{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DOUGLAS  S WHITAKER","gend":0,"add":"136 VILLA WAY","city":"YORKTOWN","state":"VA","zip":"23693-9998","dob":"1970-08-09","age":"","mstatus":"","insh":"2378648*01","cliId":"","pno":7578707566,"cno":7578707566,"email":"","ename":"","eno":"","pphy":"PREWITT, KERRY C MD","ppno":7573454800,"pcpadd":"400 SENTARA CIR STE 320","pcpcity":"WILLIAMSBURG","pcpstate":"VA","pcpzip":"23188-9998","pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Cardiology Specialists - Williamsburg","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7573454801,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["C90.00","Z51.11","Z01.810","Z94.84","Z45.2","L27.0","I12.9","N18.4","E79.0","E83.42","Z23.","NO DATA","N43.3","S30.22XA","D64.9","D69.6","R11.0","B34.9","H60.391","Z20.822","S50.11XA","S70.01XA","N17.9","R06.09","R60.0","E21.3","N18.9"],"date":["2022-11-04","2021-08-09","2021-06-04","2022-03-11","2021-09-13","2022-03-11","2021-11-12","2021-11-12","2021-11-12","2022-04-22","2022-11-04","2022-04-22","2022-12-15","2022-12-15","2022-01-13","2021-08-23","2022-01-13","2022-03-27","2022-03-27","2022-03-27","2022-12-15","2022-12-15","2021-04-26","2021-06-01","2021-05-18","2021-05-18","2022-03-11"],"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":[["","69238149001","BUMETANIDE","TAB 1MG","120","Select","Select",""],["","62559093101","CYCLOPHOSPH","CAP 50MG","48","Select","Select",""],["","00054418425","DEXAMETHASON","TAB 4MG","40","Select","Select",""],["","13107008401","LORAZEPAM","TAB 1MG","60","Select","Select",""],["","00173072020","FLOVENT HFA","AER 220MCG","12","Select","Select",""],["","59746017306","PREDNISONE","TAB 10MG","30","Select","Select",""],["","11822489910","RA HI CAL","TAB 500-200","30","Select","Select",""],["","68382004101","PROMETHAZINE","TAB 25MG","40","Select","Select",""],["","00406051201","OXYCOD\/APAP","TAB 5-325MG","30","Select","Select",""],["","69543026810","VIRT-PHOS","TAB 250 NEUT","28","Select","Select",""],["","31722077701","ACYCLOVIR","TAB 400MG","90","Select","Select",""],["","55111015430","ONDANSETRON","TAB 8MG","30","Select","Select",""],["","16729013401","ALLOPURINOL","TAB 100MG","60","Select","Select",""],["","00832532511","POT CL MICRO","TAB 20MEQ ER","20","Select","Select",""],["","31722072320","LEVOFLOXACIN","TAB 750MG","7","Select","Select",""],["","59267102501","PFIZER VACC","INJ ADLT RTU","0","Select","Select",""],["","31604002576","MAGNESIUM","CAP 400MG","12","Select","Select",""],["","59572041028","REVLIMID","CAP 10MG","28","Select","Select",""],["","16714007104","BACLOFEN","TAB 10MG","30","Select","Select",""],["","45802006436","TRIAMCINOLON","CRE 0.001","80","Select","Select",""],["","59572050321","POMALYST","CAP 3MG","21","Select","Select",""],["","82607066026","FLOWFLEX","KIT TEST","8","Select","Select",""],["","43598032675","CIPRO\/DEXA","SUS 0.3-0.1%","8","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":""}]}]}