{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"WILLIAM  H COX","gend":0,"add":"134 DOOLITTLE RD APT 22","city":"HAMPTON","state":"VA","zip":"23669-9998","dob":"1965-12-02","age":"","mstatus":"","insh":"20042609*01","cliId":"","pno":7572541385,"cno":7572541385,"email":"","ename":"","eno":"","pphy":"ZEIBER, STEPHANIE N PA-C","ppno":7577265000,"pcpadd":"200 EATON ST,","pcpcity":"HAMPTON","pcpstate":"VA","pcpzip":"23669-9998","pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Family Medicine Physicians - Nimmo","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7577265001,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F25.0","B20.","L73.9","F43.12","F32.9","F14.20","M79.672","M77.42","B35.3","B35.1","L85.1","Q66.72","F20.9","F31.81","F43.10","D23.72","M20.42","M20.41","F25.1","F20.0","L23.7","N50.89","F29.","F31.5","D84.9","J44.0","C11.9","J20.9","J06.9","R05.9","R50.9","Z20.822","R05.1","M94.0","R53.81","R03.0","R07.89","R07.81","NO DATA","I10.","E87.5","E03.9","F33.2","F15.20","F17.200","Z02.2","R11.2","R12.","F31.10","F33.3","F33.1","F32.1","F14.21","F31.2"],"date":["2023-03-24","2023-07-17","2022-03-13","2023-07-20","2023-07-17","2023-07-20","2021-11-19","2021-11-19","2021-11-19","2021-11-19","2021-03-05","2021-11-19","2023-07-20","2021-11-23","2023-06-26","2021-11-19","2021-11-19","2021-11-19","2023-01-20","2021-06-01","2021-07-16","2021-05-04","2022-02-15","2021-02-14","2021-04-22","2021-04-22","2021-04-22","2021-04-22","2021-10-07","2021-10-07","2021-10-07","2021-10-07","2022-07-07","2022-07-07","2021-10-07","2021-10-07","2022-07-07","2022-07-07","2021-04-06","2023-05-03","2021-04-06","2023-05-03","2023-05-09","2023-06-26","2023-06-09","2023-05-03","2023-05-07","2023-05-07","2023-05-11","2023-06-26","2023-07-20","2023-07-20","2023-07-17","2023-07-17"],"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":[["","00378180777","LEVOTHYROXIN","TAB 88MCG","30","Select","Select",""],["","43598016605","OLANZAPINE","10 MG","30","Select","Select",""],["","00378116591","BUSPIRONE","TAB 15MG","90","Select","Select",""],["","31722062921","ATOVAQUONE","SUS 750\/5ML","300","Select","Select",""],["","00074333330","NORVIR","TAB 100MG","60","Select","Select",""],["","23155050210","HYDROXYZ HCL","TAB 50MG","60","Select","Select",""],["","61958200202","DESCOVY","TAB 200\/25MG","30","Select","Select",""],["","59676056201","PREZISTA","TAB 600MG","30","Select","Select",""],["","65862001305","SERTRALINE","TAB 100MG","60","Select","Select",""],["","60687042095","RITONAVIR","TAB 100MG","30","Select","Select",""],["","50111043402","TRAZODONE","TAB 100MG","60","Select","Select",""],["","16729021101","DOXAZOSIN","TAB 1MG","90","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","53489011905","DOXYCYCL HYC","CAP 100MG","20","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","69842031278","8HR PAIN ER","TAB 650MG","42","Select","Select",""],["","68180016011","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","64380071207","BENZONATATE","CAP 100MG","30","Select","Select",""],["","59651036105","IBUPROFEN","600 MG","21","Select","Select",""],["","13668033005","TRAZODONE HCL","50 MG","7","Select","Select",""],["","65862001205","SERTRALINE HCL","50 MG","30","Select","Select",""],["","45802081184","NALOXONE HCL","4 MG","2","Select","Select",""],["","00527058610","DICYCLOMINE HCL","10 MG","10","Select","Select",""],["","68180098103","LISINOPRIL","20 MG","14","Select","Select",""],["","65862056090","PANTOPRAZOLE SODIUM","40 MG","14","Select","Select",""],["","29300046810","CLONIDINE HCL","0.1 MG","120","Select","Select",""],["","00536132701","ACETAMINOPHEN","325 MG","60","Select","Select",""],["","00115180301","HYDROXYZINE PAMOATE","25 MG","15","Select","Select",""],["","65862018730","ONDANSETRON HCL","4 MG","10","Select","Select",""],["","69238183207","LEVOTHYROXINE SODIUM","75 MCG","30","Select","Select",""],["","35356028460","PREZISTA TAB","600MG","30","Select","Select",""],["","61958200202","DESCOVY TAB","200\/25MG","30","Select","Select",""],["","60687042095","RITONAVIR TAB","100MG","30","Select","Select",""],["","68180016011","AZITHROMYCIN TAB","250MG","6","Select","Select",""],["","64380071206","BENZONATATE CAP","100MG","30","Select","Select",""],["","49483060350","IBUPROFEN TAB","600MG","40","Select","Select",""],["","72205020930","LURASIDONE HCL","60 MG","30","Select","Select",""],["","67877025001","QUETIAPINE FUMARATE","100 MG","30","Select","Select",""],["","00093321915","KETOCONAZOLE","2 %","15","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":""}]}]}