{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"UNIQUE   M WILLIAMS","gend":1,"add":"830 28TH ST","city":"NEWPORT NEWS","state":"VA","zip":"23607-9998","dob":"1991-07-09","age":"","mstatus":"","insh":"4391780*01","cliId":"","pno":"757\/532-6287","cno":"757\/532-6287","email":"","ename":"","eno":"","pphy":"BARRETO, BEATA MD","ppno":"757\/736-3725","pcpadd":"100 Enterprise Drive","pcpcity":"RANDOLPH","pcpstate":"VA","pcpzip":23962,"pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Family & Internal Medicine Physicians - Yorktown","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/431-7782","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["A08.4","R20.9","R51.","R10.9","R11.2","R10.84","R13.14","K22.2","K29.40","M79.89","W49.04XA","R19.4","R10.33","R63.4","R07.9","R53.81","R51.9","G89.29","Z20.822","R07.89","N32.81","R55.","J45.20","R00.2","F32.2","Z98.890","F41.1","G43.709","K21.9","D50.0","Z11.3","D50.9","R93.3","R19.7","B96.81","J30.9","R10.11","R11.10","R42.","Z53.21","Z79.899","M54.12","D64.9","K90.0","Z95.818","R00.0","K58.9","M54.2","M62.838","M62.830","R52.","F43.9","Z86.19","N89.8","K64.9","J01.90","R20.8","NO DATA","M41.124","Z72.51","Z76.89","G44.209"],"date":["2020-01-16","2020-01-16","2020-07-31","2020-09-08","2020-07-15","2020-07-15","2020-07-24","2020-07-24","2020-07-24","2021-09-11","2021-09-11","2020-03-18","2020-03-19","2020-03-18","2020-08-10","2021-08-01","2021-08-01","2021-08-01","2021-08-01","2020-08-03","2021-10-15","2021-12-16","2021-10-15","2021-10-15","2021-10-15","2021-10-15","2021-10-15","2021-10-15","2021-10-15","2021-10-15","2021-10-15","2021-10-15","2020-03-19","2020-05-06","2020-03-19","2020-05-18","2020-05-18","2020-05-18","2020-08-10","2020-08-10","2020-10-22","2020-12-03","2020-05-06","2020-05-06","2020-12-29","2020-09-22","2020-07-15","2020-08-28","2020-08-28","2020-08-28","2020-08-28","2020-08-28","2020-08-28","2020-08-28","2020-03-09","2020-05-18","2020-07-31","2020-07-31","2020-07-31","2020-07-31","2020-07-31","2020-09-14"],"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":[["","55111017915","TIZANIDINE","TAB 2MG","30","Select","Select",""],["","65862019299","FLUOXETINE","CAP 10MG","60","Select","Select",""],["","65862007701","CIPROFLOXACN","TAB 500MG","14","Select","Select",""],["","57237007710","ONDANSETRON","TAB 4MG ODT","20","Select","Select",""],["","68382004001","PROMETHAZINE","TAB 12.5MG","12","Select","Select",""],["","42192033801","HYOSCYAMINE","TAB 0.125MG","20","Select","Select",""],["","55111015930","OMEPRAZOLE","CAP 40MG","60","Select","Select",""],["","00713050324","ANUCORT-HC","SUP 25MG","6","Select","Select",""],["","68682010301","DICLOFENAC","TAB 100MG ER","20","Select","Select",""],["","42806031250","DOXYCYCL","TAB 100MG","14","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","00527128201","DICYCLOMINE","TAB 20MG","12","Select","Select",""],["","00591298539","PHENADOZ","SUP 12.5MG","12","Select","Select",""],["","16837085550","PEPCID","TAB 20MG","30","Select","Select",""],["","16714079904","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","65162037210","OXYBUTYNIN","TAB 10MG ER","30","Select","Select",""],["","00591352530","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","50111078810","AZITHROMYCIN","TAB 500MG","2","Select","Select",""],["","49035045895","ALLERGY","TAB 10MG","30","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8","Select","Select",""],["","59310057922","PROAIR","AER ","8","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":""}]}]}