{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SAVANA   C BUTTS","gend":1,"add":"452 E BRAMBLETON AVE APT B","city":"NORFOLK","state":"VA","zip":"23510-9998","dob":"2000-11-21","age":"","mstatus":"","insh":"6649548*01","cliId":"","pno":"757\/343-3061","cno":"","email":"","ename":"","eno":"","pphy":"MARKOVIC, VLADIMIR MD","ppno":"757\/533-9108","pcpadd":"3415 GRANBY STREET","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23504,"pcpcounty":"","pcpid":"","pcpname":"Hampton Roads Community Health Center","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/622-6384","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R10.2","R30.0","R52.","N39.0","L20.9","O11.4","Z37.0","Z3A.34","Z91.14","O75.89","I37.0","O69.81X0","O99.824","O99.214","E66.01","O99.52","J45.909","Z79.899","Z83.3","Z82.49","O14.93","O99.213","O99.413","Z3A.32","Z11.1","Z20.828","J45.30","Z32.01","Z68.43","Z30.9","Z11.3","Z30.09","Z34.00","I10.","Z68.42","O11.3","Z3A.33","H60.331","S99.912A","Z31.69","N76.0","Z11.52","N92.6","I51.7","O42.913","T14.90XA","Z32.02","N89.8","O26.90","O71.3","O14.14","V23.89","Z34.90","Z23.","R06.2","Z30.011","L30.9","B35.9","F33.2","N30.01","N94.6","O14.13","Z30.42","B96.89","O26.02","O26.842","Z91.19","Z3A.27","O46.93","O26.893","O13.3","O99.513","Z86.19","R11.2","NO DATA","Z87.09","Z32.00","O10.919","Q22.3","Z3A.17","V23.5","F41.9","O99.212","R82.90","Z20.822","O26.891","Z3A.01","R10.9","Z76.0","L40.9","Z33.1","E66.09"],"date":["2022-07-26","2019-01-06","2019-01-06","2019-09-21","2019-11-01","2020-04-19","2020-04-29","2020-04-29","2020-04-19","2020-04-19","2022-02-10","2020-04-19","2020-04-19","2020-04-19","2022-10-12","2020-04-19","2020-04-19","2020-04-19","2020-04-19","2020-04-19","2020-04-19","2020-04-19","2020-04-19","2020-04-19","2021-01-12","2021-01-12","2021-07-14","2022-07-18","2022-02-10","2021-07-14","2021-06-14","2019-06-05","2019-11-01","2022-07-18","2019-11-05","2020-04-23","2020-04-26","2020-07-15","2020-12-22","2019-06-05","2021-09-09","2021-09-24","2019-11-05","2020-04-23","2020-04-29","2020-12-22","2021-03-03","2020-04-19","2020-04-19","2020-04-29","2020-04-29","2021-04-22","2021-04-22","2020-03-10","2019-01-26","2022-03-01","2022-03-01","2019-01-26","2019-01-26","2019-07-10","2019-07-10","2020-04-26","2019-02-27","2019-05-21","2020-03-10","2020-03-10","2020-03-10","2020-03-10","2020-04-19","2020-04-19","2020-04-19","2020-04-19","2020-04-19","2022-02-10","2022-10-12","2022-02-10","2022-10-12","2022-10-12","2022-10-12","2022-10-12","2022-10-12","2022-10-12","2022-10-12","2022-10-12","2022-05-05","2022-07-26","2022-07-26","2022-07-26","2022-03-01","2022-03-01","2022-07-18","2022-07-18"],"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":[["","58657017001","M-NATAL","TAB ","30","Select","Select",""],["","","LISINOPRIL"," LISINOPRIL ","30","Select","Select",""],["","","TRIAMCINOLON"," TRIAMCINOLON ","80","Select","Select",""],["","68462056529","NORGEST\/ETHI","TAB ESTRADIO","28","Select","Select",""],["","45802046564","KETOCONAZOLE","SHA 0.02","120","Select","Select",""],["","","BUPROPN","TAB 150MG XL","","Select","Select",""],["","","NALTREXONE","TAB 50MG","","Select","Select",""],["","39328010610","PRENATAL","TAB 27-1MG","30","Select","Select",""],["","23155019401","NIFEDIPINE","CAP 10MG","30","Select","Select",""],["","49884018601","DOXYL\/PYRID","TAB 10-10MG","90","Select","Select",""],["","59779027408","ASPIRIN","CHW 81MG","60","Select","Select",""],["","59746011506","PROCHLORPER","TAB 10MG","20","Select","Select",""],["","69097083412","SERTRALINE","TAB 50MG","30","Select","Select",""],["","","LABETALOL","TAB 200MG","","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","60258019309","PRENATABS","TAB ","30","Select","Select",""],["","68180016106","AZITHROMYCIN","TAB 500MG","2","Select","Select",""],["","","IBUPROFEN","TAB 800MG","","Select","Select",""],["","10702002501","PHENTERMINE","TAB 37.5MG","30","Select","Select",""],["","50111033401","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","70710113908","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","59762453802","MEDROXYPR","INJ 150MG\/ML","1","Select","Select",""],["","00173068220","VENTOLIN","AER ","18","Select","Select",""],["","","CIPRODEX","SUS 0.3-0.1%","","Select","Select",""],["","","EYE","DRO 0.025%OP","","Select","Select",""],["","","AMOXICILLIN","CAP 500MG","","Select","Select",""],["","","NAPROXEN","TAB 500MG","","Select","Select",""],["","","HYDROCO\/APAP","TAB 5-325MG","","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":""}]}]}