{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ROXANNE WILBORNE","gend":1,"add":"5824 ROXBURY PL APT 101","city":"VIRGINIA BEACH","state":"VA","zip":"23462-9998","dob":"1963-04-13","age":"","mstatus":"","insh":"20038894*01","cliId":"","pno":7574631780,"cno":7574631780,"email":"","ename":"","eno":"","pphy":"ONAYEMI, OLUSOLA K MD","ppno":7573951300,"pcpadd":"2859 VIRGINIA BEACH BLVD,","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":"23452-9998","pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Family Medicine Physicians - Little Neck","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7572260247,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["U07.1","NO DATA","J96.00","J44.0","Z68.42","I69.951","J98.11","E11.65","E78.2","G89.29","J45.40","E11.51","E87.6","E66.01","F51.01","Z85.44","I10.","Z20.822","R26.89","R05.9","M25.562","I70.229","Z09.","D62.","T14.8XXA","D64.9","M25.569","I69.352","J41.0","Z99.89","M79.605","I73.9","E11.49","G47.00","G81.91","Z79.4","M25.512","Z12.11","Z12.31","N39.41","M62.81","R15.9","Z99.3","R00.0","R79.89","R11.2","B34.9","M25.561","R19.7","I70.222","R94.31","Z86.16","A59.00","Z11.3","Z87.412","Z01.419","Z12.39","Z12.4","N90.89","N95.0","M17.11","I99.8","G47.33","N30.90","J44.9","E11.9","Z87.891","D72.829","I51.7","M79.652","R69.","J45.909","Z98.890","Z68.41","I82.432","Z96.652","S70.11XA","Z86.73","Z86.002","Z83.438","Z83.3","Z82.61","Z82.5","Z82.49","Z79.899","E11.59"],"date":["2021-11-23","2023-03-29","2021-10-31","2021-10-31","2023-01-27","2021-10-31","2021-10-31","2023-08-22","2023-08-02","2023-03-29","2023-03-29","2021-11-16","2022-06-22","2023-08-02","2021-10-31","2023-01-27","2023-08-02","2021-11-03","2021-11-04","2022-12-29","2023-08-02","2022-02-16","2021-11-23","2021-11-23","2021-11-23","2022-02-16","2022-02-16","2022-02-16","2023-03-29","2023-08-22","2023-03-29","2023-03-29","2022-06-22","2022-06-22","2023-01-27","2023-08-02","2023-02-09","2023-01-27","2023-01-27","2023-06-24","2023-06-24","2023-06-24","2023-06-24","2021-11-12","2021-10-31","2021-10-31","2021-10-31","2021-10-31","2021-10-31","2021-11-13","2021-11-12","2021-11-12","2022-01-25","2022-01-25","2022-05-24","2021-10-18","2021-10-18","2021-10-18","2021-10-18","2021-10-18","2022-10-27","2021-11-16","2021-11-16","2022-12-29","2022-12-29","2022-12-29","2022-12-29","2021-11-11","2021-11-13","2022-06-23","2021-11-08","2021-11-13","2021-11-13","2021-11-13","2021-11-11","2021-11-11","2021-11-11","2023-08-02","2021-11-11","2021-11-11","2021-11-11","2021-11-11","2021-11-11","2021-11-11","2021-11-11","2023-08-02"],"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":[["","00173069700","ADVAIR DISKU","AER 500\/50","60","Select","Select",""],["","00245531990","KLOR-CON M20","TAB 20MEQ ER","28","Select","Select",""],["","65862057490","MONTELUKAST","TAB 10MG","28","Select","Select",""],["","66993058697","FLUTIC\/SALME","AER 500\/50","60","Select","Select",""],["","00002879759","HUMALOG MIX","75-25 KWIKPEN 75-25\/ML","30","Select","Select",""],["","24979002702","DILTIAZEM","24HR ER (CD) 180 MG","90","Select","Select",""],["","08290320109","BD PEN NEEDL","MIS 31GX8MM","90","Select","Select",""],["","55111014512","FLUCONAZOLE","150 MG","1","Select","Select",""],["","00169406013","VICTOZA","3-PAK 0.6 MG\/0.1","9","Select","Select",""],["","65862047030","LOSARTAN\/HCT","TAB 100-25","28","Select","Select",""],["","50228035490","PREGABALIN","150 MG","56","Select","Select",""],["","16714017501","ATORVASTATIN","TAB 40MG","28","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","62037099901","POT CL MICRO","TAB 20MEQ ER","28","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","42806071401","BENZONATATE","100 