{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TIMERRA PRAY","gend":1,"add":"537 RUFFNER ST","city":"NORFOLK","state":"VA","zip":"23504-9998","dob":"1991-06-22","age":"","mstatus":"","insh":"2826011*01","cliId":"","pno":7576212703,"cno":7576212703,"email":"","ename":"","eno":"","pphy":"HARTUNG, HILLARY M PA","ppno":7574468999,"pcpadd":"SUITE 572 825 FAIRFAX AVE","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":"23507-9998","pcpcounty":"","pcpid":"","pcpname":"EVMS Infectious Diseases","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7574467922,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I07.1","N17.9","B20.","R59.1","B45.7","I47.1","R59.0","D50.9","R50.9","B45.1","R65.10","R10.9","B49.","H35.81","H35.63","R00.0","J96.01","H30.899","Z88.1","N18.6","R06.02","Z99.2","Z88.2","Z21.","I12.0","E83.51","Z91.15","B37.7","N17.0","NO DATA","G05.3","R65.20","B45.0","E87.2","H44.19","E44.0","H30.103","J95.821","G93.2","I10.","R07.89","R07.9","E87.70","Z53.29","Z11.3","Z13.220","Z11.59","Z00.00","N18.5","B45.9","H53.8","N18.4","B00.9","Z79.899","K21.9","R11.2","R22.43","E87.5","D63.1","Z76.89","Z49.01","A41.9","J15.9","N25.81","Z20.822","R91.1","N94.89","I33.9","I33.0","R60.1","I38.","I15.2","N18.9","R94.31","J18.9","R53.81"],"date":["2021-09-29","2022-09-02","2023-04-11","2021-10-09","2021-12-21","2021-10-02","2022-11-14","2021-10-02","2021-10-20","2022-02-08","2021-10-20","2021-10-20","2021-10-20","2021-10-20","2021-10-20","2021-10-21","2023-04-02","2021-12-21","2023-02-14","2023-04-20","2023-03-06","2023-04-20","2023-02-14","2023-04-04","2023-04-16","2023-03-19","2023-03-28","2021-09-24","2021-09-24","2023-02-13","2021-09-24","2021-09-24","2021-10-21","2021-09-24","2021-09-24","2021-09-24","2021-09-24","2021-10-09","2021-10-07","2023-02-13","2022-11-16","2022-11-16","2023-04-02","2023-02-21","2021-12-06","2021-12-06","2021-01-29","2021-12-06","2022-09-02","2021-11-23","2021-11-23","2022-02-08","2022-09-09","2023-03-06","2022-11-16","2022-11-16","2023-01-26","2023-04-02","2023-02-13","2023-03-23","2022-01-03","2023-02-09","2023-02-09","2023-02-09","2023-02-09","2021-09-24","2021-09-28","2021-09-30","2021-10-01","2021-10-13","2021-10-01","2023-02-17","2023-02-17","2023-03-11","2023-02-09","2023-04-16"],"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":[["","49702024613","DOVATO","TAB 50-300MG","30","Select","Select",""],["","13925050530","DAPSONE","TAB 100MG","30","Select","Select",""],["","55111046801","METOPROL SUC","TAB 100MG ER","30","Select","Select",""],["","24689079302","CALC ACETATE","CAP 667MG","270","Select","Select",""],["","61442012110","FAMOTIDINE","TAB 20MG","30","Select","Select",""],["","00378427577","VALACYCLOVIR","500 MG","30","Select","Select",""],["","31722062921","ATOVAQUONE","750 MG\/5ML","300","Select","Select",""],["","69452020713","CALCITRIOL","CAP 0.25MCG","30","Select","Select",""],["","68462010430","FLUCONAZOLE","200 MG","60","Select","Select",""],["","61958250101","BIKTARVY","50-200-25","30","Select","Select",""],["","69452015120","VITAMIN D","CAP 50000UNT","4","Select","Select",""],["","00168005321","PETROLATUM","OIN WHITE","28","Select","Select",""],["","59267102504","PFIZER VACC","INJ ADLT RTU","0","Select","Select",""],["","00093729505","CARVEDILOL","12.5 MG","60","Select","Select",""],["","31722072250","LEVOFLOXACIN","TAB 500MG","5","Select","Select",""],["","59762040101","SUCRALFATE","TAB 1GM","30","Select","Select",""],["","68462015713","ONDANSETRON","TAB 4MG ODT","12","Select","Select",""],["","00406012305","HYDROCO\/APAP","TAB 5-325MG","30","Select","Select",""],["","16714020030","ONDANSETRON ODT","4 MG","12","Select","Select",""],["","66993001968","ALBUTEROL SULFATE HFA","90 MCG","18","Select","Select",""],["","72516003001","METOPROLOL SUCCINATE","25 MG","30","Select","Select",""],["","29300039810","AMLODIPINE BESYLATE","10 MG","30","Select","Select",""],["","63304061650","DOXYCYCLINE MONOHYDRATE","100 MG","6","Select","Select",""],["","42806071401","BENZONATATE","100 MG","30","Select","Select",""],["","00536132710","ACETAMINOPHEN","325 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":""}]}]}