7","N94.10","M54.5","M25.461","I51.7","M22.2X1","R53.83","Z68.41","E78.5","E61.1","E66.9","Z68.39","F33.1","F90.9","J34.89","M54.16","S83.241A","X50.1XXA","M25.511","R10.2","Z20.2"],"date":["2020-07-17","2021-12-01","2020-07-17","2020-07-17","2021-07-19","2021-01-05","2021-03-22","2021-06-16","2020-08-18","2021-05-24","2021-03-22","2021-03-22","2021-03-22","2021-06-01","2020-07-27","2020-06-24","2020-06-24","2020-06-24","2021-11-22","2021-11-22","2021-11-22","2021-11-22","2021-05-13","2021-06-01","2021-09-01","2021-05-14","2021-05-14","2021-12-01","2021-07-19","2021-07-19","2021-07-19","2021-07-19","2021-10-22","2021-12-23","2021-12-23","2021-12-23","2020-07-22","2021-09-09","2021-06-16","2021-09-09","2021-09-09","2021-09-09","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2021-12-09","2020-06-01","2020-09-29","2020-09-29","2020-09-29","2020-05-19","2020-05-19","2020-05-19","2020-05-19","2020-05-19","2020-08-14","2020-08-14","2020-06-16","2020-06-16","2021-05-14","2020-01-28","2020-01-28","2021-01-05","2021-06-16","2021-08-06","2019-02-04","2019-02-04","2019-04-04","2019-02-21","2019-04-04","2019-04-04","2019-05-17","2019-02-26","2019-02-26","2019-08-10","2019-05-15","2019-05-15","2019-12-16","2019-06-13","2019-07-26"],"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":[["","00093100301","BUSPIRONE","TAB 15MG","30","Select","Select",""],["","00363017508","PAIN","TAB 500MG","24","Select","Select",""],["","50580044935","TYLENOL","TAB 500MG","24","Select","Select",""],["","52817033200","CYCLOBENZAPR","TAB 10MG","20","Select","Select",""],["","69097067905","PREGABALIN","CAP 75MG","60","Select","Select",""],["","00591352530","LIDOCAINE","PAD 0.05","20","Select","Select",""],["","69097084705","ESCITALOPRAM","TAB 5MG","30","Select","Select",""],["","16571020150","DICLOFENAC","TAB 75MG DR","60","Select","Select",""],["","69452015120","VITAMIN","CAP 50000UNT","4","Select","Select",""],["","00093506105","HYDROXYZ","TAB 25MG","60","Select","Select",""],["","","IBUPROFEN","TAB 800MG","","Select","Select",""],["","00591505210","PREDNISONE","TAB 5MG","22","Select","Select",""],["","00904530660","BANOPHEN","CAP 25MG","20","Select","Select",""],["","45802005535","TRIAMCINOLON","OIN 0.001","15","Select","Select",""],["","45802065087","LORATADINE","TAB 10MG","28","Select","Select",""],["","43598081115","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","00363010706","WAL-DRYL","CAP 25MG","24","Select","Select",""],["","","FAMOTIDINE","TAB 40MG","","Select","Select",""],["","31722072690","MONTELUKAST","TAB 10MG","13","Select","Select",""],["","00378632001","VERAPAMIL","CAP 120MG ER","30","Select","Select",""],["","68462040601","INDOMETHACIN","CAP 25MG","30","Select","Select",""],["","00406012305","HYDROCO\/APAP","TAB 5-325MG","40","Select","Select",""],["","27241009803","DULOXETINE","CAP 30MG","30","Select","Select",""],["","68382004001","PROMETHAZINE","TAB 12.5MG","40","Select","Select",""],["","","AMOXICILLIN","TAB 500MG","","Select","Select",""],["","00116200116","CHLORHEX","SOL 0.0012","473","Select","Select",""],["","00591079501","DICYCLOMINE","TAB 20MG","20","Select","Select",""],["","00406048410","APAP\/CODEINE","TAB 300-30MG","12","Select","Select",""],["","57237000511","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","20","Select","Select",""],["","00781707787","METRONIDAZOL","GEL 0.75%VAG","70","Select","Select",""],["","63481068447","VOLTAREN","GEL 0.01","400","Select","Select",""],["","","SOOTHE","CHW 262MG","","Select","Select",""],["","","PROPRANOLOL","TAB 80MG","","Select","Select",""],["","68180032002","BUPROPN","TAB 300MG XL","30","Select","Select",""],["","","ONDANSETRON","TAB 8MG ODT","","Select","Select",""],["","","CLARITHROMYC","TAB 500MG","","Select","Select",""],["","","MECLIZINE","TAB 12.5MG","","Select","Select",""],["","","NYSTATIN","SUS 100000","","Select","Select",""],["","","TERCONAZOLE","CRE 0.004","","Select","Select",""],["","","CEPHALEXIN","CAP 500MG","","Select","Select",""],["","","DOXYCYC","CAP 100MG","","Select","Select",""],["","45802057178","FEXOFENADINE","TAB 180MG","30","Select","Select",""],["","00071101268","LYRICA","CAP 25MG","60","Select","Select",""],["","13107010501","PHENTERMINE","CAP 15MG","30","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","70010075401","METHOCARBAM","TAB 500MG","30","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","14","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","16","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":""}]}]}