{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JONATHAN  B HOWARD","gend":0,"add":"4494 SIR JOHNS LN","city":"VIRGINIA BEACH","state":"VA","zip":"23455-9998","dob":"1994-09-23","age":"","mstatus":"","insh":"20008501*01","cliId":"","pno":7574605207,"cno":7574605207,"email":"","ename":"","eno":"","pphy":"K C, RADHA MD","ppno":7572615910,"pcpadd":"850 KEMPSVILLE RD STE 200A","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":"23502-9998","pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Internal Medicine Physicians - Kempsville","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7574660321,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["D83.9","J45.901","J45.50","J30.9","G43.009","F43.22","K22.4","Z93.1","K94.20","K94.23","J39.8","K30.","F43.20","F41.1","R10.9","R11.0","R19.7","R42.","R07.89","B37.81","Z79.2","E27.1","E03.9","Z88.0","Z88.8","Z91.012","G97.1","R11.2","R51.9","J45.40","J30.89","G24.01","Q32.2","K31.84","M99.05","R27.8","R53.1","M62.89","L29.8","K29.50","K31.6","K29.70","Z98.890","R10.84","R79.89","G89.29","J45.909","F41.9","K21.9","Z79.899","Z79.51","G43.909","Z79.890","R68.89","J01.00","K22.10","K31.89","F84.0","Z86.14","K59.01","R12.","I10.","E23.0","J98.8","H47.333","K94.29","Z00.00","E03.8","K59.04","Z43.1","J01.90","F42.2","H47.331","Q89.9","R06.02","Z98.84","Z23.","Z20.822","E66.9","Z68.32","K52.9","G43.919","R51.0","Z91.89","R06.83","F51.5","J01.01","L29.9","R09.81","R53.81","R53.83","G97.0","J45.41","Z86.16","Z86.69","R13.10","NO DATA","R26.89","Z91.81","R40.0","G47.8","E66.8","Z68.31","J69.8","R26.81","M62.81","Z01.818","Z20.828"],"date":["2023-04-27","2021-06-18","2023-04-27","2022-04-05","2023-03-13","2022-02-22","2021-06-11","2022-12-28","2023-03-23","2021-08-06","2023-04-27","2021-09-27","2022-04-04","2023-04-11","2022-10-14","2023-01-06","2022-09-16","2022-11-29","2022-11-17","2022-11-17","2022-11-17","2023-01-02","2022-12-22","2023-01-02","2023-01-02","2023-01-02","2023-01-25","2022-12-27","2023-03-07","2023-01-04","2022-12-29","2022-11-29","2022-10-14","2022-10-14","2022-08-18","2022-08-18","2022-08-18","2022-08-18","2022-10-04","2022-10-27","2022-10-27","2022-10-27","2022-12-23","2022-10-27","2022-11-17","2022-12-23","2022-12-22","2023-01-02","2022-12-22","2023-01-02","2022-12-22","2022-12-22","2022-12-22","2021-06-23","2022-06-07","2022-10-27","2022-10-27","2023-01-02","2023-01-02","2023-01-06","2023-01-06","2022-12-22","2023-01-02","2022-12-22","2023-01-18","2021-09-27","2021-12-14","2023-01-02","2022-03-25","2021-09-27","2021-11-30","2022-04-06","2022-05-25","2022-05-25","2023-04-27","2023-01-02","2023-04-05","2022-05-20","2023-01-04","2022-07-30","2022-08-08","2022-12-22","2022-12-27","2023-01-04","2023-01-04","2023-01-04","2023-02-02","2022-05-16","2022-05-16","2022-12-22","2022-12-22","2023-01-02","2022-01-19","2022-01-19","2022-02-11","2022-02-11","2023-01-02","2023-03-30","2023-03-30","2023-04-03","2023-03-30","2023-03-17","2023-03-17","2023-03-17","2023-04-26","2023-04-26","2021-01-05","2021-01-05"],"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":[["","66689002316","HYDROCO\/APAP","SOL 7.5-325","118","Select","Select",""],["","00121072104","FLUOXETINE","SOL 20MG\/5ML","450","Select","Select",""],["","66993058697","FLUTIC\/SALME","AER 500\/50","60","Select","Select",""],["","60505265301","TRAZODONE","TAB 