{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DERRICK  D EDGHILL","gend":0,"add":"PO BOX 3375","city":"SUFFOLK","state":"VA","zip":"23439-9998","dob":"1961-01-20","age":"","mstatus":"","insh":"1181568*01","cliId":"","pno":7575356883,"cno":7575356883,"email":"","ename":"","eno":"","pphy":"MORRISON, WILLIAM PA","ppno":7579838600,"pcpadd":"114 N MAIN ST STE 200","pcpcity":"SUFFOLK","pcpstate":"VA","pcpzip":"23434-9998","pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Internal Medicine Physicians - Downtown Suffolk","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7579343012,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["C34.11","Z51.12","B34.9","J96.01","C34.91","R07.9","R63.4","J44.9","Z12.11","R94.31","R91.8","Z87.891","Z48.813","J43.2","R19.7","R09.81","Z20.822","J43.9","R59.0","D72.829","J44.1","E87.1","R90.82","K76.89","E44.0","I10.","F17.210","Z91.018","R20.0","R91.1","E78.2","Z91.89","E16.2","E16.1","R09.02","R00.0","D72.825","C34.90","D84.9","R07.81","D49.1","N28.89","A41.9","J18.9","C79.9","J90.","E86.1","R65.20","Z53.09","Z87.442","Z79.899","Z71.89","R52.","R43.9","J91.0","F10.99","Z79.891","R33.9","N48.22","R33.8","Z45.2","M25.461","M65.9","R53.1","Z85.118","J43.8","N13.30","N48.5","E07.9","E22.2","Z66.","R64.","D63.0","E03.9","Z68.1","R63.1","G89.29","M25.561","E23.0","R11.2","D64.9","N48.9"],"date":["2023-02-22","2023-02-01","2022-02-08","2023-03-22","2023-03-22","2023-03-31","2021-03-22","2021-03-22","2021-03-22","2022-09-27","2022-12-31","2022-10-03","2022-04-11","2022-12-31","2021-03-23","2021-03-23","2022-09-26","2023-03-28","2022-09-12","2022-10-03","2022-09-26","2023-03-31","2022-05-15","2022-06-10","2023-03-31","2023-03-30","2022-03-22","2022-03-22","2022-03-22","2022-03-24","2022-03-24","2022-03-24","2022-09-26","2022-09-26","2022-09-26","2022-09-28","2022-09-28","2023-03-31","2023-03-28","2022-09-28","2022-04-01","2022-04-01","2022-10-03","2022-10-03","2022-09-26","2022-09-26","2022-09-26","2022-09-26","2022-09-26","2022-10-03","2022-09-26","2023-03-28","2021-03-23","2021-03-23","2022-10-03","2023-03-22","2022-10-03","2023-03-30","2023-03-28","2023-04-20","2023-03-31","2023-03-31","2023-03-31","2023-03-31","2023-03-31","2023-03-22","2023-03-29","2023-03-29","2023-03-31","2023-03-28","2023-03-28","2023-03-28","2023-03-28","2023-03-31","2023-03-28","2023-03-28","2023-03-28","2023-03-28","2023-03-28","2023-03-30","2023-03-30","2023-04-20"],"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":[["","00172208380","HYDROCHLOROT","TAB 25MG","90","Select","Select",""],["","59267100002","PFIZER VACC","INJ COVID-19","0","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","00597015561","STIOLTO","AER 2.5-2.5","4","Select","Select",""],["","29300039705","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","00406051201","OXYCOD\/APAP","TAB 5-325MG","20","Select","Select",""],["","59746017506","PREDNISONE","TAB 20MG","6","Select","Select",""],["","69238110005","DOXYCYCL HYC","CAP 100MG","10","Select","Select",""],["","69238183007","LEVOTHYROXINE SODIUM","25 MCG","30","Select","Select",""],["","00093101042","MUPIROCIN","2 %","22","Select","Select",""],["","00143924920","AMOXICILLIN-CLAVULANATE POTASS","875-125 MG","10","Select","Select",""],["","64380097206","HYDROCORTISONE","20 MG","90","Select","Select",""],["","65862018830","ONDANSETRON HCL","8 MG","30","Select","Select",""],["","65862059805","TAMSULOSIN HCL","0.4 MG","30","Select","Select",""],["","29300039705","AMLODIPINE BESYLATE","5 MG","30","Select","Select",""],["","11822300930","SENNA PLUS","8.6MG-50MG","30","Select","Select",""],["","67877084201","FAMOTIDINE","20 MG","30","Select","Select",""],["","00406051201","OXYCODONE-ACETAMINOPHEN","5 MG-325MG","20","Select","Select",""],["","69238110005","DOXYCYCLINE HYCLATE","100 MG","10","Select","Select",""],["","62332058231","LIDOCAINE-PRILOCAINE","2.5 %-2.5%","30","Select","Select",""],["","72578008804","NYSTATIN-TRIAMCINOLONE","100000-0.1","30","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":""}]}]}