{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SUE  A MURPHY","gend":1,"add":"919 COVINGTON CT","city":"WAVERLY","state":"VA","zip":"23890-9998","dob":"1960-08-08","age":"","mstatus":"","insh":"20032598*01","cliId":"","pno":8048348948,"cno":8048348948,"email":"","ename":"","eno":"","pphy":"HERBERT, VALERIE J NP","ppno":7573128730,"pcpadd":"109 RAILROAD AVE","pcpcity":"WAKEFIELD","pcpstate":"VA","pcpzip":"23888-9998","pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Family Medicine Physicians - Wakefield","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7575109326,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I10.","M79.643","C50.911","D61.818","I25.118","J43.9","E78.5","E66.01","R60.0","E53.8","M79.89","Z68.42","C50.919","Z17.0","E04.1","D72.819","Z79.899","I25.10","J96.21","J96.22","J44.9","R91.8","J96.01","I51.7","C54.1","E11.9","E66.9","E11.649","C78.2","C78.00","J90.","D50.9","D72.829","K21.9","K80.20","T38.0X5A","Z68.39","Z79.51","Z85.3","J45.901","NO DATA","C34.90","E87.1","D64.9","I11.0","I50.9","E78.00","F41.9","G25.81","I42.9","J96.10","Z90.11","Z79.811","R10.2","E55.9","Z87.891","E11.59","D69.6","Z12.11","Z11.59","N17.9","Z79.82","Z79.84","Z79.01","C79.51","R25.2","K59.00","D53.9","I25.2","Z85.118","Z72.0","J44.1","R43.8","C78.6","R09.02","R06.02","Z85.6","J91.0","Z99.81","E16.2","C80.1","C76.3","C78.7","J96.91","E87.6","F51.01","M25.552","Z09.","N18.9","R79.89","D70.1","T45.1X5A","Z23.","R73.01","H35.3132","H25.13","R19.5","Z79.52","C57.9","R11.2","D70.0","I70.0","E86.0","I49.3","D70.8","D70.9"],"date":["2023-04-13","2021-08-30","2023-04-13","2022-01-05","2023-04-13","2023-04-13","2023-01-26","2022-11-22","2021-08-30","2022-05-05","2021-08-30","2022-01-05","2023-02-06","2023-04-13","2022-06-27","2022-11-21","2023-03-27","2023-01-26","2022-08-23","2022-08-23","2023-02-01","2022-11-10","2022-11-10","2023-03-30","2023-04-17","2022-11-30","2022-11-30","2022-12-20","2023-02-06","2022-11-10","2023-03-27","2022-08-22","2022-08-24","2023-02-01","2023-03-27","2022-08-22","2022-08-22","2023-02-01","2023-02-01","2023-03-14","2023-04-08","2022-11-10","2022-11-10","2023-02-06","2022-11-22","2023-03-14","2022-11-10","2022-12-21","2022-11-10","2023-03-30","2023-01-26","2022-10-03","2022-10-03","2021-07-05","2023-02-06","2023-03-30","2023-04-13","2022-05-05","2022-05-05","2022-05-05","2023-04-08","2023-03-27","2023-03-27","2022-10-03","2023-04-17","2021-06-10","2021-06-10","2023-03-27","2023-02-01","2022-11-10","2022-11-10","2022-11-10","2022-11-10","2023-03-06","2022-08-22","2022-11-11","2022-11-11","2023-03-06","2023-02-01","2022-12-21","2023-03-06","2023-03-06","2023-04-13","2022-11-22","2021-04-29","2021-04-29","2023-02-09","2023-04-13","2023-03-27","2023-03-27","2021-02-15","2021-02-15","2022-01-05","2022-01-05","2022-06-16","2022-06-16","2023-01-20","2023-02-01","2023-04-09","2023-04-08","2023-04-08","2023-04-13","2023-04-08","2023-03-30","2023-04-06","2023-04-07"],"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":[["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","00186077760","BRILINTA","TAB 90MG","60","Select","Select",""],["","00173069600","ADVAIR DISKU","AER 250\/50","60","Select","Select",""],["","16729003415","LETROZOLE","2.5 MG","30","Select","Select",""],["","00378395377","ATORVASTATIN","TAB 80MG","90","Select","Select",""],["","50111056001","TRAZODONE","TAB 50MG","30","Select","Select",""],["","16729018301","HYDROCHLOROT","TAB 25MG","90","Select","Select",""],["","66993058597","FLUTIC\/SALME","AER 250\/50","60","Select","Select",""],["","70700015010","OMEPRAZOLE","CAP 20MG","30","Select","Select",""],["","67877019805","AMLODIPINE","TAB 5MG","60","Select","Select",""],["","64380078706","BUSPIRONE","TAB 7.5MG","60","Select","Select",""],["","00069018921","IBRANCE","125 MG","21","Select","Select",""],["","00378932132","WIXELA INHUB","AER 250\/50","60","Select","Select",""],["","40985027062","VITAMIN D","3 25 