{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LAMONT HALL","gend":0,"add":"4753 GREEN LAWN DR","city":"VIRGINIA BEACH","state":"VA","zip":"23464-9998","dob":"1973-12-16","age":"","mstatus":"","insh":"20047433*01","cliId":"","pno":"757\/525-2961","cno":"757\/525-2961","email":"","ename":"","eno":"","pphy":"NELSON, MERRILYN E DO","ppno":"757\/395-1300","pcpadd":"2859 VIRGINIA BEACH BLVD","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":23452,"pcpcounty":"","pcpid":310023,"pcpname":"SMG - Sentara Family Medicine Physicians - Little Neck","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":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F32.9","F41.9","F12.10","C79.9","Z72.0","G89.3","N52.9","C61.","Z68.29","N10.","Z68.30","R11.10","F19.939","R10.84","R11.2","K59.03","K50.00","R10.31","R11.0","G89.4","Z68.31","G47.33","F33.1","E86.0","E87.1","K50.90","N17.9","F11.20","Z87.891","F11.23","K50.10","Z20.828","F51.04","K50.919","F11.99","R35.1","F32.0","G47.30","I10.","R10.9","Z87.19","Z20.822","F11.90","J44.9","K21.9","K92.1","K59.00","Z68.28","M54.41","G89.29","F19.94","Z65.8","F41.8","R65.10","F17.200","NO DATA","K31.89","R10.13","R10.32","Z51.5","K04.6","K02.9","Z79.891","J43.9","N40.0","G47.00","Z79.899","R19.7","Z01.818","Z23.","M54.9","J18.9"],"date":["2020-02-05","2020-11-10","2020-06-12","2021-06-25","2021-07-27","2021-06-25","2020-02-07","2021-07-27","2021-07-27","2020-05-08","2021-06-25","2020-06-09","2020-06-09","2020-07-17","2021-05-18","2021-07-27","2020-06-11","2020-12-06","2020-07-16","2020-12-14","2021-03-16","2021-06-25","2021-06-03","2020-07-15","2020-06-09","2020-12-31","2020-07-15","2020-12-11","2020-07-15","2020-12-04","2020-12-04","2020-12-04","2020-12-11","2021-07-27","2020-12-14","2021-06-25","2021-03-23","2021-03-23","2021-05-18","2021-05-14","2021-05-14","2021-05-14","2020-06-12","2020-06-12","2020-06-12","2020-06-12","2020-07-17","2020-12-23","2020-12-14","2020-12-14","2020-12-14","2020-12-14","2020-12-14","2021-05-18","2020-06-09","2020-12-31","2020-12-31","2020-12-31","2020-07-16","2020-07-16","2020-11-10","2020-11-10","2020-12-30","2020-06-09","2021-07-27","2020-06-09","2020-06-09","2020-01-08","2020-11-02","2020-11-02","2021-07-28","2021-07-28"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}},{"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":[["","70756080790","LANSOPRAZOLE ","30MG DR","30","Select","Select",""],["","57894015012","ZYTIGA ","250MG","120","Select","Select",""],["","00054472831","PREDNISONE ","5MG","60","Select","Select",""],["","00054007928","BALSALAZIDE ","750MG","270","Select","Select",""],["","47781042647","FENTANYL ","50MCG\/HR","10","Select","Select",""],["","00115165201","METOCLOPRAM ","5MG","120","Select","Select",""],["","10702005601","OXYCODONE ","10MG","120","Select","Select",""],["","00597003134","CATAPRES-TTS ","0.1\/24HR","2","Select","Select",""],["","00378087199","CLONIDINE ","0.1\/24HR","4","Select","Select",""],["","64764024060","AMITIZA ","24MCG","60","Select","Select",""],["","69547035302","NARCAN ","","2","Select","Select",""],["","65162062710","TRAMADOL ","50MG","16","Select","Select",""],["","00536110888","NICOTINE ","21MG\/24H","14","Select","Select",""],["","65862039110","ONDANSETRON ","8MG ODT","60","Select","Select",""],["","57237002801","AMOXICILLIN ","500MG","21","Select","Select",""],["","65162027210","SMZ\/TMP ","800-160","20","Select","Select",""],["","68382004101","PROMETHAZINE ","25MG","20","Select","Select",""],["","00378692191","ABIRATERONE ","500MG","60","Select","Select",""],["","57237001830","DULOXETINE ","30MG","30","Select","Select",""],["","00254302902","LUBIPROSTONE ","24MCG","60","Select","Select",""],["","50383077504","LIDOCAINE ","2% VISC","140","Select","Select",""],["","00378400305","ALPRAZOLAM ","0.5MG","5","Select","Select",""],["","65862015901","ZOLPIDEM ","5MG","30","Select","Select",""],["","68382018314","BUSPIRONE ","30MG","150","Select","Select",""],["","60432003708","LACTULOSE ","10GM\/15","237","Select","Select",""],["","69238110005","DOXYCYCL ","100MG","20","Select","Select",""],["","59310057922","PROAIR ","","8","Select","Select",""],["","00116200116","CHLORHEX ","0.12%","473","Select","Select",""],["","11822365030","RA ","200MG","25","Select","Select",""],["","00054023624","MORPHINE ","30MG","28","Select","Select",""],["","68180044701","QUETIAPINE ","100MG","30","Select","Select",""],["","16714012302","OMEPRAZOLE ","40MG","60","Select","Select",""],["","70436001004","BUPROPN ","150MG XL","30","Select","Select",""],["","45802086866","POLYETH ","3350 NF","30","Select","Select",""],["","65162046650","IBUPROFEN ","800MG","30","Select","Select",""],["","00093317431","ALBUTEROL ","HFA","8","Select","Select",""],["","67877019905","AMLODIPINE ","10MG","90","Select","Select",""],["","65862059801","TAMSULOSIN ","0.4MG","30","Select","Select",""],["","16729018201","HYDROCHLOROT ","12.5MG","30","Select","Select",""],["","52565005630","TRIAMCINOLON ","0.10%","60","Select","Select",""],["","00574705012","BISACODYL ","10MG","10","Select","Select",""],["","00363876020","SENNA-S ","8.6-50MG","60","Select","Select",""],["","00067815202","VOLTAREN ","1%","50","Select","Select",""],["","65162083366","DICLOFENAC ","1%","100","Select","Select",""],["","59267100003","PFIZER ","COVID-19","0","Select","Select",""],["","42192033901","HYOSCYAMINE ","0.125MG","60","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","",""],["No","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["Yes","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":""}]}]}