{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SHAWONDA  L VINSON","gend":1,"add":"972 EDWIN DR","city":"VIRGINIA BEACH","state":"VA","zip":"23464-9998","dob":"1978-10-22","age":"","mstatus":"","insh":"20041459*01","cliId":"","pno":7579497410,"cno":7579497410,"email":"","ename":"","eno":"","pphy":"BOHRT TERCEROS, VALERIA MD","ppno":7575070900,"pcpadd":"1925 GLENN MITCHELL DR STE 202","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":"23456-9998","pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Endocrinology Specialists - Princess Anne","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7573016462,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E66.2","G47.33","G47.31","E11.65","E11.21","Z79.4","L30.8","I11.0","I50.9","E66.9","Z68.42","Z86.73","E11.319","F17.210","R21.","G47.00","G47.36","G25.81","Z43.2","R07.89","R05.9","E66.01","Z20.822","B35.1","I73.9","I50.22","Z68.43","E11.29","R80.9","Z79.899","E11.9","H25.813","I10.","NO DATA","I25.10","Z72.0","Z93.2","E66.3","G47.30","E11.8","H10.33","L40.9","E11.69","E78.5","L30.9","E87.5","L40.0","N17.9","E11.3319","I50.32","J96.02","J96.01","Z79.01","Z87.01","R60.0","E11.3291","H10.45","E87.1","I13.0","N39.0","I95.9","E11.22","B96.4","J42.","J96.10","R82.81","N18.9","R53.1","R11.2","R10.9","R19.5","R00.0","R10.811","D72.829","D63.1","K43.9","E11.51","E78.2","J45.909","Z20.828"],"date":["2022-03-15","2023-03-25","2023-04-09","2023-04-10","2021-04-27","2022-12-22","2021-10-07","2021-10-07","2021-10-07","2021-10-07","2023-03-25","2021-10-07","2023-04-10","2021-10-07","2021-10-07","2022-03-15","2022-03-15","2022-03-15","2023-04-08","2021-10-10","2021-10-10","2022-12-22","2021-10-10","2023-01-27","2023-04-10","2021-03-30","2021-06-29","2022-12-22","2023-02-22","2023-03-03","2023-03-29","2023-02-20","2023-04-10","2023-03-29","2022-04-01","2022-04-01","2023-02-23","2023-02-22","2023-02-22","2022-12-13","2022-12-22","2023-02-22","2022-12-22","2023-03-28","2021-01-15","2023-03-29","2023-03-03","2023-03-29","2021-01-14","2023-04-10","2021-01-14","2021-01-14","2021-01-14","2021-01-14","2021-04-28","2023-02-20","2023-02-20","2023-03-29","2023-04-10","2023-03-25","2023-03-29","2023-04-10","2023-03-25","2023-03-25","2023-03-25","2023-03-29","2023-04-10","2023-03-25","2023-04-10","2023-04-10","2023-04-10","2023-04-10","2023-04-10","2023-04-10","2023-04-10","2023-04-10","2023-04-10","2023-04-10","2023-04-10","2021-01-12"],"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":[["","00088221905","LANTUS SOLOS","INJ 100\/ML","9","Select","Select",""],["","50228018001","GABAPENTIN","300 MG","30","Select","Select",""],["","68382009501","CARVEDILOL","25 MG","180","Select","Select",""],["","43547035410","LISINOPRIL","20 MG","90","Select","Select",""],["","29300039805","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","00054429731","FUROSEMIDE","TAB 20MG","30","Select","Select",""],["","00093506101","HYDROXYZ HCL","TAB 25MG","30","Select","Select",""],["","68180063509","ATORVASTATIN","TAB 10MG","90","Select","Select",""],["","13668033201","TRAZODONE","TAB 150MG","30","Select","Select",""],["","00169406013","VICTOZA","3-PAK 0.6 MG\/0.1","9","Select","Select",""],["","59746017506","PREDNISONE","TAB 20MG","12","Select","Select",""],["","64380073706","VITAMIN D","CAP 50000UNT","12","Select","Select",""],["","53885000810","ONETOUCH DEL","MIS PLUS 33G","100","Select","Select",""],["","53885027150","ONETOUCH","TES VERIO","50","Select","Select",""],["","64380071206","BENZONATATE","CAP 100MG","30","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","00074055402","HUMIRA PEN","INJ 40\/0.4ML","2","Select","Select",""],["","45802005505","TRIAMCINOLON","OIN 0.001","454","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","08489830910","PEN NEEDLES","MIS 31GX8MM","100","Select","Select",""],["","00169369619","NOVOLOG MIX","INJ FLEXPEN","12","Select","Select",""],["","73070020315","INS ASP PROT","INJ FLEXPEN","12","Select","Select",""],["","00002879759","HUMALOG MIX","75-25 KWIKPEN 75-25\/ML","15","Select","Select",""],["","70700010617","CLOBETASOL","OIN 0.0005","60","Select","Select",""],["","00574402435","ERYTHROMYCIN","5 MG\/GRAM","3.5","Select","Select",""],["","57894006103","STELARA","90 MG\/ML","1","Select","Select",""],["","53885000810","ONETOUCH DELICA PLUS LANCET","33 GAUGE","100","Select","Select",""],["","16714017301","ATORVASTATIN CALCIUM","10 MG","90","Select","Select",""],["","60758011905","PREDNISOLONE ACETATE","1 %","5","Select","Select",""],["","53885092701","ONETOUCH VERIO REFLECT METER","","1","Select","Select",""],["","53885027150","ONETOUCH VERIO TEST STRIP","","50","Select","Select",""],["","13668033201","TRAZODONE HCL","150 MG","90","Select","Select",""],["","29300039805","AMLODIPINE BESYLATE","10 MG","90","Select","Select",""],["","08489830910","DROPLET PEN NEEDLE","31 GX5\/16\"","100","Select","Select",""],["","00093506101","HYDROXYZINE HCL","25 MG","60","Select","Select",""],["","43598044874","NICOTINE PATCH","21 MG\/24HR","14","Select","Select",""],["","00065081604","PATADAY ONCE DAILY RELIEF","0.7 %","2.5","Select","Select",""],["","65862007701","CIPROFLOXACIN HCL","500 MG","3","Select","Select",""],["","70700010617","CLOBETASOL PROPIONATE","0.05 %","60","Select","Select",""],["","42799060501","LOPERAMIDE","2 MG","16","Select","Select",""],["","51660007021","GUAIFENESIN ER","600 MG","20","Select","Select",""],["","53885019401","ONETOUCH VERIO FLEX METER","","1","Select","Select",""],["","63824000886","MUCINEX","600 MG","20","Select","Select",""],["","00121086750","VANCOMYCIN HCL","125 MG","30","Select","Select",""],["","00406051201","OXYCODONE-ACETAMINOPHEN","5 MG-325MG","30","Select","Select",""],["","00143928501","AMOXICILLIN","875 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":""}]}]}