50MG","30","Select","Select",""],["","00781627043","OXCARBAZEPIN","SUS 300MG\/5M","1000","Select","Select",""],["","00173069700","ADVAIR DISKU","AER 500\/50","60","Select","Select",""],["","65862066430","ARIPIPRAZOLE","15 MG","60","Select","Select",""],["","00093100301","BUSPIRONE","TAB 15MG","120","Select","Select",""],["","69238183801","LEVOTHYROXIN","TAB 150MCG","90","Select","Select",""],["","00378698188","LANSOPRAZOLE","15 MG","60","Select","Select",""],["","68180035302","SERTRALINE","TAB 100MG","60","Select","Select",""],["","65162069890","GABAPENTIN","SOL 250\/5ML","360","Select","Select",""],["","00378932232","WIXELA INHUB","AER 500\/50","60","Select","Select",""],["","00054318863","DIAZEPAM","5 MG\/5 ML","300","Select","Select",""],["","31722072690","MONTELUKAST","TAB 10MG","90","Select","Select",""],["","68382004001","PROMETHAZINE","TAB 12.5MG","20","Select","Select",""],["","00173068220","VENTOLIN HFA","AER ","18","Select","Select",""],["","00591352530","LIDOCAINE","PAD 0.05","60","Select","Select",""],["","00054372250","PREDNISONE","SOL 5MG\/5ML","120","Select","Select",""],["","68382071782","ZOLMITRIPTAN","TAB 5MG ODT","9","Select","Select",""],["","64764017130","DEXILANT","CAP 30MG DR","30","Select","Select",""],["","68382000514","TOPIRAMATE","25 MG","360","Select","Select",""],["","70539000102","TYMLOS","INJ ","2","Select","Select",""],["","08290320119","BD PEN NEEDL","MIS 31GX5MM","100","Select","Select",""],["","00002840001","FORTEO","20MCG\/DOSE","2.4","Select","Select",""],["","50383004224","PREDNISOLONE","SOL 15MG\/5ML","25","Select","Select",""],["","59762007401","HYDROCORT","TAB 10MG","500","Select","Select",""],["","08290309628","SYRINGE LUER","MIS -LOK 1ML","2","Select","Select",""],["","08290324910","INSULIN SYRG","MIS 0.3\/31G","2","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","00574200815","NYSTOP","POW 100000","15","Select","Select",""],["","65862021901","CEFDINIR","SUS 250\/5ML","100","Select","Select",""],["","08290305156","BD NEEDLES","MIS 22GX1.5\"","2","Select","Select",""],["","59267102501","PFIZER VACC","INJ ADLT RTU","0","Select","Select",""],["","00904667840","OXYCODONE","SOL 5MG\/5ML","50","Select","Select",""],["","08290305906","3ML SYRINGE","MIS 22GX1.5\"","2","Select","Select",""],["","00168009960","KETOCONAZOLE","2 %","60","Select","Select",""],["","71858015505","TIROSINT-SOL","175 MCG\/ML","30","Select","Select",""],["","00904515460","GUAIFENESIN","TAB 200MG","30","Select","Select",""],["","00069097195","VIBRAMYCIN","SYP 50MG\/5ML","280","Select","Select",""],["","70710145902","AZITHROMYCIN","200 MG\/5ML","45","Select","Select",""],["","00078035752","TRILEPTAL","300 MG\/5ML","1000","Select","Select",""],["","72618300002","NURTEC","TAB 75MG ODT","10","Select","Select",""],["","24470090004","BP WASH","LIQ 0.05","113","Select","Select",""],["","00023650110","UBRELVY","TAB 100MG","10","Select","Select",""],["","51759020210","AJOVY","INJ 225\/1.5","2","Select","Select",""],["","65649000330","TRULANCE","3 MG","30","Select","Select",""],["","00093929167","CLONAZEP ODT","TAB 0.25MG","60","Select","Select",""],["","54838050280","HYDROXYZ HCL","SYP 10MG\/5ML","1419","Select","Select",""],["","60505083001","MOMETASONE","SPR 50MCG","17","Select","Select",""],["","45802056201","CLINDAMYCIN","SOL 