{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MELISSA   E BEASLEY","gend":1,"add":"1330 RESERVOIR AVE APT B2","city":"NORFOLK","state":"VA","zip":"23504-9998","dob":"1979-12-03","age":"","mstatus":"","insh":"7157258*01","cliId":"","pno":"757\/270-7030","cno":"757\/452-1161","email":"","ename":"","eno":"","pphy":"WILLARD, RICHARD N MD","ppno":"757\/446-7900","pcpadd":"SUITE 310 825 FAIRFAX AVENUE","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23507,"pcpcounty":"","pcpid":"","pcpname":"EVMS OB\/GYN","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/446-8907","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N76.0","B96.89","N30.01","O02.1","O30.001","O46.91","O03.9","O20.9","Z01.419","R10.2","R30.0","O26.891","R42.","Z34.91","F17.210","O09.521","O23.591","Z3A.01","Z72.0","R06.02","R07.9","I10.","J45.909","Z53.29","Z87.891","M54.5","M54.16","L02.415","R07.89","M54.10","Z76.0","S01.412A","N89.8","Z20.2","Z88.5","Z91.040","Z88.6","Z91.018","Z86.19","N30.00","S30.860A"],"date":["2020-05-14","2020-05-14","2021-05-22","2020-02-12","2020-02-12","2020-02-12","2020-02-18","2020-02-18","2021-01-08","2021-12-06","2021-12-06","2020-01-22","2020-01-22","2020-01-22","2021-12-06","2020-02-11","2020-02-11","2020-02-11","2021-04-26","2021-08-14","2021-08-14","2021-12-06","2021-08-14","2021-08-14","2021-08-14","2020-06-22","2020-06-22","2020-07-12","2020-11-05","2020-11-05","2021-04-26","2021-05-24","2021-12-06","2021-12-06","2021-12-06","2021-12-06","2021-12-06","2021-12-06","2021-12-06","2019-11-29","2019-11-29"],"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":[["","","PERMETHRIN"," PERMETHRIN ","60","Select","Select",""],["","","CEPHALEXIN"," CEPHALEXIN ","28","Select","Select",""],["","","IBUPROFEN","TAB 800MG","","Select","Select",""],["","","DOXYCYCL","CAP 100MG","","Select","Select",""],["","","LIDOCAINE","PAD 0.05","","Select","Select",""],["","","LABETALOL","TAB 200MG","","Select","Select",""],["","","PREDNISONE","TAB 10MG","","Select","Select",""],["","","ALBUTEROL","AER HFA","","Select","Select",""],["","","MISOPROSTOL","TAB 200MCG","","Select","Select",""],["","","MELOXICAM","TAB 7.5MG","","Select","Select",""],["","","CYCLOBENZAPR","TAB 10MG","","Select","Select",""],["","","METHYLPRED","TAB 4MG","","Select","Select",""],["","","NYSTATIN","CRE 100000","","Select","Select",""],["","","GABAPENTIN","CAP 300MG","","Select","Select",""],["","","METRONIDAZOL","TAB 500MG","","Select","Select",""],["","","HYDROCO\/APAP","TAB 7.5-325","","Select","Select",""],["","","FLUCONAZOLE","TAB 150MG","","Select","Select",""],["","","SMZ\/TMP","TAB 800-160","","Select","Select",""],["","","BENZONATATE","CAP 100MG","","Select","Select",""],["","","METHOCARBAM","TAB 500MG","","Select","Select",""],["","","PROAIR","AER ","","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":""}]}]}