{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" J   DLANORRJ LLEWNROC","gend":0,"add":"S HT31 017791 RLRT T","city":"VIRGINIA BEACH","state":"VA","zip":"23451-9998","dob":"1968-06-15","age":"","mstatus":"","insh":"70500210*29","cliId":"","pno":"04\/7575162-2","cno":"","email":"","ename":"","eno":"","pphy":"MEBRAHTU, SEMRET T MD","ppno":"757\/395-6900","pcpadd":"184B LASKIN RD","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":23451,"pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Primary Care & Therapy Center - Oceanfront","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G47.33","F39.","F10.20","F11.20","Z01.818","J44.9","I10.","F32.9","Z23.","J98.4","Z20.828","M20.12","M20.42","Q66.229","Z98.890","G89.18","R60.9","M79.672","M21.962","M79.662","F33.2","E66.01","Z68.37","I82.412","F33.42","Z00.00","Z13.220","Z13.29","Z12.5","M21.619","Z12.11","Z13.228","Z13.0","Z03.89","Q66.222","I82.432","F31.31","Z72.0","G47.30","Z98.1","L71.9","Z68.36","R20.2","Z86.79","E55.9","F17.200","R00.0","F17.210","E66.8","Z79.899","R06.81","M54.5","R53.82","E66.9","G89.29","M43.16","E87.2","D62.","M20.5X2","M20.5X1","K21.9","M54.16","G40.909","F10.21","I95.9","R09.02","F31.9","R53.83","N40.1","M51.26","R39.14","G47.39","Z13.1","E78.2","G43.009","G47.9","I95.89","N40.0","Z47.89","E11.9","E78.00","K08.89","K08.9","Z01.810","G44.209","I25.2"],"date":["2021-04-21","2020-04-13","2020-04-13","2020-04-13","2020-10-09","2021-04-21","2021-04-21","2020-09-29","2020-09-30","2020-10-06","2020-10-09","2021-02-12","2021-02-12","2021-02-12","2020-12-22","2020-10-19","2020-10-19","2021-02-12","2021-02-12","2020-12-22","2021-09-01","2021-04-21","2021-04-21","2021-04-21","2021-04-21","2020-07-17","2020-07-17","2020-07-17","2020-07-17","2020-07-17","2020-07-17","2020-07-17","2020-07-17","2020-04-07","2020-10-13","2020-12-22","2020-01-08","2020-01-08","2020-01-08","2020-01-08","2020-01-08","2020-01-08","2020-04-15","2020-04-15","2020-09-21","2020-10-06","2021-12-03","2019-12-02","2019-05-28","2019-05-28","2019-05-28","2019-08-14","2019-08-14","2019-11-04","2019-11-04","2019-11-08","2019-11-04","2019-11-08","2019-11-04","2019-11-04","2019-12-02","2019-11-04","2019-12-02","2019-11-04","2019-11-04","2019-11-04","2019-11-04","2019-04-25","2019-04-25","2019-04-25","2019-04-25","2019-02-11","2019-01-09","2019-01-09","2019-01-09","2019-05-06","2019-11-08","2019-11-08","2019-12-02","2019-12-02","2019-12-02","2019-02-20","2019-02-20","2019-09-23","2019-02-11","2019-09-23"],"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":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"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":[["","65862069730","VENLAFAXINE","CAP 150MG ER","30","Select","Select",""],["","","NALTREXONE","TAB 50MG","","Select","Select",""],["","16729013816","CLONAZEPAM","TAB 2MG","30","Select","Select",""],["","68462012605","GABAPENTIN","TAB 600MG","120","Select","Select",""],["","43547028910","BUPROPION","TAB 150MG SR","60","Select","Select",""],["","","XARELTO","TAB 20MG","","Select","Select",""],["","68382013905","TOPIRAMATE","TAB 50MG","60","Select","Select",""],["","","WIXELA","AER 250\/50","","Select","Select",""],["","","ACETAMIN","TAB 500MG","","Select","Select",""],["","00173069600","ADVAIR","AER 250\/50","60","Select","Select",""],["","59267100003","PFIZER","INJ COVID-19","0","Select","Select",""],["","58160088752","FLUARIX","INJ 2021-22","0","Select","Select",""],["","66993058597","FLUTIC\/SALME","AER 250\/50","60","Select","Select",""],["","00069047103","CHANTIX","PAK 0.5& 1MG","53","Select","Select",""],["","","METROGEL","GEL 0.01","","Select","Select",""],["","","METRONIDAZOL","GEL 0.01","","Select","Select",""],["","","DULOXETINE","CAP 30MG","","Select","Select",""],["","00054452725","LITHIUM","TAB 300MG","120","Select","Select",""],["","","FLUOXETINE","CAP 20MG","","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","00173068220","VENTOLIN","AER ","18","Select","Select",""],["","","OXYCODONE","TAB 5MG","","Select","Select",""],["","","PROMETHAZINE","TAB 25MG","","Select","Select",""],["","","VITAMIN","CAP 50000UNT","","Select","Select",""],["","68382013201","TAMSULOSIN","CAP 0.4MG","30","Select","Select",""],["","","QUETIAPINE","TAB 100MG","","Select","Select",""],["","","SILDENAFIL","TAB 20MG","","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","","MELATONIN","TAB 5MG","","Select","Select",""],["","","CEFUROXIME","TAB 500MG","","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","00085113201","PROVENTIL","AER HFA","7","Select","Select",""],["","65862050320","AMOX\/K","TAB 875-125","20","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","57237001106","MIRTAZAPINE","TAB 15MG ODT","30","Select","Select",""],["","00527133701","BACLOFEN","TAB 20MG","30","Select","Select",""],["","00527174330","PHENTERMINE","CAP 37.5MG","30","Select","Select",""],["","00406051201","OXYCOD\/APAP","TAB 5-325MG","28","Select","Select",""],["","00009540001","NICOTROL","INH ","168","Select","Select",""],["","62541020330","QSYMIA","CAP 11.25-69","30","Select","Select",""],["","00172392670","DIAZEPAM","TAB 5MG","14","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":""}]}]}