{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CATRENA   L LEAVY","gend":1,"add":"3514 DUBLIN CT","city":"VIRGINIA BEACH","state":"VA","zip":"23453-9998","dob":"1971-10-15","age":"","mstatus":"","insh":"1956882*01","cliId":"","pno":"757\/790-6431","cno":"757\/790-6431","email":"","ename":"","eno":"","pphy":"CALLAHAN, ROBERT D MD","ppno":"757\/395-1700","pcpadd":"3745 HOLLAND RD","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":23452,"pcpcounty":"","pcpid":700505,"pcpname":"SMG - Sentara Family Medicine Physicians - Chimney Hill","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/507-9004","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R07.9","R06.09","R07.89","C50.412","D64.81","Z17.0","R06.02","F43.10","R10.13","K59.00","K21.9","R93.89","R53.83","N65.0","Z85.3","Z90.13","C50.212","NO DATA","R05.","R42.","R11.0","C50.512","C50.912","L70.9","L81.9","Z42.1","Z88.5","Z79.899","Z83.3","Z82.49","Z82.3","Z80.9","Z92.21","Z92.3","Z11.59","R06.00","Z00.00","E05.90","Z12.39","N95.1","Z23.","F41.8","M79.602","I99.9","N64.89","L76.34","K29.70","M77.9","L30.9","L85.8","Z01.419","R68.82","R22.32","I89.0","Z11.52","D48.1","I97.2","M25.612","S16.1XXA","K22.70","M79.641","J30.9","J06.9","R13.14","I99.8","Z01.812","Z20.822","U07.1","Z79.811","Z48.3"],"date":["2020-02-10","2021-03-17","2020-12-10","2021-09-09","2020-09-03","2021-09-09","2020-11-17","2021-09-28","2021-04-07","2021-04-07","2021-04-07","2021-04-07","2021-09-09","2021-07-26","2021-07-26","2021-07-26","2020-11-09","2020-10-05","2021-08-11","2020-04-15","2020-12-07","2020-10-27","2021-08-12","2020-06-24","2020-06-24","2020-10-05","2020-10-05","2020-10-05","2020-10-05","2020-10-05","2020-10-05","2020-10-05","2020-07-08","2020-07-08","2020-07-08","2021-03-17","2020-12-07","2020-12-07","2020-12-07","2021-01-07","2020-12-07","2020-01-07","2021-09-08","2020-07-08","2020-10-05","2020-10-22","2020-12-10","2021-06-17","2020-01-22","2020-01-22","2020-06-29","2020-06-29","2021-05-10","2021-05-10","2021-06-01","2021-07-16","2021-03-03","2021-09-08","2020-01-15","2020-03-27","2021-05-24","2021-05-24","2020-06-09","2020-06-29","2020-10-05","2021-07-23","2021-07-30","2021-07-30","2021-09-09","2021-09-08"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",null,"","","","","","","","","","","","","","",null,"","","","","","","","","","","",null]}},{"a":[]}]},{"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":[]}]},{"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":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","60505384801","CELECOXIB ","100MG","60","Select","Select",""],["","62175061743","PANTOPRAZOLE ","40MG","30","Select","Select",""],["","00187516245","RETIN-A ","0.05%","45","Select","Select",""],["","00574220545","TRETINOIN ","0.05%","45","Select","Select",""],["","67877025130","TRIAMCINOLON ","0.10%","60","Select","Select",""],["","45802057178","FEXOFENADINE ","180MG","30","Select","Select",""],["","16729003415","LETROZOLE ","2.5MG","30","Select","Select",""],["","45802091987","CETIRIZINE ","10MG","30","Select","Select",""],["","68180012202","CEPHALEXIN ","500MG","40","Select","Select",""],["","65862042005","SMZ\/TMP ","800-160","20","Select","Select",""],["","00228202950","ALPRAZOLAM ","0.5MG","2","Select","Select",""],["","65862039110","ONDANSETRON ","8MG ODT","30","Select","Select",""],["","47781019601","OXYCOD\/APAP ","5-325MG","50","Select","Select",""],["","69097094312","GABAPENTIN ","300MG","30","Select","Select",""],["","00406324301","HYDROMORPHON ","2MG","50","Select","Select",""],["","69543038810","KETOROLAC ","10MG","20","Select","Select",""],["","00904678480","ASPIRIN ","325MG EC","30","Select","Select",""],["","13107008405","LORAZEPAM ","1MG","10","Select","Select",""],["","00054001925","PREDNISONE ","50MG","3","Select","Select",""],["","68382003516","VENLAFAXINE ","75MG ER","30","Select","Select",""],["","45802086866","POLYETH ","3350 NF","14","Select","Select",""],["","00603459321","METHYLPRED ","4MG","21","Select","Select",""],["","65162019050","NAPROXEN ","500MG","10","Select","Select",""],["","51224001060","BENZONATATE ","100MG","30","Select","Select",""],["","00054327099","FLUTICASONE ","50MCG","16","Select","Select",""],["","00406012305","HYDROCO\/APAP ","5-325MG","40","Select","Select",""],["","67253090150","ALPRAZOLAM","0.5MG","2","Select","Select",""],["","62175061743","PANTOPRAZOLE","40MG","30","Select","Select",""],["","00574220545","TRETINOIN","0.05%","45","Select","Select",""],["","67877025130","TRIAMCINOLON","0.10%","60","Select","Select",""],["","45802057178","FEXOFENADINE","180MG","30","Select","Select",""],["","00187516245","RETIN-A","0.05%","45","Select","Select",""],["","16729003415","LETROZOLE","2.5MG","30","Select","Select",""],["","60505384801","CELECOXIB","100MG","60","Select","Select",""],["","68180012202","CEPHALEXIN","500MG","40","Select","Select",""],["","65862042005","SMZ\/TMP","800-160","20","Select","Select",""],["","45802091987","CETIRIZINE","10MG","30","Select","Select",""],["","65862018730","ONDANSETRON","4MG","10","Select","Select",""],["","00406324301","HYDROMORPHON","2MG","50","Select","Select",""],["","13107008405","LORAZEPAM","1MG","10","Select","Select",""],["","00093031401","KETOROLAC","10MG","20","Select","Select",""],["","47781019601","OXYCOD\/APAP","5-325MG","50","Select","Select",""],["","00536123201","ASPIRIN","325MG EC","30","Select","Select",""],["","00054001925","PREDNISONE","50MG","3","Select","Select",""],["","69097094312","GABAPENTIN","300MG","30","Select","Select",""],["","45802086866","POLYETH","3350 NF","14","Select","Select",""],["","65162019050","NAPROXEN","500MG","10","Select","Select",""],["","00054327099","FLUTICASONE","50MCG","16","Select","Select",""],["","00603459321","METHYLPRED","4MG","21","Select","Select",""],["","00406012305","HYDROCO\/APAP","5-325MG","40","Select","Select",""],["","67877057305","BENZONATATE","100MG","30","Select","Select",""],["","68382003516","VENLAFAXINE","75MG ER","30","Select","Select",""],["","00904530760","BANOPHEN ","CAP 50MG","1","Select","Select",""]]}},{"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":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[[["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["No","Select","","","","","Select","",""]]]},{"t":"Mini-Cog","q":[{"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":""}]}]}