{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"STEPHANIE N THORNTON","gend":1,"add":"464 WHEALTON ROAD","city":"HAMPTON","state":"VA","zip":"23666-9998","dob":"1985-08-11","age":"","mstatus":"","insh":"7619227*01","cliId":"","pno":7577737498,"cno":7577737498,"email":"","ename":"","eno":"","pphy":"WELSH, CATHERINE C NP","ppno":7577363700,"pcpadd":"2104 EXECUTIVE DRIVE,","pcpcity":"HAMPTON","pcpstate":"VA","pcpzip":"23666-9998","pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Family Medicine Physicians - Peninsula Towne","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"7573673906, 7575952151 ","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7578279978,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R10.9","R39.9","R31.0","R59.1","T75.3XXS","N20.0","S40.012A","S52.122A","W19.XXXA","R10.11","D18.09","R76.8","R31.29","N32.81","R35.0","R35.1","N39.41","R39.14","Z12.11","Z79.1","Z20.828","R53.83","R68.89","R10.13","D70.8","M25.561","N15.9","D70.9","M25.50","R07.89","B02.9","R05.9","R51.9","Z20.822","M25.551","F90.2","F43.12","S52.022A","M25.531","M79.646","G56.01","M18.11","K29.70","Z03.818","H04.123","NO DATA"],"date":["2022-09-29","2022-09-29","2022-09-29","2022-09-29","2022-09-29","2021-04-01","2021-06-04","2021-06-04","2021-06-04","2022-02-04","2022-02-04","2022-02-04","2021-01-27","2021-01-27","2021-01-27","2021-01-27","2021-01-27","2021-01-27","2021-03-16","2021-03-16","2021-01-24","2022-07-28","2022-01-06","2022-01-06","2022-01-06","2023-01-04","2021-01-04","2022-07-28","2022-07-28","2023-07-10","2023-07-10","2022-01-11","2022-01-11","2022-01-11","2022-01-28","2022-02-16","2022-02-16","2021-06-03","2022-05-10","2022-05-10","2022-05-10","2022-05-10","2021-03-29","2021-11-19","2023-01-12","2023-01-12"],"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":[["","55111064501","OMEPRAZOLE","CAP 40MG","180","Select","Select",""],["","72647033101","METHYLPRED","TAB 4MG","14","Select","Select",""],["","68382005101","MELOXICAM","TAB 15MG","30","Select","Select",""],["","65862018601","CLINDAMYCIN","CAP 300MG","21","Select","Select",""],["","65162046650","IBUPROFEN","TAB 800MG","40","Select","Select",""],["","00591225823","SCOPOLAMINE","DIS 1MG\/3DAY","10","Select","Select",""],["","68462019001","NAPROXEN","TAB 500MG","60","Select","Select",""],["","31722099601","HYDROCO\/APAP","TAB 5-325MG","18","Select","Select",""],["","50111078810","AZITHROMYCIN","TAB 500MG","3","Select","Select",""],["","50383026505","LOTEPREDNOL ETABONATE","0.5 %","5","Select","Select",""],["","71571033383","EYSUVIS","0.25 %","8.3","Select","Select",""],["","00023916360","RESTASIS","0.05 %","60","Select","Select",""],["","31722077801","ACYCLOVIR","800 MG","35","Select","Select",""],["","60505620202","CYCLOSPORINE","0.05 %","60","Select","Select",""],["","24208053725","LUMIFY","0.025 %","7.5","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":""}]}]}