{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ZEONTRE MOORE","gend":0,"add":"18 FARRAGUTT ST APT B","city":"PORTSMOUTH","state":"VA","zip":"23702-9998","dob":"2005-04-24","age":"","mstatus":"","insh":"1018001*01","cliId":"","pno":7579983601,"cno":7579983601,"email":"","ename":"","eno":"","pphy":"OLES, JILL M NP","ppno":7572529140,"pcpadd":"301 RIVERWALK AVE,","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":"23510-9998","pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Neurosurgery Specialists - Norfolk","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7577934149,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F91.3","F90.2","S01.93XA","S06.9X0A","S05.32XA","S05.42XA","S06.9X9A","S02.30XA","S02.91XA","S06.5X9A","W34.00XA","V58.89","S06.6X9A","S05.91XA","I60.9","S02.19XA","S04.019A","R45.1","S06.2X9S","X95.8XXD","G44.319","R41.840","G47.9","R26.89","R41.3","R41.841","R41.842","R41.844","R51.9","S60.419A","M25.561","R00.0","R40.2422","I95.9","T14.8XXA","M95.2","H54.40","J96.90","S01.83XA","D72.829","S05.8X2A","S02.839A","R41.89","R53.1","J95.821","S01.90XA","S09.90XA","X95.9XXA","S06.2X6S","Z74.09","T15.02XA","F02.81","F45.1","W34.00XD","H53.8","M79.604","M54.2","T14.90XA","F12.90","Z02.89","Z65.3","Z65.1","R11.2","Z20.822","Z79.899","R26.1","T14.8XXD","R68.89","S06.369A","Y24.9XXA","Z98.890","S04.011A","H35.61","H04.123","S06.6X0A","J96.02","NO DATA","S05.52XA","E87.0","S02.19XB","S06.5X0A","S02.121A","S02.31XA","S02.831A","H35.60","R41.0","H11.421","S06.890A","S02.92XB","F54.","F91.8","R27.9","F90.9","Z91.19","F02.80"],"date":["2022-05-01","2022-05-01","2022-05-13","2023-04-18","2022-05-13","2022-05-13","2022-11-03","2022-04-29","2022-05-01","2022-05-01","2022-12-29","2023-02-09","2022-05-01","2022-05-01","2022-05-02","2022-05-02","2022-05-05","2022-05-05","2023-05-25","2023-01-25","2023-05-25","2023-01-25","2023-05-25","2023-05-25","2022-10-27","2022-10-27","2022-10-27","2023-01-25","2023-03-22","2023-03-22","2023-03-22","2023-03-22","2023-03-22","2023-03-22","2023-03-22","2023-03-22","2023-03-22","2022-04-23","2022-04-22","2022-04-23","2022-04-30","2022-04-22","2022-04-26","2022-04-26","2022-04-21","2022-04-21","2022-05-10","2022-04-21","2022-05-10","2022-06-16","2022-04-25","2022-05-09","2022-05-09","2022-05-09","2022-06-22","2023-03-22","2023-03-22","2023-03-22","2021-10-06","2021-10-06","2021-10-06","2021-10-06","2021-10-09","2022-05-05","2021-10-09","2022-09-08","2022-10-24","2022-10-24","2022-04-21","2022-04-21","2022-12-29","2022-05-05","2022-04-22","2022-10-24","2022-04-21","2022-04-21","2022-04-21","2022-05-05","2022-04-21","2022-04-21","2022-04-21","2022-04-21","2022-04-21","2022-04-21","2022-04-21","2022-04-21","2022-04-21","2022-05-05","2022-05-05","2022-05-10","2022-05-05","2022-05-05","2022-05-05","2022-05-05","2022-05-10"],"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":[["","00065039605","CYCLOGYL","SOL 1% OP","5","Select","Select",""],["","24208091055","ERYTHROMYCIN","OIN 5MG\/GM","4","Select","Select",""],["","60505058204","MOXIFLOXACIN","SOL HCL 0.5%","3","Select","Select",""],["","10006073038","MAG OXIDE","TAB 400MG","30","Select","Select",""],["","61314039601","CYCLOPENTOL","SOL 1% OP","2","Select","Select",""],["","60758011905","PREDNISOLONE","SUS 1% OP","5","Select","Select",""],["","65162069890","GABAPENTIN","SOL 250\/5ML","180","Select","Select",""],["","80681008500","MELATONIN","3 MG","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":""}]}]}