MCG","30","Select","Select",""],["","00310737220","BUDES\/FORMOT","AER 80-4.5","10","Select","Select",""],["","62037099901","POT CL MICRO","TAB 20MEQ ER","4","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","59267100001","PFIZER VACC","INJ COVID-19","0","Select","Select",""],["","08373917700","VALVD HOLDNG","MIS CHAMBER","1","Select","Select",""],["","69097052444","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","45802086803","POLYETH GLYC","POW 3350 NF","510","Select","Select",""],["","52817032010","BACLOFEN","TAB 10MG","90","Select","Select",""],["","69315011701","FUROSEMIDE","40 MG","60","Select","Select",""],["","74312015606","D3","CAP 25MCG","30","Select","Select",""],["","70010006305","METFORMIN","TAB 500MG","60","Select","Select",""],["","80681016900","VITAMIN D3","TAB 25MCG","30","Select","Select",""],["","53885001110","ONETOUCH DEL","MIS PLUS 30G","100","Select","Select",""],["","53885024450","ONETOUCH","TES ULTRA","50","Select","Select",""],["","43386031214","GAVILAX","POW ","510","Select","Select",""],["","53489014301","SPIRONOLACT","TAB 25MG","30","Select","Select",""],["","61442012101","FAMOTIDINE","20 MG","90","Select","Select",""],["","00378001805","METOPROL TAR","TAB 25MG","60","Select","Select",""],["","00093227534","AMOX\/K CLAV","TAB 875-125","20","Select","Select",""],["","57237007710","ONDANSETRON","TAB 4MG ODT","15","Select","Select",""],["","53746010905","HYDROCO\/APAP","TAB 5-325MG","12","Select","Select",""],["","69097017353","IPRATROPIUM\/","SOL ALBUTER","90","Select","Select",""],["","70954006010","PREDNISONE","TAB 20MG","15","Select","Select",""],["","00904679489","ASPIRIN LOW","CHW 81MG","30","Select","Select",""],["","16729023301","ROPINIROLE","TAB 0.5MG","20","Select","Select",""],["","00781808926","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","70000012901","MUCUS REL DM","LIQ 5-100\/5","200","Select","Select",""],["","00173069600","ADVAIR DISKUS","250-50 MCG","60","Select","Select",""],["","00054032756","FLUTICASONE-SALMETEROL","250-50 MCG","60","Select","Select",""],["","53885099425","ONETOUCH ULTRA TEST STRIP","","25","Select","Select",""],["","41167005840","ASPERCREME LIDOCAINE","4 %","5","Select","Select",""],["","00378395377","ATORVASTATIN CALCIUM","80 MG","90","Select","Select",""],["","70010006305","METFORMIN HCL","500 MG","60","Select","Select",""],["","53489014301","SPIRONOLACTONE","25 MG","90","Select","Select",""],["","64380078706","BUSPIRONE HCL","7.5 MG","60","Select","Select",""],["","60687040583","IPRATROPIUM-ALBUTEROL","0.5-3MG\/3","90","Select","Select",""],["","67877019905","AMLODIPINE BESYLATE","10 MG","60","Select","Select",""],["","00093317431","ALBUTEROL SULFATE HFA","90 MCG","8.5","Select","Select",""],["","70954040310","DEXAMETHASONE","4 MG","8","Select","Select",""],["","69097052444","DICLOFENAC SODIUM","1 %","100","Select","Select",""],["","43598016430","OLANZAPINE","5 MG","28","Select","Select",""],["","68462016301","CARVEDILOL","6.25 MG","60","Select","Select",""],["","71930001852","ONDANSETRON HCL","8 MG","30","Select","Select",""],["","00406055201","OXYCODONE HCL","5 MG","5","Select","Select",""],["","11917002642","SALINE NASAL SPRAY","0.65 %","88","Select","Select",""],["","00093101042","MUPIROCIN","2 %","22","Select","Select",""],["","65862050220","AMOXICILLIN-CLAVULANATE POTASS","500-125 MG","14","Select","Select",""],["","00603020922","MAGNESIUM OXIDE","400 MG","30","Select","Select",""],["","00536104710","SODIUM BICARBONATE","650 MG","60","Select","Select",""],["","00406051205","OXYCODONE-ACETAMINOPHEN","5 MG-325MG","12","Select","Select",""],["","53885001110","ONETOUCH DELICA PLUS LANCET","30 GAUGE","100","Select","Select",""],["","00536250676","SALINE MIST","0.65 %","44","Select","Select",""],["","62037072001","POTASSIUM CHLORIDE","20 MEQ","60","Select","Select",""],["","11917005024","CALCIUM","600-VIT D3 600MG-5MCG","90","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":""}]}]}