{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"AZIYAH   N THOMPSON","gend":1,"add":"301 ADVOCATE COURT APT C","city":"NEWPORT NEWS","state":"VA","zip":"23608-9998","dob":"2002-03-25","age":"","mstatus":"","insh":"7939663*01","cliId":"","pno":"757\/508-9687","cno":"","email":"","ename":"","eno":"","pphy":"GIBSON, RUTH R NP","ppno":"757\/542-2000","pcpadd":"20209 SENTARA WAY STE 200","pcpcity":"CARROLLTON","pcpstate":"VA","pcpzip":23314,"pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Family Medicine Physicians - St. Luke's","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/542-2001","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["O98.519","U07.1","O24.119","E11.9","Z3A.00","R51.9","Z20.2","E66.9","Z68.54","Z79.899","R05.","NO DATA","J02.9","Z20.822","N30.01","B96.89","N76.0","S91.312A","R11.2","Z33.1","O21.0","Z34.90","Z01.84","O98.811","A54.9","E08.65","O23.591","R79.89","Z13.220","A74.9","A59.01","L83.","E11.69","R70.0","E28.2","G47.09","R40.0","F90.2","R06.83","M54.6","M25.511","Z23.","E78.6","N91.2","L20.84","Z11.3","T17.1XXA"],"date":["2021-09-02","2021-09-02","2021-09-02","2021-09-19","2021-09-02","2021-09-02","2021-09-19","2021-09-19","2021-09-19","2021-09-19","2021-09-02","2021-09-02","2021-09-02","2021-09-02","2021-08-22","2021-02-02","2021-02-02","2020-03-18","2021-08-22","2021-08-22","2021-08-27","2021-08-27","2021-08-27","2021-08-27","2021-08-27","2021-08-27","2021-08-27","2021-08-27","2021-08-27","2021-08-27","2021-08-27","2019-04-17","2019-04-17","2019-04-17","2019-04-17","2019-04-17","2019-04-17","2019-04-17","2019-04-17","2019-04-17","2019-04-17","2019-03-27","2019-03-27","2019-03-27","2019-03-27","2019-03-27","2019-03-04"],"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":[["","00536408501","PRENATAL","TAB 28-0.8MG","30","Select","Select",""],["","68462015713","ONDANSETRON","TAB 4MG ODT","30","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","51224012250","AZITHROMYCIN","TAB 500MG","2","Select","Select",""],["","00185012201","NITROFURANTN","CAP 100MG","10","Select","Select",""],["","11917009215","FERROUS","TAB 325MG","30","Select","Select",""],["","00904759080","FEROSUL","TAB 325MG","30","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","28","Select","Select",""],["","80681002500","VITAMIN","TAB 100MG","30","Select","Select",""],["","49884068905","METOCLOPRAM","TAB 10MG","20","Select","Select",""],["","16729022501","SPIRONOLACT","TAB 25MG","30","Select","Select",""],["","68382095201","AMPHET\/DEXTR","TAB 10MG","60","Select","Select",""],["","64380080807","IBUPROFEN","TAB 600MG","21","Select","Select",""],["","13668048450","MINOCYCLINE","CAP 100MG","60","Select","Select",""],["","45802006435","TRIAMCINOLON","CRE 0.001","30","Select","Select",""],["","67877015905","METFORMIN","TAB 500MG ER","60","Select","Select",""],["","51672130100","AMMONIUM","CRE 0.12","385","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":""}]}]}