{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"AHMUAD PARKS","gend":0,"add":"201 PADDINGTON PL APT 101","city":"HAMPTON","state":"VA","zip":"23669-9998","dob":"1998-05-14","age":"","mstatus":"","insh":"20078676*01","cliId":"","pno":3478254425,"cno":3478254425,"email":"","ename":"","eno":"","pphy":"GEORGE, DYLAN M NP","ppno":7577265000,"pcpadd":"200 EATON ST","pcpcity":"HAMPTON","pcpstate":"VA","pcpzip":"23669-9998","pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Family Medicine Physicians - Old Hampton","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7575109223,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["D57.00","D64.9","R52.","Z68.22","R07.9","M54.9","A41.9","E80.6","J18.9","D57.1","R10.10","R74.01","E55.9","Z00.00","Z23.","NO DATA","Z13.220","K80.20","D59.9","D72.829","Z91.09","K59.00","E87.2","E87.1","Z20.822","G89.29","I51.7","R79.89","R74.8","Z80.1","Z82.49","Z79.899","I36.1","R29.898","M79.604","M79.605","Z09.","K80.80","E86.0","R65.10","R03.0","D72.828","K80.81","D50.0","R93.5"],"date":["2023-04-21","2023-04-23","2022-09-04","2022-03-04","2022-08-28","2022-08-28","2022-09-22","2023-04-13","2022-09-22","2023-04-25","2023-04-23","2023-04-19","2023-04-25","2023-03-28","2023-03-28","2023-04-11","2023-03-28","2023-04-19","2022-09-05","2023-04-06","2022-08-10","2022-08-10","2022-09-22","2022-08-28","2022-08-28","2022-08-28","2022-08-28","2022-08-28","2023-04-11","2022-08-28","2022-08-28","2022-08-28","2022-09-09","2022-11-18","2022-11-18","2022-11-18","2022-09-28","2022-09-28","2023-04-23","2023-04-11","2023-04-03","2023-04-07","2023-04-13","2023-04-19","2023-04-19"],"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":[["","11534016503","FOLIC ACID","1 MG","30","Select","Select",""],["","49884072401","HYDROXYUREA","500 MG","180","Select","Select",""],["","71770012030","SIKLOS","TAB 1000MG","60","Select","Select",""],["","00406051205","OXYCOD\/APAP","TAB 5-325MG","60","Select","Select",""],["","00363023820","STOOL SOFTNR","CAP 100MG","30","Select","Select",""],["","63824000832","MUCINEX","TAB 600MG ER","14","Select","Select",""],["","68462010530","ONDANSETRON","TAB 4MG","30","Select","Select",""],["","00363410040","STOOL SOFTEN","CAP 100MG","30","Select","Select",""],["","45963055650","GABAPENTIN","300 MG","90","Select","Select",""],["","00406324301","HYDROMORPHON","TAB 2MG","20","Select","Select",""],["","63304045101","MORPHINE SUL","TAB 30MG ER","10","Select","Select",""],["","00172572880","FAMOTIDINE","TAB 20MG","30","Select","Select",""],["","00536252525","CAPSAICIN","CRE 0.00025","60","Select","Select",""],["","00406055201","OXYCODONE","TAB 5MG","60","Select","Select",""],["","00904699860","DOCUSATE SOD","CAP 100MG","30","Select","Select",""],["","74312052807","VITAMIN D","3 50 MCG","90","Select","Select",""],["","00406324301","HYDROMORPHONE HCL","2 MG","12","Select","Select",""],["","00591315901","URSODIOL","300 MG","60","Select","Select",""],["","69315021101","NIFEDIPINE","10 MG","90","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":""}]}]}