{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LEQUITA M CHERRY","gend":1,"add":"1010 BRYCE LN","city":"VIRGINIA BEACH","state":"VA","zip":"23464-9998","dob":"1981-05-10","age":"","mstatus":"","insh":"5653703*01","cliId":"","pno":7575892875,"cno":7575892875,"email":"","ename":"","eno":"","pphy":"RILEY, SCOTT M NP","ppno":7572525820,"pcpadd":"STE 208 1933 EDWIN DR,","pcpcity":"CHESAPEAKE","pcpstate":"VA","pcpzip":"23322-9998","pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Family Medicine & Pediatrics - Edinburgh","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7579639609,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K21.9","R11.2","D72.829","E87.6","R82.90","R63.4","T83.32XA","Z30.430","R10.10","J45.40","G43.919","R56.9","G72.3","R00.0","Z76.89","I49.3","J45.20","G43.909","E46.","F43.10","F17.210","M32.9","Z79.51","Z72.0","Z53.8","Z97.5","R51.9","V49.40XA","E86.0","R73.9","R63.6","Z20.822","Z82.49","Z80.1","Z83.3","Z88.0","R53.81","R07.9","G89.29","R10.9","N30.00","E87.1","Z01.419","Z20.828"],"date":["2022-11-08","2022-11-08","2022-11-08","2022-11-08","2022-11-08","2022-11-08","2021-07-09","2021-07-09","2021-08-16","2022-06-29","2022-11-22","2022-11-22","2022-11-22","2022-07-27","2021-06-22","2021-08-10","2022-01-25","2022-08-08","2022-01-25","2022-01-25","2022-07-27","2022-07-27","2022-06-22","2022-06-29","2021-06-24","2021-06-24","2021-10-15","2021-10-15","2022-07-27","2022-07-27","2022-07-27","2022-07-27","2022-07-27","2022-07-27","2022-07-27","2022-07-27","2022-07-27","2021-09-23","2021-09-23","2021-04-27","2021-04-27","2021-04-27","2021-05-14","2021-04-08"],"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":[["","00093221001","SUCRALFATE","TAB 1GM","120","Select","Select",""],["","65862085901","FAMOTIDINE","20 MG","60","Select","Select",""],["","00603254428","BUT\/APAP\/CAF","TAB ","20","Select","Select",""],["","43386035701","HYDROCO\/APAP","TAB 7.5-325","6","Select","Select",""],["","50111033401","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","70710113908","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","63304069301","CLINDAMYCIN","CAP 300MG","20","Select","Select",""],["","45802075930","PROMETHAZINE","SUP 25MG","10","Select","Select",""],["","70436015301","POT CHLORIDE","TAB 20MEQ ER","5","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","49483060450","IBUPROFEN","TAB 800MG","15","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","30","Select","Select",""],["","57237016199","OMEPRAZOLE","CAP 20MG","90","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","50111064701","FLUOXETINE","CAP 10MG","60","Select","Select",""],["","00378932132","WIXELA INHUB","250-50 MCG","60","Select","Select",""],["","00173069600","ADVAIR DISKU","AER 250\/50","60","Select","Select",""],["","00245531911","KLOR-CON M20","TAB 20MEQ ER","3","Select","Select",""],["","00536135807","COENZYME Q10","CAP 30MG","60","Select","Select",""],["","63948016843","RIBOFLAVIN","TAB 400MG","90","Select","Select",""],["","00603020922","MAG OXIDE","TAB 400MG","30","Select","Select",""],["","49483070110","FLUOXETINE HCL","10 MG","90","Select","Select",""],["","00603254428","BUTALBITAL-ACETAMINOPHEN-CAFFE","50-325-40","20","Select","Select",""],["","00603020922","MAGNESIUM OXIDE","400 MG","30","Select","Select",""],["","11877001140","BINAXNOW COVID-","19 AG SELF TEST","8","Select","Select",""],["","00173069600","ADVAIR DISKUS","250-50 MCG","60","Select","Select",""],["","65862039010","ONDANSETRON TAB","4MG ODT","30","Select","Select",""],["","59310057922","PROAIR HFA AER","","8","Select","Select",""],["","00093317431","ALBUTEROL AER HFA","","8","Select","Select",""],["","57237016199","OMEPRAZOLE CAP","20MG","90","Select","Select",""],["","49483070110","FLUOXETINE CAP","10MG","30","Select","Select",""],["","45802075930","PROMETHAZINE SUP","25MG","10","Select","Select",""],["","00603254428","BUT\/APAP\/CAF TAB","","20","Select","Select",""],["","00378699252","ALBUTEROL NEB","1.25MG\/3","75","Select","Select",""],["","00173069600","ADVAIR DISKU AER","250\/50","60","Select","Select",""],["","00378932132","WIXELA INHUB AER","250\/50","60","Select","Select",""],["","00245531911","KLOR-CON M","20 TAB 20MEQ ER","3","Select","Select",""],["","65862085901","FAMOTIDINE TAB","20MG","120","Select","Select",""],["","00093221001","SUCRALFATE TAB","1GM","120","Select","Select",""],["","00603020922","MAG OXIDE TAB","400MG","90","Select","Select",""],["","63948016843","RIBOFLAVIN TAB","400MG","90","Select","Select",""],["","00536135807","COENZYME Q","10 CAP 30MG","60","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":""}]}]}