{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"PHILIP L WHEATLEY","gend":0,"add":"3847 ARTHUR DR","city":"SUFFOLK","state":"VA","zip":"23438-9998","dob":"1964-03-29","age":"","mstatus":"","insh":"20037177*01","cliId":"","pno":7574343959,"cno":7574343959,"email":"","ename":"","eno":"","pphy":"WOODS, DAVID W MD","ppno":7573636800,"pcpadd":"#100 816 INDEPENDENCE BLVD,","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":"23455-9998","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":7575079029,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z23.","E11.9","E03.9","E11.69","E78.5","R94.31","I25.118","C92.00","E66.01","G47.33","I10.","I25.10","D72.0","F41.9","M06.9","I25.2","Z68.38","Z79.52","Z79.82","Z79.51","Z79.84","Z79.899","Z99.89","R79.89","C92.01","M25.569","R94.5","M17.11","G89.18","Z47.1","I11.9","E07.9","G47.30","K21.9","E78.00","D53.9","M62.50","Z85.6","Z87.891","Z95.5","Z96.651","Z79.01","Z79.4","Z92.21","Z94.84","M06.09","Z94.81","K37.","D89.813","M19.90","S69.82XA","R74.01","Z08.","Z01.818","M25.561","R59.0","E66.09","Z68.37","D36.0","I78.1","B02.29","Z85.828","E11.49","R20.2","M20.42","M20.41","M21.372","Z01.810","Z68.35","E78.2","H53.8","Z86.010","E66.9","H04.123","J30.9","E11.41","Z95.828","L03.114","R22.2","N40.1","Z12.5","Z12.11","R15.2","R39.12","J30.1","I25.810","B02.9","K59.00","C91.00","D61.9","Z86.19","I70.0"],"date":["2021-10-07","2023-06-15","2023-06-15","2023-06-15","2023-06-15","2022-07-19","2023-06-13","2022-08-03","2023-04-10","2023-06-27","2023-04-10","2022-02-28","2021-06-17","2021-06-17","2021-06-17","2021-06-17","2021-06-17","2022-03-15","2022-03-15","2021-06-17","2021-06-17","2021-11-03","2023-01-12","2021-03-24","2023-06-29","2021-10-07","2022-12-21","2022-03-01","2022-02-28","2022-07-27","2022-03-15","2022-03-15","2022-08-29","2023-01-12","2022-03-15","2022-03-15","2022-03-15","2022-03-15","2022-03-15","2022-03-15","2023-02-22","2022-03-15","2022-03-15","2022-08-03","2022-08-03","2023-08-17","2023-08-17","2023-04-10","2023-04-10","2023-08-17","2021-01-26","2021-02-15","2021-07-08","2022-02-22","2022-06-17","2022-12-13","2022-08-26","2022-08-29","2022-08-29","2023-09-07","2023-09-07","2023-09-07","2021-08-18","2023-08-07","2023-08-07","2023-08-07","2022-08-01","2021-12-14","2022-01-03","2021-12-14","2022-07-26","2022-12-21","2022-12-21","2021-11-03","2022-01-03","2023-08-07","2021-06-17","2021-11-17","2022-06-27","2022-06-27","2022-06-27","2022-06-27","2022-06-27","2022-06-27","2023-01-12","2022-03-01","2021-09-15","2021-10-06","2021-12-16","2021-12-16","2021-12-16","2023-04-10"],"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":[["","00116200116","CHLORHEX GLU","SOL 0.0012","473","Select","Select",""],["","00228202910","ALPRAZOLAM","0.5 MG","50","Select","Select",""],["","68180096901","LEVOTHYROXIN","TAB 100MCG","90","Select","Select",""],["","27241013436","CHOLESTYRAM","POW 4GM","90","Select","Select",""],["","70010006505","METFORMIN","TAB 1000MG","60","Select","Select",""],["","29300022019","MONTELUKAST","TAB 10MG","90","Select","Select",""],["","69238154401","HYDROXYCHLOR","TAB 200MG","180","Select","Select",""],["","59746017206","PREDNISONE","5 MG","30","Select","Select",""],["","55111064505","OMEPRAZOLE","40 MG","90","Select","Select",""],["","68180063709","ATORVASTATIN","TAB 40MG","90","Select","Select",""],["","13668010401","ISOSORB MONO","TAB 30MG ER","90","Select","Select",""],["","00173072020","FLOVENT HFA","AER 220MCG","12","Select","Select",""],["","00006027731","JANUVIA","100 MG","30","Select","Select",""],["","11822511150","RA VIT B-12","TAB 