{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TRAMEKA   M WARDRETT","gend":1,"add":"10 LANGILLE CT APT 100","city":"HAMPTON","state":"VA","zip":"23663-9998","dob":"1988-08-09","age":"","mstatus":"","insh":"20036939*01","cliId":"","pno":"757\/951-5738","cno":"","email":"","ename":"","eno":"","pphy":"WALLACE, DAVID M MD","ppno":"757\/726-5000","pcpadd":"200 EATON ST","pcpcity":"HAMPTON","pcpstate":"VA","pcpzip":23669,"pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Family Medicine Physicians - Old Hampton","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/726-5001","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["D57.00","K62.5","I26.99","Z86.718","F43.23","D64.9","M76.32","M25.552","S33.6XXA","D57.1","M62.838","G47.00","Z79.01","Z86.73","Z86.711","R07.9","J18.9","R51.","E83.19","E55.9","M87.052","A41.9","F11.20","M87.9","G89.29","J45.30","Z20.828","Z96.643","Z95.828","Z87.891","Z79.51","Z79.899","M76.31","J96.01","D57.01","J81.1","H57.02","N17.9","R04.0","J45.909","R51.9","M54.9","M19.90","Z90.49","R06.02","E87.6","Z88.8","Z88.7","M17.11","J45.20","M79.604","M79.605","E83.111","I63.30","G89.4","Z87.39","R06.00","R00.0","N83.201","R10.32","R11.2","R06.09","S39.012A","Z88.6","M87.059","Z96.649","R07.89","R10.9","I49.8","Z96.60","Z88.1","Z88.5","Z20.822","K92.1","K64.8","D50.9","K59.03","T40.2X5A","Z83.2","M79.601","R52.","K59.00","Z79.891","I82.409","M51.26","I82.722","I27.82","Z28.21","Z13.6","Z13.1","D57.80","F32.9","R10.84","F17.210","I63.9","S00.83XA","M70.72","M25.512","F32.89","G47.01","M79.603","M79.602","A63.0","F11.90","Z79.1","I67.89","J45.31","R87.810","F41.9","R05.9","R06.01","Z88.3","Z82.49","Z83.3","R22.0","K04.7","K08.89","I36.1","R94.31","G43.809","M25.551","R70.1","J02.9","D57.219","E87.3","E87.70","Z72.0","V58.69","N28.9","T50.2X5A","J90.","G47.9","G43.909","Z79.02","Z71.85","NO DATA","O34.11","M94.0","Z33.1","M54.89","O99.89","Z3A.22","O26.893","Z3A.29","O99.013","Z3A.33","Z39.1","Z34.82","Z34.83","M79.662","Q21.1","Z3A.19","O99.513","O99.353","J06.9","J98.11","O47.03","O99.02","O99.324","Z37.0","O99.354","O70.0","Z23.","Z3A.37","Z91.14","O99.52","I26.09","R10.30","I82.220","O80.","O99.012","O99.323","F19.20","O99.019","O76.","O66.5","D62.","D47.3","R00.2","Z38.00","P05.18","R60.0","O20.0","Z3A.09","O26.891","Z3A.12","M22.91","I82.210","T82.868A","O99.412","F11.21","O99.352","O99.512","V23.9","V23.89","Z3A.32","Z91.19","O35.2XX0","M22.41","M25.561","Z3A.36","S20.229A","Z3A.21","Z3A.23","T59.811A","R50.9","R68.89","Z56.0","R09.82","J98.01","J45.41","R65.10","F33.9","I10.","D72.829","M25.511","Z84.81","R10.31","S06.0X0A","S16.1XXA","F07.81","S43.401A","R20.2","I67.9","T78.3XXA","K52.9","R53.83","M87.88","R01.1","Z87.898","Z84.89","Z86.2","M79.661","M79.609","M25.50","X08.8XXD","M25.559","K76.9","Z28.310","N39.0","R19.7","I49.9","R06.82","J45.901","D73.5","M79.671","Z96.642","Z51.81","M79.606","Z87.09","D57.419","R07.1","T75.89XA","R09.81","R79.89","R06.2","R53.81","Z28.9","R06.4","M25.519","M16.10","D57.819","M54.2","Z96.641","Z87.19","R35.0","J40.","R11.10","J20.9"],"date":["2022-11-08","2022-02-08","2021-11-06","2022-11-08","2020-12-02","2022-07-17","2020-12-01","2022-08-07","2020-10-16","2022-11-02","2022-02-25","2022-10-06","2022-11-08","2022-11-08","2022-10-25","2022-10-13","2022-08-22","2020-03-06","2022