{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CHAVONA   R BOYCE-WILSON","gend":1,"add":"5009 BARK LN","city":"VIRGINIA BEACH","state":"VA","zip":"23455-9998","dob":"1988-04-17","age":"","mstatus":"","insh":"3968170*01","cliId":"","pno":"757\/214-2186","cno":"757\/201-1941","email":"","ename":"","eno":"","pphy":"ONAYEMI, OLUSOLA K MD","ppno":"757\/395-1300","pcpadd":"2859 VIRGINIA BEACH BLVD","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":23452,"pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Family Medicine Physicians - Little Neck","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/226-0247","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z00.00","E11.65","E55.9","F43.23","H40.1131","Z01.419","Z11.3","N64.4","N76.0","K21.9","M54.9","L42.","E05.90","B96.89","R10.2","R60.0","R09.81","J30.1","M79.671","M79.672","M21.41","M21.42","M72.2","J01.90","O24.419","J45.990","N30.00","R30.0","D50.0","Z80.3","N39.3","M62.89","Z23.","B35.3","E11.40","R07.89","H53.021","N62.","G89.29","M54.6","R35.0","O24.410","O36.63X0","O40.9XX0","Z3A.34","Z3A.35","O24.414","V23.9","Z71.3","Z3A.36","O42.913","O26.619","K80.20","Z37.0","M54.89","Z3A.33","Z30.017","Z32.02","A59.9","Z30.9","N83.201","Z30.09","Z32.01","N89.8","Z36.89","O26.613","G89.18","R45.86","Z97.5","N39.0","N83.9","O42.013","K83.1","O26.62","O34.211","O24.424","O40.3XX0","O99.284","J45.909","O99.52","Z79.899","Z79.4","O99.02","O26.899","R51.","R42.","Z3A.19","R81.","O90.0","J01.01","Z3A.29","Z39.2","Z3A.32","Z39.1","Z34.82","Z34.83","L29.9"],"date":["2021-04-14","2021-09-03","2021-04-14","2021-12-31","2021-08-19","2021-06-21","2021-06-21","2021-08-20","2021-09-03","2021-09-03","2021-09-03","2021-09-03","2021-09-03","2021-09-03","2020-06-11","2020-06-11","2021-02-02","2021-02-02","2021-04-26","2021-04-26","2021-04-26","2021-04-26","2021-04-26","2021-12-10","2020-01-27","2020-01-27","2020-07-22","2020-07-22","2020-10-14","2020-10-14","2020-04-21","2020-04-21","2020-11-18","2020-11-23","2020-11-23","2021-05-13","2021-02-17","2021-07-27","2021-09-20","2021-09-20","2019-03-27","2019-11-08","2019-11-05","2019-11-05","2019-10-29","2019-11-06","2019-11-06","2019-11-06","2019-11-06","2019-11-08","2019-11-09","2019-11-09","2019-11-09","2019-11-09","2019-09-11","2019-10-22","2019-12-06","2019-12-06","2019-02-15","2019-02-15","2019-02-15","2019-03-07","2019-04-08","2019-04-08","2019-04-08","2019-11-01","2019-11-11","2019-12-16","2019-12-16","2019-02-07","2019-02-07","2019-11-09","2019-11-08","2019-11-08","2019-11-09","2019-11-08","2019-11-08","2019-11-08","2019-11-08","2019-11-08","2019-11-08","2019-11-08","2019-11-08","2019-07-18","2019-07-18","2019-07-18","2019-07-18","2019-07-18","2019-11-14","2019-01-30","2019-09-26","2019-11-19","2019-10-11","2019-10-28","2019-10-28","2019-10-28","2019-10-29"],"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":[["","","ONETOUCH"," ONETOUCH ","100","Select","Select",""],["","","FLUTICASONE"," FLUTICASONE ","16","Select","Select",""],["","","PROAIR","AER ","","Select","Select",""],["","","ALBUTEROL","AER HFA","","Select","Select",""],["","45802006436","TRIAMCINOLON","CRE 0.001","80","Select","Select",""],["","51660093901","CETIRIZINE","TAB 10MG","90","Select","Select",""],["","69238110005","DOXYCYCL","CAP 100MG","14","Select","Select",""],["","68462011944","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","","METRONIDAZOL"," METRONIDAZOL ","70","Select","Select",""],["","55111064501","OMEPRAZOLE","CAP 40MG","30","Select","Select",""],["","58160088752","FLUARIX","INJ 2021-22","0","Select","Select",""],["","","KETOCONAZOLE","CRE 0.02","","Select","Select",""],["","","VENTOLIN","AER ","","Select","Select",""],["","","AMOX\/K","TAB 875-125","","Select","Select",""],["","","ACCU-CHEK","KIT AVIVA PL","","Select","Select",""],["","","PREDNISONE","TAB 10MG","","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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}