1000 TR","30","Select","Select",""],["","16714085401","METOPROL SUC","TAB 100MG ER","90","Select","Select",""],["","65862044930","VALACYCLOVIR","TAB 1GM","21","Select","Select",""],["","53885024510","ONETOUCH","TES ULTRA","100","Select","Select",""],["","00456120130","LINZESS","CAP 145MCG","90","Select","Select",""],["","59267100002","PFIZER VACC","INJ COVID-19","0","Select","Select",""],["","58160082311","SHINGRIX","INJ 50\/0.5ML","1","Select","Select",""],["","65862018601","CLINDAMYCIN","CAP 300MG","28","Select","Select",""],["","61442011201","ACYCLOVIR","TAB 400MG","60","Select","Select",""],["","65162004710","OXYCODONE","TAB 5MG","40","Select","Select",""],["","11822300930","SENNA PLUS","TAB 8.6-50MG","60","Select","Select",""],["","50458058030","XARELTO","TAB 10MG","14","Select","Select",""],["","58602075521","PAIN RELIEF","TAB 500MG","240","Select","Select",""],["","65862018730","ONDANSETRON","TAB 4MG","30","Select","Select",""],["","65862059801","TAMSULOSIN","CAP 0.4MG","30","Select","Select",""],["","31722099601","HYDROCO\/APAP","TAB 5-325MG","15","Select","Select",""],["","31722088290","ROSUVASTATIN","TAB 5MG","45","Select","Select",""],["","57237002801","AMOXICILLIN","TAB 500MG","30","Select","Select",""],["","65162046650","IBUPROFEN","TAB 800MG","28","Select","Select",""],["","70010006505","METFORMIN HCL","1000 MG","60","Select","Select",""],["","69238154401","HYDROXYCHLOROQUINE SULFATE","200 MG","60","Select","Select",""],["","53885099425","ONETOUCH ULTRA TEST STRIP","","25","Select","Select",""],["","68180097001","LEVOTHYROXINE SODIUM","112 MCG","30","Select","Select",""],["","31722088290","ROSUVASTATIN CALCIUM","5 MG","15","Select","Select",""],["","64980028001","GLIPIZIDE ER","5 MG","90","Select","Select",""],["","51672404801","CLOTRIMAZOLE-BETAMETHASONE","1 %-0.05 %","45","Select","Select",""],["","11822511150","RA VIT B-","12 TAB 1000 TR","30","Select","Select",""],["","69238154401","HYDROXYCHLOR TAB","200MG","60","Select","Select",""],["","59746017206","PREDNISONE TAB","5MG","90","Select","Select",""],["","00006027731","JANUVIA TAB","100MG","30","Select","Select",""],["","55111064505","OMEPRAZOLE CAP","40MG","90","Select","Select",""],["","00228202910","ALPRAZOLAM TAB","0.5MG","50","Select","Select",""],["","29300022019","MONTELUKAST TAB","10MG","90","Select","Select",""],["","11822300930","SENNA PLUS TAB","8.6-50MG","60","Select","Select",""],["","68180096901","LEVOTHYROXIN TAB","100MCG","90","Select","Select",""],["","65162004710","OXYCODONE TAB","5MG","40","Select","Select",""],["","50458058030","XARELTO TAB","10MG","14","Select","Select",""],["","65862018730","ONDANSETRON TAB","4MG","30","Select","Select",""],["","58160082311","SHINGRIX INJ","50\/0.5ML","1","Select","Select",""],["","31722059101","METOPROL SUC TAB","100MG ER","90","Select","Select",""],["","70010006505","METFORMIN TAB","1000MG","60","Select","Select",""],["","58602075521","PAIN RELIEF TAB","500MG","240","Select","Select",""],["","13668010401","ISOSORB MONO TAB","30MG ER","90","Select","Select",""],["","65862059801","TAMSULOSIN CAP","0.4MG","30","Select","Select",""],["","31722099601","HYDROCO\/APAP TAB","5-325MG","15","Select","Select",""],["","31722088290","ROSUVASTATIN TAB","5MG","15","Select","Select",""],["","65162046650","IBUPROFEN TAB","800MG","28","Select","Select",""],["","57237002801","AMOXICILLIN TAB","500MG","30","Select","Select",""],["","72516003101","METOPROLOL SUCCINATE","50 MG","90","Select","Select",""],["","00002143480","TRULICITY","1.5 MG\/0.5","2","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":""}]}]}