{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JADIS WINSTON","gend":0,"add":"364 DEPUTY LN APT E","city":"NEWPORT NEWS","state":"VA","zip":"23608-9998","dob":"2003-02-14","age":"","mstatus":"","insh":"8537542*01","cliId":"","pno":"757\/604-4987","cno":"","email":"","ename":"","eno":"","pphy":"HUSEN, SRIE D MD","ppno":"757\/594-1850","pcpadd":"STE 100 11803 JEFFERSON AVE","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":23606,"pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Family Medicine Physicians - Port Warwick","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/594-1841","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["L20.82","S21.331A","R09.02","V58.89","S22.41XB","S42.101B","V54.12","V54.16","M21.371","E87.8","E87.1","D62.","D69.6","J45.909","I10.","R00.0","F12.10","Z79.01","J86.9","T14.90XA","J94.2","T78.08XA","S21.131A","NO DATA","L02.213","B95.61","M79.2","D64.9","E46.","Z09.","W34.00XA","B99.9","R50.9","R05.","S27.2XXA","S27.321A","X95.9XXA","S81.041A","S21.341A","S51.842A","S22.41XA","S42.111B","S82.121B","S52.252B","M79.605","R53.81","S82.141B","S27.1XXA","J95.811","J93.9","Y24.9XXA","A41.9","J90.","E44.0","G62.9","Z79.899","Z91.02","Z91.018","Z91.013","Z87.891","S27.391S","Z90.2","N28.9","R06.02","R53.1","R46.89","S21.109A","I49.9","T81.44XA","R91.8","Z97.8","D72.829","G56.91","Z68.1"],"date":["2022-02-01","2022-07-16","2022-07-16","2022-06-07","2022-06-02","2022-06-02","2022-06-02","2022-06-02","2022-06-02","2022-06-02","2022-06-02","2022-06-02","2022-06-02","2022-06-07","2022-06-09","2022-06-02","2022-06-02","2022-06-07","2022-07-07","2022-05-07","2022-05-24","2022-05-24","2022-06-07","2022-06-09","2022-06-07","2022-06-12","2022-06-12","2022-06-12","2022-06-12","2022-06-02","2022-06-02","2022-06-10","2022-06-07","2020-01-24","2022-05-26","2022-05-26","2022-05-26","2022-05-26","2022-05-26","2022-05-26","2022-05-26","2022-05-26","2022-05-26","2022-05-26","2020-10-31","2020-10-31","2022-05-07","2022-05-07","2022-05-07","2022-05-20","2022-05-20","2022-06-09","2022-06-07","2022-06-09","2022-06-07","2022-06-07","2022-06-07","2022-06-07","2022-06-07","2022-06-07","2022-06-07","2022-06-07","2022-05-16","2022-06-07","2022-06-07","2022-06-07","2022-05-07","2022-05-10","2022-06-09","2022-06-09","2022-06-09","2022-06-09","2022-06-09","2022-06-09"],"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":[["","00781185220","AMOX\/K","TAB 875-125","14","Select","Select",""],["","51672128202","TRIAMCINOLON","CRE 0.001","60","Select","Select",""],["","57664047758","METOPROL","TAB 50MG","60","Select","Select",""],["","00003089321","ELIQUIS","TAB 2.5MG","70","Select","Select",""],["","70010075405","METHOCARBAM","TAB 500MG","40","Select","Select",""],["","67877019890","AMLODIPINE","TAB 5MG","14","Select","Select",""],["","67877022301","GABAPENTIN","CAP 300MG","90","Select","Select",""],["","57664037708","TRAMADOL","TAB 50MG","28","Select","Select",""],["","16729018301","HYDROCHLOROT","TAB 25MG","14","Select","Select",""],["","00085113204","PROVENTIL","AER HFA","7","Select","Select",""],["","69238126601","OSELTAMIVIR","CAP 75MG","10","Select","Select",""],["","64380080807","IBUPROFEN","TAB 600MG","20","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","65162070486","FLUOCIN","OIL BODY","118","Select","Select",""],["","51672130606","ALCLOMETASON","CRE 0.0005","45","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":""}]}]}