{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"GABRIELLE   V PARKER","gend":1,"add":"178 CORAL GABLES CT APT 4","city":"VIRGINIA BEACH","state":"VA","zip":"23452-9998","dob":"1991-05-07","age":"","mstatus":"","insh":"20057978*01","cliId":"","pno":"757\/632-1949","cno":"","email":"","ename":"","eno":"","pphy":"HURWITZ, JENNIE R MD","ppno":"757\/252-9600","pcpadd":"STE 200 1800 CAMELOT DR","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":23454,"pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Pediatric Physicians - Camelot","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/351-2905","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F31.9","F33.1","Z30.013","J06.9","B97.89","R05.","J98.01","F17.211","R16.0","E66.01","K92.1","R94.5","F10.10","R55.","F12.90","R10.9","G89.29","R11.0","E11.65","Z20.822","Z79.84","F17.200","Z68.41","R04.2","R11.2","R19.7","F31.32","F41.1","O26.891","U07.1","R06.02","Z3A.11","O98.511","O99.211","Z3A.12","E11.9","F41.9","F51.05","NO DATA","F32.9","F99.","E11.42","B35.1","K80.20","K76.0","F41.8","F60.3","V62.84","F31.60","T50.902A","F12.20","Z91.5","F39.","Z65.8","F19.94","T14.91XA","O26.899","Z3A.00","Z33.1","O20.8","Z3A.01","Z87.891","Z91.040","Z91.018","O20.9","Z3A.14","O24.911","Z3A.15","O42.912","O24.112","O99.212","E66.9","Z79.4","Z3A.20","M19.90","J44.9","O99.512","O26.612","O99.342","Z90.49","Z3A.22","K80.00","Z20.828","F17.210","D72.829","R35.0","T42.4X2A","Z3A.09","F10.129","Z00.00","Z12.4","H66.91","J20.9","L60.0","L60.1","B35.3","H53.9","L30.1","M79.671","M79.672","G43.011","R56.9","F31.63","J01.00","F31.4","G47.00","O24.912","Z3A.21","Z30.42","Z72.0","R10.2","N93.9","R10.10","O21.9","O99.330","Z86.32","Z87.59","Z32.01","K76.9","Z34.91","R50.9","O24.111","E66.3","R52.","O99.352","G47.9","R44.3","Z3A.16","R87.619","E78.00","Z68.42","R00.0","F41.0","R10.84","M25.572","E11.69","K92.0","O20.0","O24.311","O99.341","F90.9","O26.611","O41.8X10","O46.8X1","V23.9","Z71.3","O99.891","R10.32","O26.852","H54.7","Z97.3","R44.0","Z79.899","J45.20","K21.9","D18.03","R79.89","Z86.59","K81.9","G89.18","S93.402A","S93.401A","Z3A.13","Z23.","R82.90","O98.512","F31.0","F33.2","J18.9","R07.0","F50.81","G47.33","R06.81","R40.0","G25.81","R06.83","E61.1","R10.11","K80.50","N30.00","G47.61","Z79.811","Z79.83","Z79.3","G43.909","D64.9","F34.1","F12.10","R51.","R53.83","O9A.213","O99.513","O24.113","S05.02XA","Z3A.30","H53.142","O99.213","Z3A.31","O47.03","Z3A.32","O99.013","O26.613","O99.343","O99.353","G43.009","J45.909","S92.101A","O26.893","R42.","Z83.3","Z86.16","Z3A.29","Z3A.33","Z3A.35","O21.2","O24.414","Z3A.24","O41.8X30","V23.5","O24.12","O26.62","Z37.0","O99.354","F31.89","O99.02","O99.214","O99.344","O99.824","Z3A.40","Z3A.28","Z3A.38","S99.912A","S80.212A","S92.422A","M25.571","S92.425A","Z87.898","Z86.69","R10.13","R31.9","Z86.19","O36.5920","Z3A.27","Z34.93","O99.820","O99.323","Z3A.34","Z3A.37","O24.913","Z11.1","R53.1","R26.89","S92.151A","O99.613","K52.9","O47.00","Z3A.36","Z91.51","N39.0","D35.02","K75.81","E11.649","D50.8","Z32.02","Z13.31","Z39.2","V54.12","M19.072","G40.909","N85.8","Z03.71","O09.43","E11.29","Z68.39","R80.9","R07.89","D35.00","S63.502A","R10.811","Z87.19","Z80.0"],"date":["2022-08-11","2020-10-01","2020-07-02","2021-10-03","2020-03-20","2020-03-20","2020-03-20","2020-03-20","2022-03-30","2022-04-02","2020-09-15","2021