{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KIRSTY SCHOPPAUL","gend":1,"add":"417 CAMERON CT","city":"VIRGINIA BEACH","state":"VA","zip":"23452-9998","dob":"1974-12-27","age":"","mstatus":"","insh":"20064329*01","cliId":"","pno":"757\/761-6795","cno":"757\/761-6795","email":"","ename":"","eno":"","pphy":"LIPTON, ERIC MD","ppno":"757\/363-6848","pcpadd":"SUITE 100 816 INDEPENDENCE BLVD","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":23455,"pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Family Medicine Physicians - Independence","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/507-9033","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F34.1","R11.0","Z20.828","M54.41","Q76.49","M54.6","R07.81","M54.2","M62.838","M79.2","NO DATA","R26.9","F17.200","G89.29","R14.0","R13.12","K58.9","M54.12","M47.816","M53.3","M47.814","M41.25","M48.02","M47.812","R03.1","R07.89","H93.13","M25.561","M76.31","F06.4","R13.10","K31.89","R19.4","R10.33","R19.7","J30.1","K21.9","Z72.0","R51.9","G44.85","R40.4","F41.9","R25.9","R20.9","R41.82","Z00.00","Z12.4","R53.83","G47.00","G47.63","G47.8","R06.83","F17.210","Z91.040","Z88.2","Z88.8","Z91.048","Z91.09","Z79.899","Z79.1","L97.921","R06.02","M54.5","R20.8","R55.","R51.","D17.1","Z01.812","Z20.822","R10.13","R63.4","Z23.","M51.36","J45.20","G43.909","F32.9","Z88.4","R06.00","L98.491","L08.9","L03.116","R10.10"],"date":["2022-10-25","2020-10-29","2020-10-29","2022-09-28","2022-09-28","2022-09-28","2022-09-28","2022-09-28","2022-09-28","2022-09-28","2022-09-28","2022-09-28","2022-09-28","2022-09-28","2020-12-22","2020-12-22","2020-12-22","2021-05-06","2021-10-05","2021-01-05","2021-01-05","2021-01-05","2021-01-05","2021-01-05","2021-01-11","2021-01-11","2021-02-15","2022-02-23","2022-02-23","2021-01-15","2020-10-06","2020-11-02","2020-11-02","2020-11-02","2020-11-02","2021-02-15","2021-02-15","2021-02-15","2022-05-06","2022-05-06","2022-05-06","2022-05-06","2020-08-05","2020-08-05","2020-08-05","2020-08-03","2020-08-03","2021-04-05","2021-04-05","2021-04-05","2021-04-05","2021-04-05","2021-10-05","2021-10-05","2021-10-05","2021-10-05","2021-04-05","2021-04-05","2021-10-05","2021-04-05","2020-07-07","2020-08-27","2021-03-19","2020-04-06","2020-05-04","2020-08-05","2020-09-17","2021-04-02","2021-04-02","2020-09-18","2020-09-18","2021-04-17","2021-10-05","2021-10-05","2021-10-05","2021-10-05","2021-10-05","2020-05-19","2020-06-05","2020-06-05","2020-06-05","2020-10-26"],"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":[["","69097084507","CYCLOBENZAPR","TAB 5MG","60","Select","Select",""],["","29300011716","TOPIRAMATE","TAB 100MG","120","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","57237001830","DULOXETINE","CAP 30MG","60","Select","Select",""],["","58160084252","BOOSTRIX","INJ ","0","Select","Select",""],["","00228277811","PROPRANOLOL","CAP 60MG ER","30","Select","Select",""],["","33342009441","RIZATRIPTAN","TAB 10MG ODT","15","Select","Select",""],["","42806001101","SULINDAC","TAB 200MG","60","Select","Select",""],["","49035061246","ALLERGY","TAB 10MG","90","Select","Select",""],["","31722054201","INDOMETHACIN","CAP 25MG","90","Select","Select",""],["","45802065078","LORATADINE","TAB 10MG","90","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","72205001490","PREGABALIN","CAP 100MG","60","Select","Select",""],["","00071101268","LYRICA","CAP 25MG","90","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","20","Select","Select",""],["","68462018022","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","00173068220","VENTOLIN","AER ","18","Select","Select",""],["","59310057922","PROAIR","AER ","8","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":""}]}]}