MG","30","Select","Select",""],["","69543025216","VIRTUSSIN AC","SOL 100-10\/5","118","Select","Select",""],["","55111019605","CLOPIDOGREL","75 MG","28","Select","Select",""],["","45802016000","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","00093007301","ZOLPIDEM","TAB 5MG","30","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","4","Select","Select",""],["","00002823305","INSULIN LISP","INJ PROTAMIN","30","Select","Select",""],["","00378827093","ALBUTEROL","NEB 0.00083","90","Select","Select",""],["","59746017310","PREDNISONE","TAB 10MG","10","Select","Select",""],["","31722099601","HYDROCO\/APAP","TAB 5-325MG","20","Select","Select",""],["","00548301500","LIDOCAINE","GEL 0.02","20","Select","Select",""],["","67877021905","CEPHALEXIN","500 MG","14","Select","Select",""],["","50580069202","TYLENOL","TAB 500MG","30","Select","Select",""],["","65162068210","PHENAZOPYRID","TAB 200MG","6","Select","Select",""],["","00054327099","FLUTICASONE PROPIONATE","50 MCG","16","Select","Select",""],["","00093317431","ALBUTEROL SULFATE HFA","90 MCG","8.5","Select","Select",""],["","62332005090","LOSARTAN-HYDROCHLOROTHIAZIDE","100MG-25MG","28","Select","Select",""],["","00093007301","ZOLPIDEM TARTRATE","5 MG","30","Select","Select",""],["","00093505898","ATORVASTATIN CALCIUM","40 MG","30","Select","Select",""],["","65862057490","MONTELUKAST SODIUM","10 MG","28","Select","Select",""],["","65162083366","DICLOFENAC SODIUM","1 %","100","Select","Select",""],["","00245531990","KLOR-CON M","20 20 MEQ","28","Select","Select",""],["","00406012301","HYDROCODONE-ACETAMINOPHEN","5 MG-325MG","20","Select","Select",""],["","00832532511","POTASSIUM CHLORIDE","20 MEQ","90","Select","Select",""],["","72578005518","DOXYCYCLINE HYCLATE","100 MG","14","Select","Select",""],["","00093007301","ZOLPIDEM TAB","5MG","30","Select","Select",""],["","55111019605","CLOPIDOGREL TAB","75MG","28","Select","Select",""],["","62332012390","PREGABALIN CAP","150MG","56","Select","Select",""],["","60505258009","ATORVASTATIN TAB","40MG","28","Select","Select",""],["","08290320109","BD PEN NEEDL MIS","31GX8MM","100","Select","Select",""],["","68682099498","DILTIAZEM CAP","180MG ER","28","Select","Select",""],["","00054327099","FLUTICASONE SPR","50MCG","16","Select","Select",""],["","59746033990","LOSARTAN\/HCT TAB","100-25","30","Select","Select",""],["","66993058697","FLUTIC\/SALME AER","500\/50","60","Select","Select",""],["","59310057922","PROAIR HFA AER","","8","Select","Select",""],["","65162083366","DICLOFENAC GEL","1%","100","Select","Select",""],["","00169406013","VICTOZA INJ","18MG\/3ML","9","Select","Select",""],["","55111072530","MONTELUKAST TAB","10MG","28","Select","Select",""],["","00002879759","HUMALOG MIX INJ","75\/25KWP","15","Select","Select",""],["","00173069700","ADVAIR DISKU AER","500\/50","60","Select","Select",""],["","50111033402","METRONIDAZOL TAB","500MG","4","Select","Select",""],["","00093317431","ALBUTEROL AER HFA","","8","Select","Select",""],["","31722099601","HYDROCO\/APAP TAB","5-325MG","20","Select","Select",""],["","17478071130","LIDOCAINE GEL","2% JELLY","30","Select","Select",""],["","55111014512","FLUCONAZOLE TAB","150MG","2","Select","Select",""],["","00487950103","ALBUTEROL NEB","0.083%","90","Select","Select",""],["","00002751101","HUMALOG MIX SUS","75\/25","15","Select","Select",""],["","50580069202","TYLENOL TAB","500MG","30","Select","Select",""],["","67877021905","CEPHALEXIN CAP","500MG","14","Select","Select",""],["","42806071401","BENZONATATE CAP","100MG","30","Select","Select",""],["","65162068210","PHENAZOPYRID TAB","200MG","6","Select","Select",""],["","65162068210","PHENAZOPYRIDINE HCL","200 MG","6","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":""}]}]}