{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TAMEISHA   D ELLIOTT","gend":1,"add":"2512 OAKLEAF PL APT 303","city":"PORTSMOUTH","state":"VA","zip":"23707-9998","dob":"1995-12-31","age":"","mstatus":"","insh":"8270899*01","cliId":"","pno":"757\/535-8962","cno":"","email":"","ename":"","eno":"","pphy":"LAYNE, MICHAEL MD","ppno":"757\/446-5955","pcpadd":"825 FAIRFAX AVE SUITE 118","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23507,"pcpcounty":"","pcpid":"","pcpname":"EVMS Ghent Family Medicine","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/446-5196","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F41.9","F32.9","Z20.2","N93.9","Z30.9","Z32.02","S63.601A","Z23.","J30.2","NO DATA","R06.02","Z03.818","N76.0","B96.89","F33.1","Z02.0","N92.6","R11.2","N10.","O36.5930","Z3A.32","Z11.3","Z11.4","Z11.1","A59.01","Z3A.29","Z34.92","Z3A.26","Z3A.35","Z39.1","Z34.82","Z34.83","O34.211","O98.52","Z37.0","O99.824","B00.9","Z3A.37","Z67.21","Z91.02","Z30.017","O34.219","Z39.2","Z3A.30","Z3A.34","Z3A.31","J10.1","O36.5990","O16.3","Z67.91","Z3A.33","O80.","Z97.5","Z86.19","Z3A.36","Z3A.28","Z34.93","O36.0930","F31.32","F90.2","F51.04","N72.","A53.9"],"date":["2021-09-09","2021-09-09","2022-08-10","2022-08-10","2022-08-10","2021-11-04","2020-04-17","2020-03-06","2021-04-13","2020-07-20","2020-07-20","2020-07-20","2022-03-16","2021-04-22","2021-09-17","2020-03-04","2020-03-10","2020-06-28","2020-11-28","2019-08-12","2019-07-08","2022-03-16","2022-03-16","2019-03-27","2019-03-27","2019-06-19","2019-06-27","2019-06-27","2019-07-25","2019-07-25","2019-07-25","2019-07-25","2019-08-12","2019-08-12","2019-08-12","2019-08-12","2019-08-12","2019-08-12","2019-08-12","2019-08-12","2019-08-14","2019-08-12","2019-09-27","2019-06-24","2019-07-22","2019-07-03","2019-12-22","2019-06-19","2019-06-19","2019-06-19","2019-07-11","2019-08-12","2019-12-03","2019-12-03","2019-08-05","2019-06-11","2019-07-27","2019-08-12","2022-10-10","2022-10-10","2022-10-10","2022-03-18","2022-03-18"],"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":[["","57237000511","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","70700011885","VIENVA","TAB 0.1-20","84","Select","Select",""],["","65862044990","VALACYCLOVIR","TAB 1GM","30","Select","Select",""],["","65862037401","ESCITALOPRAM","TAB 10MG","49","Select","Select",""],["","29300046810","CLONIDINE","TAB 0.1MG","30","Select","Select",""],["","62332003731","LAMOTRIGINE","TAB 25MG","45","Select","Select",""],["","69238110005","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","4","Select","Select",""],["","00555904558","AVIANE","TAB ","84","Select","Select",""],["","51862002806","LUTERA","TAB ","84","Select","Select",""],["","43598081115","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","00378334053","XULANE","DIS 150-35","3","Select","Select",""],["","","ETONOGESTREL","MIS ETHY EST","","Select","Select",""],["","00135061601","FLONASE","SUS 27.5MCG","6","Select","Select",""],["","11917010300","WAL-ITIN","TAB 10MG","30","Select","Select",""],["","45802065087","LORATADINE","TAB 10MG","30","Select","Select",""],["","00555088602","ESTRADIOL","TAB 1MG","14","Select","Select",""],["","","OXYCODONE","TAB 5MG","","Select","Select",""],["","64679096401","AZITHROMYCIN","TAB 500MG","2","Select","Select",""],["","65162046650","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","","CEFDINIR","CAP 300MG","","Select","Select",""],["","","ONDANSETRON","TAB 4MG ODT","","Select","Select",""],["","00904759080","FEROSUL","TAB 325MG","30","Select","Select",""],["","31604002674","D3","TAB 2000UNIT","30","Select","Select",""],["","00904531346","PRENATAL","TAB 27-0.8MG","30","Select","Select",""],["","49022008436","CLOTRIMAZOLE","CRE 1% VAG","45","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","20","Select","Select",""],["","69238126601","OSELTAMIVIR","CAP 75MG","10","Select","Select",""],["","51672130406","TERCONAZOLE","CRE 0.004","45","Select","Select",""],["","00904645780","DOK","CAP 100MG","30","Select","Select",""],["","00904585652","CALCIUM","TAB 600MG","60","Select","Select",""],["","64380071206","BENZONATATE","CAP 100MG","30","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":""}]}]}