{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KEONI   M SCOTT","gend":1,"add":"3796 TOWNE POINT RD APT C","city":"PORTSMOUTH","state":"VA","zip":"23703-9998","dob":"1992-12-21","age":"","mstatus":"","insh":"9708499*01","cliId":"","pno":"757\/977-9461","cno":"","email":"","ename":"","eno":"","pphy":"BAUMGARTEN, MARGARET MD","ppno":"757\/397-6344","pcpadd":"3640 HIGH STREET SUITE 3B","pcpcity":"PORTSMOUTH","pcpstate":"VA","pcpzip":23707,"pcpcounty":"","pcpid":"","pcpname":"EVMS Portsmouth Family Medicine","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/606-1185","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R11.2","V23.9","O10.919","Z3A.20","R89.9","O10.013","O40.3XX0","O36.0930","Z3A.30","O10.913","O36.63X0","O99.213","Z3A.33","G47.33","E66.01","Z68.43","I10.","G89.29","J45.909","Z34.90","Z3A.17","G89.18","N92.5","R11.0","Z32.01","Z01.810","N83.209","Z3A.32","O76.","O32.1XX0","Z3A.34","Z37.0","O16.2","V23.5","Z3A.16","Z01.818","F43.22","F50.89","O10.912","Z3A.18","R82.90","Z3A.29","O11.3","O99.513","O99.353","G43.909","Z20.822","Z67.41","Z79.899","Z88.2","O26.893","O99.214","Z3A.31","R51.9","Z51.89","Z01.30","Z00.00","M25.561","I51.7","I34.0","G47.21","F51.04","J45.21","R06.02","N92.6","O11.4","O99.354","O99.42","O99.52","J45.20","O99.824","O32.8XX0","O62.0","Z39.1"],"date":["2020-12-14","2021-02-23","2021-02-23","2021-02-23","2021-02-23","2021-05-18","2021-05-26","2021-05-04","2021-05-04","2021-05-25","2021-05-25","2021-05-25","2021-05-25","2021-11-09","2022-01-04","2022-01-04","2022-01-04","2022-01-04","2022-01-04","2021-01-29","2021-01-29","2021-05-29","2020-11-23","2020-11-23","2020-12-14","2021-11-10","2020-12-14","2021-05-18","2021-05-28","2021-05-28","2021-05-28","2021-05-28","2021-01-22","2021-02-09","2021-01-22","2021-11-10","2021-12-09","2021-12-09","2021-02-09","2021-02-09","2021-02-09","2021-04-27","2021-04-27","2021-05-03","2021-05-03","2021-05-26","2021-04-27","2021-05-26","2021-05-03","2021-11-28","2021-05-26","2021-05-26","2021-05-03","2021-05-03","2021-06-09","2021-06-09","2021-12-01","2021-12-01","2021-04-29","2021-05-26","2021-10-14","2021-10-14","2021-11-28","2021-11-28","2022-09-09","2021-05-26","2021-05-26","2021-05-26","2021-05-26","2021-05-26","2021-05-26","2021-05-26","2021-05-26","2021-06-11"],"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":[["","65862018730","ONDANSETRON","TAB 4MG","20","Select","Select",""],["","11917007492","CALCIUM","","60","Select","Select",""],["","80681013800","CALCIUM\/D3","TAB 600MG","60","Select","Select",""],["","64380080707","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","68682010910","NIFEDIPINE","TAB 60MG ER","30","Select","Select",""],["","59267102501","PFIZER","INJ ADLT RTU","0","Select","Select",""],["","68180072003","AMLODIPINE","TAB 5MG","90","Select","Select",""],["","00378727253","NORETHINDRON","TAB 0.35MG","84","Select","Select",""],["","00781543820","CEFPODOXIME","TAB 100MG","28","Select","Select",""],["","70505010010","DOXYL\/PYRID","TAB 10-10MG","100","Select","Select",""],["","00713053612","PROMETHEGAN","SUP 12.5MG","21","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","28","Select","Select",""],["","00536440601","VITAMIN","TAB 25MG","30","Select","Select",""],["","00904759080","FEROSUL","TAB 325MG","30","Select","Select",""],["","00093220310","METOCLOPRAM","TAB 10MG","20","Select","Select",""],["","00781707787","METRONIDAZOL","GEL 0.75%VAG","70","Select","Select",""],["","41167000609","UNISOM","TAB 25MG","30","Select","Select",""],["","00173071820","FLOVENT","AER 44MCG","11","Select","Select",""],["","00378827052","ALBUTEROL","NEB 0.00083","75","Select","Select",""],["","11917018338","BP","KIT WRIST","1","Select","Select",""],["","51862017901","BUT\/APAP\/CAF","CAP ","15","Select","Select",""],["","00904645780","DOK","CAP 100MG","60","Select","Select",""],["","64980033912","MAGNESIUM-OX","TAB 400MG","60","Select","Select",""],["","60258017101","MAG","TAB 400MG","60","Select","Select",""],["","00955101010","ENOXAPARIN","INJ 100MG\/ML","8","Select","Select",""],["","67112010100","TRICARE","TAB PRENATAL","30","Select","Select",""],["","11917009215","FERROUS","TAB 325MG","30","Select","Select",""],["","00904530624","BANOPHEN","CAP 25MG","40","Select","Select",""],["","00406012305","HYDROCO\/APAP","TAB 5-325MG","20","Select","Select",""],["","44946104509","PNV","TAB PLUS","30","Select","Select",""],["","00363410040","STOOL","CAP 100MG","60","Select","Select",""],["","11917017654","PRENATAL","CHW 0.4-32.5","30","Select","Select",""],["","00378797052","IPRATROPIUM","SOL 0.02%INH","62","Select","Select",""],["","00378064110","PREDNISONE","TAB 10MG","26","Select","Select",""],["","68382004001","PROMETHAZINE","TAB 12.5MG","48","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":""}]}]}