{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"HOWARD  G NORTON","gend":0,"add":"1041 CREAMER ROAD","city":"NORFOLK","state":"VA","zip":"23503-9998","dob":"1977-10-25","age":"","mstatus":"","insh":"1940879*01","cliId":"","pno":7579357672,"cno":7579357672,"email":"","ename":"","eno":"","pphy":"GALLON, JESSICA MARIE NP","ppno":8042543500,"pcpadd":"2116 W LABURNUM AVENUE,","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":"23227-9998","pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Family Medicine & Walk-In - Suffolk","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8042541616,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K70.31","K72.90","I85.10","K25.9","D64.9","F10.10","F32.9","N52.8","Z98.52","K70.30","F19.20","NO DATA","F33.2","M18.12","Z01.812","B35.6","M54.5","G89.4","G89.29","Z76.82","R11.0","R61.","Z79.899","R14.0","J90.","M79.642","F17.210","Z88.1","Z91.048","Z20.822","R31.9","D50.0","T82.9XXA","Z95.828","R07.9","R51.9","Y71.0","Z12.11","Z87.09","M65.312","K74.60","R16.1","R93.429","F41.1","F10.21","F11.20","F90.9","V54.16","M79.645","F32.89","M54.16","M51.26","C22.0","I83.90","L91.8","M79.641","Z11.59","Z00.00","R55.","R52.","S82.852A","F33.41","Z72.0","Z71.6","K92.2","S93.05XA","E87.6","I49.3","I95.1","Z83.3","Z82.49","Z88.8","M25.572","S82.852S","G89.18","R06.83","R21.","I77.6","R09.82","G47.33","K21.9","M54.9","I85.00","F10.20","F33.1","F33.9","Z01.810","Z01.818","R94.31","T84.84XA","I49.5","Z04.9","E46.","M62.84","M65.331","Z47.89","Z48.02","Z03.89","F10.988","D50.9","L82.0","M25.342","M25.842","F90.0","G47.09","E87.1","S61.412A","N52.9","T78.40XA","Z47.1","Z96.692","M19.042","F41.8","M62.81","M79.644","Z98.890","R10.9","Z71.89","F10.11","M51.9","L29.9","M51.36","M51.16","J94.8","R18.8","Z01.89","Z20.828","T82.898A","K52.9","R50.9","R00.0","Z90.49","Z91.09","M24.842","M96.0","Z23.","I81.","S82.842K","M86.672","G47.30","F17.200","F11.90","F11.99","T84.69XA","M86.662","F11.10","S82.53XK","G47.00","K59.00","Z09.","S06.0XAA","S01.111A","R79.89","M86.9","R26.2","F19.10","G62.1","M62.59","M86.172","M86.8X7","Z87.19"],"date":["2023-05-12","2022-04-20","2021-06-16","2021-11-19","2022-08-31","2022-08-31","2022-08-31","2021-05-27","2021-05-27","2023-06-14","2021-06-18","2023-05-12","2021-06-18","2022-06-30","2021-08-14","2021-09-03","2021-09-14","2023-04-26","2023-04-11","2023-05-12","2022-09-12","2021-09-14","2023-05-12","2022-02-10","2022-03-21","2022-09-12","2023-05-12","2022-12-13","2022-09-12","2022-03-21","2022-02-10","2023-03-27","2022-03-18","2023-06-14","2022-03-19","2022-03-19","2022-03-19","2023-01-09","2022-08-31","2022-04-28","2022-11-16","2022-07-19","2022-07-19","2023-05-22","2023-06-14","2023-03-29","2023-03-27","2023-03-27","2022-12-08","2022-01-10","2021-10-29","2021-08-06","2021-12-22","2021-12-22","2022-01-10","2022-01-10","2022-03-14","2022-07-01","2023-03-24","2023-05-13","2022-09-14","2023-05-05","2023-04-03","2023-01-09","2022-09-12","2022-09-15","2022-09-12","2022-09-12","2022-09-12","2022-09-12","2022-09-12","2022-12-13","2022-09-12","2022-12-13","2023-04-03","2023-01-09","2023-01-09","2023-01-09","2023-01-09","2023-01-26","2023-01-26","2022-03-18","2021-05-12","2023-05-22","2021-11-01","2021-08-09","2021-08-06","2021-08-06","2021-08-06","2022-01-12","2022-03-19","2022-03-19","2021-01-05","2021-01-05","2022-01-24","2022-01-24","2023-03-24","2022-03-02","2022-03-02","2022-03-02","2022-04-27","2022-06-07","2022-06-07","2022-08-23","2022-08-09","2021-08-09","2021-04-02","2021-05-25","2021-07-30","2022-05-11","2022-05-11","2022-06-07","2023-03-29","2023-05-14","2022-03-10","2022-03-21","2022-03-21","2022-09-14","2021-06-18","2021-08-09","2021