0.01","30","Select","Select",""],["","08290309637","LUER-LOK SYR","MIS 1ML\/20G","2","Select","Select",""],["","00009082501","SOLU-CORTEF","INJ 100MG","1","Select","Select",""],["","65862021150","MINOCYCLINE","CAP 100MG","10","Select","Select",""],["","67877054588","CEPHALEXIN","SUS 250\/5ML","300","Select","Select",""],["","55513084301","AIMOVIG","INJ 140MG\/ML","1","Select","Select",""],["","32909074103","READI-CAT 2","SUS BERRY","450","Select","Select",""],["","50419077301","CIPRO (10%)","SUS 500MG\/5","100","Select","Select",""],["","68180065701","DOXYCYCLINE","SUS 25MG\/5ML","300","Select","Select",""],["","45802028001","BENZOYL PER","LIQ 5% WASH","142","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","21","Select","Select",""],["","00143992801","CIPROFLOXACN","TAB 500MG","14","Select","Select",""],["","31722072250","LEVOFLOXACIN","TAB 500MG","3","Select","Select",""],["","57237000630","FLUCONAZOLE","200 MG","14","Select","Select",""],["","69238145802","POT CHLORIDE","SOL 0.2","225","Select","Select",""],["","00904672059","ACETAMIN","TAB 500MG","60","Select","Select",""],["","70710116201","MECLIZINE","TAB 25MG","60","Select","Select",""],["","68462015713","ONDANSETRON","TAB 4MG ODT","20","Select","Select",""],["","00713052612","PROMETHEGAN","SUP 25MG","10","Select","Select",""],["","69238207701","PROPRANOLOL","TAB 10MG","60","Select","Select",""],["","57664078486","CLONAZEPAM","0.25 MG","60","Select","Select",""],["","60505265301","TRAZODONE HCL","50 MG","30","Select","Select",""],["","60505083001","MOMETASONE FUROATE","50 MCG","17","Select","Select",""],["","65862057490","MONTELUKAST SODIUM","10 MG","30","Select","Select",""],["","54838050280","HYDROXYZINE HCL","10 MG\/5 ML","1419","Select","Select",""],["","00093100301","BUSPIRONE HCL","15 MG","120","Select","Select",""],["","00173069700","ADVAIR DISKUS","500-50 MCG","60","Select","Select",""],["","68180035302","SERTRALINE HCL","100 MG","60","Select","Select",""],["","55513084301","AIMOVIG AUTOINJECTOR","140 MG\/ML","1","Select","Select",""],["","66689010502","THYQUIDITY","100MCG\/5ML","200","Select","Select",""],["","69238207701","PROPRANOLOL HCL","10 MG","60","Select","Select",""],["","13811071230","VENLAFAXINE HCL ER","37.5 MG","30","Select","Select",""],["","42806040021","METHYLPREDNISOLONE","4 MG","21","Select","Select",""],["","00781627043","OXCARBAZEPINE","300 MG\/5ML","1000","Select","Select",""],["","51759020210","AJOVY AUTOINJECTOR","225 MG\/1.5","1.5","Select","Select",""],["","68382071782","ZOLMITRIPTAN ODT","5 MG","9","Select","Select",""],["","70710116201","MECLIZINE HCL","25 MG","60","Select","Select",""],["","68180065208","DOXYCYCLINE MONOHYDRATE","100 MG","20","Select","Select",""],["","54838055550","ONDANSETRON HCL","4 MG\/5 ML","300","Select","Select",""],["","66993001968","ALBUTEROL SULFATE HFA","90 MCG","18","Select","Select",""],["","64380097106","HYDROCORTISONE","10 MG","500","Select","Select",""],["","70710166801","PROCHLORPERAZINE MALEATE","10 MG","60","Select","Select",""],["","00173071920","FLOVENT HFA","110 MCG","12","Select","Select",""],["","76204020025","ALBUTEROL SULFATE","2.5 MG\/3ML","150","Select","Select",""],["","66993007996","FLUTICASONE PROPIONATE HFA","110 MCG","12","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":""}]}]}