{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JOYCE HUNT","gend":1,"add":"3308 RAINIER CT APT 104","city":"VIRGINIA BEACH","state":"VA","zip":"23452-9998","dob":"1990-09-30","age":"","mstatus":"","insh":"20056963*01","cliId":"","pno":"757\/776-9994","cno":"757\/776-9994","email":"","ename":"","eno":"","pphy":"CAVIN, JENNIFER E MD","ppno":"757\/413-7600","pcpadd":"5320 PROVIDENCE RD STE 301","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":23464,"pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Family Medicine Physicians - Providence Road","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/413-7601","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F31.81","F39.","F41.9","F32.9","G47.00","F43.10","M21.612","K59.00","K44.9","N83.201","M20.12","F90.0","F31.12","S02.5XXA","G89.29","K04.7","F17.200","Z98.890","Z90.49","R11.0","R05.9","J06.9","R10.84","R11.2","R07.89","F90.9","F31.9","K08.9","N93.8","M94.0","F41.1","F43.23","Z01.419","Z12.4","Z30.46","Z01.810","M76.822","M79.672","D64.9","R68.89","B34.9","Z51.81","R10.9","N91.2","Z32.02","R10.13","K21.9","R10.10","Z30.9","J20.9","R00.0","NO DATA","K29.90","Z13.0","Z13.1","Z13.29","K14.6","K29.70","K29.80","R06.02","R07.9","E66.9","R68.81","R10.32","E03.9","Z82.49","Z83.3","Z82.3","Z80.51","Z80.7","Z87.891","Z20.828","U07.1","Z79.899","Z79.3","F17.210","Z87.19"],"date":["2021-03-15","2021-03-15","2022-06-22","2021-03-15","2021-03-15","2021-03-15","2020-08-07","2022-01-14","2022-04-12","2020-08-07","2021-03-12","2022-11-14","2022-11-14","2021-09-29","2021-06-03","2021-06-03","2022-01-14","2021-08-19","2022-06-22","2021-06-03","2021-11-15","2021-11-15","2022-01-14","2022-01-14","2022-06-07","2021-03-15","2022-06-22","2021-06-03","2021-08-03","2022-06-08","2022-09-08","2020-07-16","2020-10-06","2020-10-06","2020-10-06","2021-02-25","2021-12-07","2021-12-07","2022-11-04","2022-11-04","2022-11-04","2021-02-12","2020-08-12","2021-07-29","2021-08-19","2022-06-22","2021-08-06","2021-08-06","2021-08-19","2021-11-16","2021-11-16","2022-06-22","2022-04-12","2021-03-17","2021-03-17","2021-03-17","2021-09-29","2022-04-12","2022-04-12","2021-11-16","2022-06-07","2022-06-22","2022-06-22","2020-08-12","2022-04-12","2020-08-12","2020-08-12","2020-08-12","2020-08-12","2020-08-12","2020-08-12","2020-09-09","2022-01-20","2022-04-12","2022-04-12","2022-04-12","2022-04-12"],"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":[["","67877057505","BENZONATATE","CAP 200MG","30","Select","Select",""],["","57844012001","ADDERALL","TAB 20MG","30","Select","Select",""],["","63402030230","LATUDA","TAB 20MG","30","Select","Select",""],["","43547030603","ARIPIPRAZOLE","TAB 20MG","30","Select","Select",""],["","59651000305","OMEPRAZOLE","CAP 40MG","90","Select","Select",""],["","75137000493","PERCOGESIC","TAB 12.5-325","15","Select","Select",""],["","00378064110","PREDNISONE","TAB 10MG","42","Select","Select",""],["","42806034501","AMPHET\/DEXTR","TAB 30MG","60","Select","Select",""],["","68462010530","ONDANSETRON","TAB 4MG","12","Select","Select",""],["","00143122701","DICYCLOMINE","TAB 20MG","30","Select","Select",""],["","49884072501","BUSPIRONE","TAB 7.5MG","60","Select","Select",""],["","67877032005","IBUPROFEN","TAB 600MG","30","Select","Select",""],["","76385012450","METHOCARBAM","TAB 750MG","60","Select","Select",""],["","00603188016","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","28","Select","Select",""],["","71335100604","LITHIUM","CAP 300MG","90","Select","Select",""],["","50428042388","MELATONIN","CAP 10MG","30","Select","Select",""],["","69452015120","VITAMIN","CAP 50000UNT","4","Select","Select",""],["","45802048678","DOCUSATE","CAP 100MG","30","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","6","Select","Select",""],["","50428264783","STOOL","CAP 100MG","10","Select","Select",""],["","65862050320","AMOX\/K","TAB 875-125","14","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0","Select","Select",""],["","00116200116","CHLORHEX","SOL 0.0012","473","Select","Select",""],["","00093117410","PENICILLN","TAB 500MG","28","Select","Select",""],["","00093310905","AMOXICILLIN","CAP 500MG","22","Select","Select",""],["","60432053760","NYSTATIN","SUS 100000","60","Select","Select",""],["","00555077902","MEDROXYPR","TAB 10MG","7","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","68180016011","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","51991029201","OXCARBAZEPIN","TAB 150MG","60","Select","Select",""],["","59779076678","PAIN","TAB 325MG","30","Select","Select",""],["","00378797052","IPRATROPIUM","SOL 0.02%INH","62","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","27808008602","HYD","SUS 10-8\/5ML","70","Select","Select",""],["","14539067501","HYDROXYZ","CAP 50MG","30","Select","Select",""],["","69097083412","SERTRALINE","TAB 50MG","30","Select","Select",""],["","00093738201","VENLAFAXINE","TAB 75MG","180","Select","Select",""],["","45802086866","POLYETH","POW 3350 NF","28","Select","Select",""],["","00093816201","QUETIAPINE","TAB 100MG","60","Select","Select",""],["","16571020210","DICLOFENAC","TAB 50MG DR","60","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":""}]}]}