-08-09","2021-08-17","2021-08-17","2022-04-20","2022-11-16","2023-03-07","2022-01-29","2022-03-18","2022-03-18","2022-03-18","2022-03-18","2022-03-18","2022-03-18","2022-06-07","2022-11-10","2022-11-16","2022-11-16","2023-05-05","2023-03-29","2023-03-29","2023-03-31","2023-05-22","2023-04-03","2023-03-27","2023-05-14","2023-03-27","2023-03-27","2023-03-27","2023-03-27","2023-03-24","2023-03-08","2023-03-08","2023-03-08","2023-04-28","2023-05-14","2023-04-28","2023-04-30","2023-05-14","2023-05-12","2023-06-14","2023-05-05"],"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":[["","65862052305","GABAPENTIN","600 MG","84","Select","Select",""],["","65649030302","XIFAXAN","550 MG","60","Select","Select",""],["","62107003813","THERA-M","TAB ","30","Select","Select",""],["","69315011710","FUROSEMIDE","40 MG","30","Select","Select",""],["","53746051501","SPIRONOLACT","TAB 100MG","60","Select","Select",""],["","31722071390","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","62332000931","VENLAFAXINE","TAB 37.5MG","14","Select","Select",""],["","50111056001","TRAZODONE","TAB 50MG","30","Select","Select",""],["","69315012701","FOLIC ACID","TAB 1000MCG","90","Select","Select",""],["","50383079516","LACTULOSE","10 G\/15 ML","473","Select","Select",""],["","65862037401","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","00536466138","THEREMS-M","TAB ","30","Select","Select",""],["","00005475850","CENTRUM SILV","TAB 50+MEN","30","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","70748013306","SILDENAFIL","TAB 100MG","5","Select","Select",""],["","68180059306","DESVENLAFAX","TAB 100MG ER","30","Select","Select",""],["","00406051201","OXYCOD\/APAP","TAB 5-325MG","30","Select","Select",""],["","59267100002","PFIZER VACC","INJ COVID-19","0","Select","Select",""],["","45963043965","CONSTULOSE","SOL 10GM\/15","1800","Select","Select",""],["","11822322860","RA ONE DAILY","TAB MAXIMUM","30","Select","Select",""],["","00536344801","CHEWABL VITE","CHW CHILDRNS","30","Select","Select",""],["","72647033104","METHYLPRED","TAB 4MG","21","Select","Select",""],["","65162019010","NAPROXEN","TAB 500MG","60","Select","Select",""],["","52817019610","TRAMADOL HCL","TAB 100MG","25","Select","Select",""],["","53746061701","TRAMADL\/APAP","TAB 37.5-325","60","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","24","Select","Select",""],["","11822334910","RA EAR","DRO 6.5% OT","15","Select","Select",""],["","68382005101","MELOXICAM","TAB 15MG","30","Select","Select",""],["","65862007930","TERBINAFINE","TAB 250MG","15","Select","Select",""],["","57237000930","MIRTAZAPINE","TAB 30MG","30","Select","Select",""],["","57237002801","AMOXICILLIN","TAB 500MG","28","Select","Select",""],["","31722099601","HYDROCO\/APAP","TAB 5-325MG","10","Select","Select",""],["","00116200116","CHLORHEX GLU","SOL 0.0012","946","Select","Select",""],["","12547017162","BENADRYL","CRE 1-0.1%","28","Select","Select",""],["","58160088752","FLUARIX QUAD","INJ 2021-22","0","Select","Select",""],["","45802081184","NALOXONE HCL","4 MG","2","Select","Select",""],["","65862018601","CLINDAMYCIN","CAP 300MG","40","Select","Select",""],["","00406324301","HYDROMORPHON","TAB 2MG","26","Select","Select",""],["","57896092110","ASPIRIN","TAB 325MG EC","30","Select","Select",""],["","59417010510","VYVANSE","50 MG","11","Select","Select",""],["","11822511120","RA MELATONIN","TAB 5MG","30","Select","Select",""],["","65162027210","SMZ\/TMP DS","TAB 800-160","20","Select","Select",""],["","00115180301","HYDROXYZ PAM","CAP 25MG","90","Select","Select",""],["","68180035209","SERTRALINE","TAB 50MG","30","Select","Select",""],["","50383093093","BUPRENORPHIN","SUB 