{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MARION M MORRIS","gend":1,"add":"3813 FOXGLOVE CT","city":"VIRGINIA BEACH","state":"VA","zip":"23453-9998","dob":"1967-07-13","age":"","mstatus":"","insh":"20039505*01","cliId":"","pno":7577182278,"cno":7577182278,"email":"","ename":"","eno":"","pphy":"LOCK II, DONALD W DO","ppno":7573952500,"pcpadd":"1024 FIRST COLONIAL RD,","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":"23454-9998","pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Family Medicine Physicians - First Colonial","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7572759700,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J44.9","M75.111","M25.511","G89.29","T50.902A","Z20.828","S43.431A","M67.911","M65.811","Z88.5","Z88.1","Z88.6","M25.611","G89.18","Z98.890","M24.611","J96.00","F10.10","B18.2","M25.512","M75.42","M75.82","I10.","Z72.89","E78.2","E03.9","Z68.21","I95.9","J96.90","E87.2","J96.01","V58.89","Z48.89","M75.02","M75.112","E11.40","R11.0","Z79.4","G43.909","F10.29","K86.0","F41.8","E03.8","Z23.","F41.9","E53.8","M76.61","M72.2","S86.812A","R94.31","R79.89","Z91.19","J42.","Z01.818","B35.9","M25.111","T42.4X2A","R57.9","F10.24","T43.3X2A","T46.4X2A","T38.1X2A","T51.0X2A","E87.6","Z20.822","NO DATA","E78.5","F17.210","K21.9","R10.2","R63.4","Z68.22","E11.65","F17.219","M75.122","S20.211A","H60.92","J01.00","J20.9","Z72.0","Z01.810"],"date":["2022-07-20","2022-02-02","2022-09-26","2022-09-26","2022-02-22","2021-02-25","2021-09-14","2021-05-21","2021-05-10","2021-05-10","2021-05-10","2021-05-10","2021-05-10","2023-08-08","2022-09-26","2022-03-03","2022-02-19","2022-02-20","2022-02-20","2023-08-08","2022-06-20","2022-06-20","2022-07-14","2021-09-13","2021-09-13","2022-07-20","2021-09-13","2022-02-21","2022-02-19","2022-02-19","2022-02-20","2022-03-03","2022-03-03","2023-08-08","2023-08-11","2022-07-20","2021-12-08","2022-07-20","2021-12-08","2022-07-20","2022-07-20","2022-07-14","2021-01-12","2021-05-25","2021-07-16","2021-05-25","2021-01-12","2021-01-12","2021-01-12","2021-05-21","2021-05-25","2021-05-25","2021-05-25","2021-09-01","2021-09-01","2021-09-14","2022-02-19","2022-02-19","2022-02-19","2022-02-19","2022-02-19","2022-02-19","2022-02-19","2022-02-19","2022-02-19","2022-02-19","2022-02-19","2022-02-19","2022-02-19","2022-07-20","2021-02-01","2021-02-01","2021-02-01","2021-02-01","2023-08-07","2021-12-20","2023-02-09","2023-02-09","2023-02-09","2023-02-09","2023-08-07"],"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":[["","00781107905","ALPRAZOLAM","TAB 1MG","30","Select","Select",""],["","00406055201","OXYCODONE","TAB 5MG","28","Select","Select",""],["","65162010250","GABAPENTIN","CAP 300MG","90","Select","Select",""],["","69238183207","LEVOTHYROXIN","TAB 75MCG","90","Select","Select",""],["","42806040021","METHYLPRED","TAB 4MG","21","Select","Select",""],["","53885024510","ONETOUCH","TES ULTRA","300","Select","Select",""],["","65862050220","AMOX\/K CLAV","TAB 500-125","9","Select","Select",""],["","08290320109","BD PEN NEEDL","MIS 31GX8MM","100","Select","Select",""],["","68180098003","LISINOPRIL","TAB 10MG","30","Select","Select",""],["","10702000350","PROMETHAZINE","TAB 25MG","90","Select","Select",""],["","00088221905","LANTUS SOLOS","INJ 100\/ML","15","Select","Select",""],["","65162062711","TRAMADOL HCL","TAB 50MG","20","Select","Select",""],["","68382050010","OMEPRAZOLE","CAP 40MG","90","Select","Select",""],["","62135098505","DOXYCYCLINE HYCLATE","100 MG","20","Select","Select",""],["","42806071401","BENZONATATE","100 MG","15","Select","Select",""],["","24208063562","NEOMYCIN-POLYMYXIN-HC","3.5-10K-1","10","Select","Select",""],["","00406055201","OXYCODONE TAB","5MG","30","Select","Select",""],["","69238183207","LEVOTHYROXIN TAB","75MCG","90","Select","Select",""],["","00781107905","ALPRAZOLAM TAB","1MG","60","Select","Select",""],["","65162010250","GABAPENTIN CAP","300MG","270","Select","Select",""],["","42806040021","METHYLPRED TAB","4MG","21","Select","Select",""],["","53885024510","ONETOUCH TES ULTRA","","300","Select","Select",""],["","65862050220","AMOX\/K CLAV TAB","500-125","9","Select","Select",""],["","08290320109","BD PEN NEEDL MIS","31GX8MM","100","Select","Select",""],["","68180098003","LISINOPRIL TAB","10MG","90","Select","Select",""],["","10702000350","PROMETHAZINE TAB","25MG","90","Select","Select",""],["","00088221905","LANTUS SOLOS INJ","100\/ML","15","Select","Select",""],["","65162062711","TRAMADOL HCL TAB","50MG","20","Select","Select",""],["","68382050010","OMEPRAZOLE CAP","40MG","90","Select","Select",""],["","00406012305","HYDROCODONE-ACETAMINOPHEN","5 MG-325MG","10","Select","Select",""],["","00406055201","OXYCODONE HCL","5 MG","30","Select","Select",""],["","00363058714","ASPIRIN EC","81 MG","84","Select","Select",""],["","00904672059","ACETAMINOPHEN","500 MG","60","Select","Select",""],["","57237007710","ONDANSETRON ODT","4 MG","20","Select","Select",""],["","00363017508","PAIN RELIEVER","500 MG","60","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":""}]}]}