-06-09","2020-10-15","2020-09-18","2021-10-08","2022-11-08","2022-07-11","2022-10-06","2022-07-11","2020-10-17","2022-10-25","2021-11-17","2022-10-25","2022-10-25","2022-11-08","2020-12-01","2022-04-20","2021-10-03","2021-06-30","2021-06-30","2021-07-05","2021-07-05","2022-11-08","2022-02-10","2022-06-25","2022-11-08","2022-11-08","2022-08-23","2022-05-08","2022-10-25","2022-10-25","2022-09-19","2022-09-22","2022-10-18","2022-05-27","2021-07-19","2020-10-24","2021-04-22","2022-10-08","2020-08-18","2022-11-09","2020-08-31","2021-10-26","2022-07-02","2021-10-22","2021-06-03","2022-10-25","2022-04-20","2022-09-23","2022-08-29","2022-09-06","2021-10-26","2021-10-26","2022-10-25","2022-10-25","2022-09-14","2022-11-02","2020-03-04","2022-02-08","2020-03-04","2020-03-04","2022-08-01","2022-08-15","2022-04-29","2022-06-08","2022-07-26","2020-10-01","2020-10-24","2022-06-09","2022-06-09","2021-12-15","2020-12-23","2020-12-23","2021-06-10","2021-06-10","2022-05-30","2021-06-23","2021-09-17","2021-05-22","2020-09-25","2022-03-24","2021-04-22","2021-04-22","2021-08-31","2022-03-24","2021-09-11","2021-09-11","2021-09-11","2021-10-02","2021-10-03","2021-10-03","2022-09-23","2022-08-29","2021-10-22","2020-01-30","2022-06-08","2022-01-28","2021-12-15","2020-11-20","2021-03-26","2021-07-03","2022-11-09","2020-03-18","2022-08-27","2021-12-12","2020-06-03","2022-04-19","2021-06-24","2021-06-24","2021-06-24","2021-06-24","2021-06-24","2021-06-24","2021-07-04","2021-11-17","2022-07-11","2022-07-26","2021-12-15","2022-10-13","2019-01-23","2019-03-05","2019-07-05","2019-02-05","2019-05-03","2019-04-09","2019-05-22","2019-05-27","2019-07-15","2019-06-27","2019-06-28","2019-06-28","2019-06-28","2019-11-04","2019-11-30","2019-03-15","2019-05-24","2019-05-24","2022-07-03","2019-12-10","2019-06-20","2019-07-18","2019-07-18","2019-07-19","2019-07-18","2019-07-18","2019-07-18","2019-07-19","2022-08-22","2019-07-18","2019-12-02","2019-02-15","2019-04-07","2019-07-19","2019-04-10","2019-07-08","2019-07-01","2019-07-01","2019-07-19","2019-07-19","2019-11-30","2019-04-20","2019-07-05","2019-07-19","2019-07-19","2019-11-22","2019-01-09","2019-01-09","2019-01-23","2019-01-28","2019-02-13","2019-04-04","2019-04-04","2019-04-04","2019-04-04","2019-04-04","2019-04-04","2019-07-15","2019-06-13","2019-06-13","2019-06-23","2019-01-28","2019-02-08","2019-02-08","2019-07-15","2019-03-11","2019-04-03","2019-04-10","2022-08-22","2022-09-11","2022-09-11","2022-09-22","2022-09-11","2022-09-14","2022-09-19","2022-09-23","2022-09-23","2022-09-30","2022-09-23","2022-03-24","2022-01-09","2022-09-02","2022-02-10","2022-02-10","2022-02-10","2022-02-10","2022-02-25","2022-03-24","2022-01-24","2022-01-28","2022-08-01","2022-01-28","2022-05-08","2022-01-28","2022-01-28","2022-02-13","2022-02-15","2022-03-21","2022-07-10","2022-08-22","2022-08-27","2022-07-11","2022-07-11","2022-08-15","2022-09-06","2022-09-23","2022-01-16","2022-04-06","2022-05-08","2022-07-07","2022-07-07","2022-07-08","2022-10-25","2022-09-30","2022-09-30","2022-05-11","2022-08-22","2022-08-29","2022-08-29","2022-09-14","2022-08-01","2022-02-16","2022-04-06","2022-08-07","2022-09-06","2022-01-17","2022-02-13","2022-05-24","2022-05-24","2022-05-24","2022-07-06","2022-07-06","2022-07-06"],"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":[["","42858010201","OXYCOD\/APAP","TAB 