8MG","7","Select","Select",""],["","12496120803","SUBOXONE","8 MG-2 MG","30","Select","Select",""],["","68180035309","SERTRALINE HCL","100 MG","30","Select","Select",""],["","68382066205","SPIRONOLACTONE","100 MG","30","Select","Select",""],["","43598058230","BUPRENORPHINE-NALOXONE","8 MG-2 MG","15","Select","Select",""],["","47781026305","OXYCODONE HCL","5 MG","12","Select","Select",""],["","50383070016","FLUTICASONE PROPIONATE","50 MCG","16","Select","Select",""],["","43598044770","NICOTINE PATCH","14MG\/24HR","28","Select","Select",""],["","43547028910","BUPROPION HCL SR","150 MG","60","Select","Select",""],["","31722071390","PANTOPRAZOLE SODIUM","40 MG","30","Select","Select",""],["","64253022235","HEPARIN FLUSH","10 UNIT\/ML","90","Select","Select",""],["","00005475865","CENTRUM SILVER MEN","300-600MCG","30","Select","Select",""],["","42858030201","HYDROMORPHONE HCL","4 MG","30","Select","Select",""],["","00781324664","ENOXAPARIN SODIUM","40MG\/0.4ML","2.4","Select","Select",""],["","63807010010","SODIUM CHLORIDE","0.9 %","480","Select","Select",""],["","45802006436","TRIAMCINOLONE ACETONIDE","0.1 %","80","Select","Select",""],["","50383093093","BUPRENORPHINE HCL","8 MG","56","Select","Select",""],["","65162027210","SULFAMETHOXAZOLE-TRIMETHOPRIM","800-160 MG","14","Select","Select",""],["","50242004164","CATHFLO ACTIVASE","2 MG","2","Select","Select",""],["","45963043864","ENULOSE","10 G\/15 ML","473","Select","Select",""],["","08290306546","NORMAL SALINE FLUSH","0.9 %","360","Select","Select",""],["","70010075405","METHOCARBAMOL","500 MG","90","Select","Select",""],["","00409488710","WATER","","10","Select","Select",""],["","50228018001","GABAPENTIN CAP","300MG","180","Select","Select",""],["","53746051501","SPIRONOLACT TAB","100MG","60","Select","Select",""],["","68180059306","DESVENLAFAX TAB","100MG ER","30","Select","Select",""],["","31722099601","HYDROCO\/APAP TAB","5-325MG","28","Select","Select",""],["","10702001801","OXYCODONE TAB","5MG","24","Select","Select",""],["","31722071390","PANTOPRAZOLE TAB","40MG","30","Select","Select",""],["","00406051201","OXYCOD\/APAP TAB","5-325MG","30","Select","Select",""],["","65649030302","XIFAXAN TAB","550MG","60","Select","Select",""],["","31722016601","GABAPENTIN TAB","600MG","90","Select","Select",""],["","13107000130","MIRTAZAPINE TAB","7.5MG","90","Select","Select",""],["","00005475850","CENTRUM SILV TAB","50+MEN","30","Select","Select",""],["","00527512570","LACTULOSE SOL","10GM\/15","1800","Select","Select",""],["","50111056001","TRAZODONE TAB","50MG","30","Select","Select",""],["","45963043965","CONSTULOSE SOL","10GM\/15","1800","Select","Select",""],["","69547035302","NARCAN SPR","","2","Select","Select",""],["","00093216568","NALOXONE HCL SPR","","2","Select","Select",""],["","00054429931","FUROSEMIDE TAB","40MG","60","Select","Select",""],["","52817019610","TRAMADOL HCL TAB","100MG","28","Select","Select",""],["","72647033104","METHYLPRED TAB","4MG","21","Select","Select",""],["","65862018601","CLINDAMYCIN CAP","300MG","40","Select","Select",""],["","59417010510","VYVANSE CAP","50MG","28","Select","Select",""],["","11822511120","RA MELATONIN TAB","5MG","30","Select","Select",""],["","57896092110","ASPIRIN TAB","325MG EC","30","Select","Select",""],["","00406324301","HYDROMORPHON TAB","2MG","24","Select","Select",""],["","65862042005","SMZ\/TMP DS TAB","800-160","14","Select","Select",""],["","00115180301","HYDROXYZ PAM CAP","25MG","90","Select","Select",""],["","00904692561","SERTRALINE TAB","50MG","28","Select","Select",""],["","50383093093","BUPRENORPHIN SUB","8MG","7","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":""}]}]}