-04-27","2020-06-01","2022-08-10","2021-04-22","2022-10-02","2021-04-22","2021-04-22","2022-10-07","2022-02-08","2022-10-07","2021-08-18","2022-10-07","2021-08-07","2022-10-02","2022-08-19","2022-11-14","2022-11-14","2021-10-03","2022-01-06","2021-10-03","2021-10-10","2021-10-06","2021-10-06","2021-10-06","2022-10-03","2022-08-11","2020-09-15","2022-04-02","2020-09-15","2020-09-15","2020-08-06","2020-08-06","2020-11-23","2022-04-07","2021-05-24","2022-08-11","2021-06-08","2021-06-08","2021-06-08","2021-06-08","2021-06-08","2022-08-09","2021-06-08","2021-06-08","2021-06-08","2021-08-13","2021-08-13","2021-09-02","2021-08-29","2021-09-07","2022-10-03","2022-10-03","2022-10-03","2021-10-25","2021-10-25","2021-12-11","2021-11-10","2021-12-08","2022-01-25","2022-01-25","2022-04-07","2022-10-03","2021-12-08","2021-12-08","2022-02-28","2022-01-06","2021-12-08","2022-01-06","2022-10-03","2021-12-21","2020-11-23","2020-12-08","2021-08-13","2021-03-01","2021-03-01","2021-06-04","2021-09-23","2020-02-25","2020-03-17","2020-03-17","2020-03-24","2021-06-12","2020-06-25","2020-06-25","2020-06-25","2021-01-29","2020-05-04","2022-08-08","2022-08-08","2020-05-14","2020-05-14","2021-06-06","2021-06-08","2021-06-30","2021-07-12","2022-05-10","2021-12-11","2022-07-14","2020-11-17","2022-08-19","2021-02-11","2021-04-27","2021-08-13","2021-08-13","2021-08-13","2021-08-13","2021-08-13","2021-09-02","2021-09-10","2021-10-03","2021-10-04","2021-10-04","2021-10-04","2021-11-08","2021-11-08","2021-11-08","2021-11-08","2020-02-27","2020-02-27","2020-02-27","2020-05-07","2020-05-07","2021-05-29","2022-08-09","2021-04-21","2021-06-03","2021-08-29","2021-08-29","2021-08-29","2022-08-11","2021-08-29","2021-08-29","2021-08-29","2022-04-07","2022-01-25","2022-03-29","2022-10-02","2021-10-25","2021-10-25","2021-10-25","2021-11-08","2022-08-09","2021-12-03","2022-08-05","2020-05-14","2020-05-14","2020-05-14","2020-11-23","2020-11-27","2021-02-13","2021-05-08","2021-10-19","2022-01-25","2022-01-25","2022-01-06","2019-09-19","2019-05-14","2019-05-25","2019-06-24","2019-09-19","2019-05-15","2019-05-15","2019-05-15","2019-07-04","2019-06-16","2019-05-15","2022-10-03","2019-10-16","2019-10-16","2019-06-16","2019-06-16","2019-06-16","2019-06-16","2022-08-11","2022-08-11","2019-08-23","2019-08-23","2019-08-24","2019-08-24","2022-02-15","2022-04-02","2022-04-08","2022-02-17","2022-02-15","2022-02-15","2022-04-08","2022-02-23","2022-03-30","2022-03-02","2022-04-02","2022-04-02","2022-04-02","2022-04-02","2022-03-30","2022-08-11","2022-08-11","2022-03-04","2022-02-08","2022-02-08","2022-02-28","2022-02-08","2022-03-10","2022-03-23","2022-01-06","2022-02-28","2022-01-10","2022-04-02","2022-04-02","2022-04-07","2022-04-07","2022-04-08","2022-04-07","2022-04-07","2022-04-07","2022-04-07","2022-04-07","2022-04-07","2022-05-10","2022-01-31","2022-04-10","2022-08-01","2022-08-09","2022-08-07","2022-08-09","2022-08-15","2022-08-09","2022-08-09","2022-08-19","2022-08-19","2022-08-19","2022-01-25","2022-01-25","2022-02-08","2022-03-29","2022-02-28","2022-03-17","2022-04-10","2022-04-10","2022-07-17","2022-08-10","2022-08-10","2022-08-30","2022-03-04","2022-03-04","2022-03-27","2022-03-31","2022-03-27","2022-08-05","2022-10-07","2022-10-07","2022-07-01","2022-07-01","2022-07-14","2022-07-14","2022-06-10","2022-08-11","2022-08-11","2022-08-11","2022-02-20","2022-03-29","2022-03-29","2022-05-06","2022-05-06","2022-05-06","2022-08-05","2022-08-07","2022-10-27","2022-10-03","2022-10-03","2022-10-03"],"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":[["","29300011101","LAMOTRIGINE","TAB 