5-325MG","18","Select","Select",""],["","69097094312","GABAPENTIN","CAP 300MG","90","Select","Select",""],["","50428029673","CVS","SUS ANTI-GAS","335","Select","Select",""],["","76385012450","METHOCARBAM","TAB 750MG","60","Select","Select",""],["","64380071207","BENZONATATE","CAP 100MG","30","Select","Select",""],["","47335075649","IPRATROPIUM\/","SOL ALBUTER","150","Select","Select",""],["","50111056001","TRAZODONE","TAB 50MG","30","Select","Select",""],["","42858030101","HYDROMORPHON","TAB 2MG","20","Select","Select",""],["","69315012710","FOLIC","TAB 1000MCG","30","Select","Select",""],["","00172392670","DIAZEPAM","TAB 5MG","12","Select","Select",""],["","00115155701","OXYCODONE","TAB 15MG ER","60","Select","Select",""],["","16571040250","CETIRIZINE","TAB 10MG","3","Select","Select",""],["","50458057930","XARELTO","TAB 20MG","30","Select","Select",""],["","00378075101","CYCLOBENZAPR","TAB 10MG","270","Select","Select",""],["","00378064205","PREDNISONE","TAB 20MG","10","Select","Select",""],["","68462015713","ONDANSETRON","TAB 4MG ODT","12","Select","Select",""],["","00527169505","BUT\/APAP\/CAF","TAB ","90","Select","Select",""],["","42806054701","VITAMIN","CAP 1.25MG","12","Select","Select",""],["","50742061510","METOPROL","TAB 25MG ER","30","Select","Select",""],["","00904530661","DIPHENHYDRAM","CAP 25MG","30","Select","Select",""],["","00603188016","LIDOCAINE","PAD 0.05","60","Select","Select",""],["","59779001922","ALLERGY","CAP 25MG","30","Select","Select",""],["","00904530660","BANOPHEN","CAP 25MG","30","Select","Select",""],["","68180016011","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","43386009019","GAVILYTE-G","SOL ","4000","Select","Select",""],["","66689000816","NYSTATIN","SUS 100000","200","Select","Select",""],["","10572010001","PEG-3350","SOL ELECTROL","4000","Select","Select",""],["","59011041510","OXYCONTIN","TAB 15MG CR","60","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","50428055955","GENTLE","SUP 10MG","8","Select","Select",""],["","72786010101","OXBRYTA","TAB 500MG","90","Select","Select",""],["","51660007354","GUAIF\/DM","TAB 60-1200","20","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","00591321901","BUT\/ASA\/CAFF","CAP ","30","Select","Select",""],["","00173069600","ADVAIR","AER 250\/50","60","Select","Select",""],["","42457042060","ENDARI","POW 5GM","120","Select","Select",""],["","66993058597","FLUTIC\/SALME","AER 250\/50","60","Select","Select",""],["","00054418325","DEXAMETHASON","TAB 2MG","12","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","20","Select","Select",""],["","27808008602","HYD","SUS 10-8\/5ML","100","Select","Select",""],["","69842081266","MUCUS","TAB 60-1200","20","Select","Select",""],["","00378932132","WIXELA","AER 250\/50","60","Select","Select",""],["","10702000350","PROMETHAZINE","TAB 25MG","20","Select","Select",""],["","00143924920","AMOX\/K","TAB 875-125","10","Select","Select",""],["","69618004901","SENNA","TAB 8.6-50MG","60","Select","Select",""],["","62011008601","HM","SPR 0.0065","44","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","53746046605","IBUPROFEN","TAB 800MG","90","Select","Select",""],["","00093314701","CEPHALEXIN","CAP 500MG","3","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":""}]}]}