25MG","42","Select","Select",""],["","00904759080","FEROSUL","TAB 325MG","60","Select","Select",""],["","08290320550","BD  PEN NEEDL","MIS 32GX5\/32","100","Select","Select",""],["","61874013030","VRAYLAR","CAP 3MG","30","Select","Select",""],["","00591352530","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","57237007710","ONDANSETRON","TAB 4MG ODT","12","Select","Select",""],["","00143122701","DICYCLOMINE","TAB 20MG","30","Select","Select",""],["","00088221905","LANTUS","INJ 100\/ML","30","Select","Select",""],["","","TRAZODONE","TAB 100MG","","Select","Select",""],["","17478007035","ERYTHROMYCIN","OIN 5MG\/GM","4","Select","Select",""],["","81131000720","D3","CAP 2000UNIT","60","Select","Select",""],["","53885014301","ONETOUCH","MIS LANCETS","100","Select","Select",""],["","68645045790","ENALAPRIL","TAB 20MG","30","Select","Select",""],["","00002879959","HUMALOG","INJ 100\/ML","30","Select","Select",""],["","00904699880","DOCUSATE","CAP 100MG","60","Select","Select",""],["","49035053112","EQ","TAB 500MG","60","Select","Select",""],["","39328010610","PRENATAL","TAB 27-1MG","30","Select","Select",""],["","08627001601","DEXCOM","MIS TRANSMIT","1","Select","Select",""],["","","IBUPROFEN","TAB 800MG","","Select","Select",""],["","12843003520","STOOL","CAP 100MG","30","Select","Select",""],["","","HYDROXYZ","TAB 25MG","","Select","Select",""],["","16500056010","ONE","CAP PRENATAL","30","Select","Select",""],["","29300041519","CYCLOBENZAPR","TAB 10MG","15","Select","Select",""],["","00761081212","CALCIUM\/D","TAB 600MG","60","Select","Select",""],["","80681013800","CALCIUM\/D3","TAB 600MG","60","Select","Select",""],["","68645054659","METFORMIN","TAB 1000MG","60","Select","Select",""],["","81131038679","RELION","MIS 32GX4MM","200","Select","Select",""],["","74300000848","VISINE","DRO RELIEF","15","Select","Select",""],["","68645052354","SERTRALINE","TAB 100MG","30","Select","Select",""],["","00406012301","HYDROCO\/APAP","TAB 5-325MG","5","Select","Select",""],["","00378210001","LOPERAMIDE","CAP 2MG","24","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","6","Select","Select",""],["","","NAPROXEN","TAB 500MG","","Select","Select",""],["","57896010410","ACETAMINOPHE","TAB 325MG","20","Select","Select",""],["","16729044310","BUPROPN","TAB 150MG XL","30","Select","Select",""],["","16714071503","OMEPRAZOLE","CAP 20MG","30","Select","Select",""],["","69238110002","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","","PROMETHAZINE","TAB 25MG","","Select","Select",""],["","","BENZONATATE","CAP 100MG","","Select","Select",""],["","16729013800","CLONAZEPAM","TAB 2MG","30","Select","Select",""],["","68645057290","GLIMEPIRIDE","TAB 2MG","30","Select","Select",""],["","","ALBUTEROL","AER HFA","","Select","Select",""],["","50458058501","CONCERTA","TAB 18MG","30","Select","Select",""],["","31722095201","METHYLPHENID","TAB 18MG ER","30","Select","Select",""],["","","ZOLPIDEM","TAB 12.5MG","","Select","Select",""],["","49884027711","OLANZA\/FLUOX","CAP 3-25MG","30","Select","Select",""],["","68382005005","MELOXICAM","TAB 7.5MG","14","Select","Select",""],["","63402030430","LATUDA","TAB 40MG","30","Select","Select",""],["","49035048462","ACETAMINOPHN","TAB 500MG","60","Select","Select",""],["","00002323030","SYMBYAX","CAP 3-25MG","30","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","00173069600","ADVAIR","AER 250\/50","60","Select","Select",""],["","62542030117","HYD","SUS 10-8\/5ML","15","Select","Select",""],["","70010010810","GABAPENTIN","CAP 100MG","90","Select","Select",""],["","68180071160","CEFDINIR","CAP 300MG","10","Select","Select",""],["","63824000832","MUCINEX","TAB 600MG ER","14","Select","Select",""],["","68645014059","FAMOTIDINE","TAB 20MG","20","Select","Select",""],["","66993058597","FLUTIC\/SALME","AER 250\/50","60","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","00169643810","LEVEMIR","INJ FLEXTOUC","15","Select","Select",""],["","13107008305","LORAZEPAM","TAB 0.5MG","8","Select","Select",""],["","10006073017","VITAMIN","TAB 50MG","30","Select","Select",""],["","41167000609","UNISOM","TAB 25MG","30","Select","Select",""],["","63304061650","DOXYCYC","CAP 100MG","6","Select","Select",""],["","69315012710","FOLIC","TAB 1000MCG","30","Select","Select",""],["","49035044164","SLEEP","TAB 25MG","30","Select","Select",""],["","57599080300","FREESTY","MIS 2 READER","1","Select","Select",""],["","63323058282","GLUCAGON","SOL 1MG","1","Select","Select",""],["","00002822259","INSULIN","INJ 100\/ML","30","Select","Select",""],["","59762045001","COLESTIPOL","TAB 1GM","60","Select","Select",""],["","00904404073","ASPIRIN","CHW 81MG","60","Select","Select",""],["","60505024701","MIRTAZAPINE","TAB 15MG","30","Select","Select",""],["","69102030001","SUBVENITE","KIT START 49","49","Select","Select",""],["","00173068220","VENTOLIN","AER ","18","Select","Select",""],["","33342030011","ESZOPICLONE","TAB 2MG","30","Select","Select",""],["","00456114030","VIIBRYD","TAB 40MG","30","Select","Select",""],["","69097012203","TOPIRAMATE","TAB 25MG","120","Select","Select",""],["","","VENLAFAXINE","CAP 150MG ER","","Select","Select",""],["","","BROM\/PSE\/DM","SYP ","","Select","Select",""],["","","CHANTIX","TAB 1MG","","Select","Select",""],["","","AMMONIUM","CRE 0.12","","Select","Select",""],["","","ATOMOXETINE","CAP 40MG","","Select","Select",""],["","","AMOXICILLIN","CAP 500MG","","Select","Select",""],["","","VIRTUSSIN","SOL 100-10\/5","","Select","Select",""],["","","TERBINAFINE","TAB 250MG","","Select","Select",""],["","","AMOX\/K","TAB 875-125","","Select","Select",""],["","","CIPRODEX","SUS 0.3-0.1%","","Select","Select",""],["","","HYDROCORT","CRE 0.01","","Select","Select",""],["","","INDOMETHACIN","CAP 50MG","","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","12","Select","Select",""],["","","TRAMADOL","TAB 50MG","","Select","Select",""],["","55111016730","OLANZAPINE","TAB 15MG","30","Select","Select",""],["","31722054501","LITHIUM","CAP 300MG","90","Select","Select",""],["","59417010310","VYVANSE","CAP 30MG","30","Select","Select",""],["","56151149002","TRUE","KIT AIR","1","Select","Select",""],["","50111064701","FLUOXETINE","CAP 10MG","30","Select","Select",""],["","99073070914","FREESTYLE    KIT FREEDOM","KIT FREEDOM","1","Select","Select",""],["","65702043810","ACCU-CHEK","TES AVIVA PL","1","Select","Select",""],["","00193737701","CONTOUR","KIT NEXT","1","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":""}]}]}