{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BRUCE  A WILSON","gend":0,"add":"2580 SALEM ROAD","city":"VIRGINIA BEACH","state":"VA","zip":"23456-9998","dob":"1964-03-15","age":"","mstatus":"","insh":"20043664*01","cliId":"","pno":7574010471,"cno":7574010471,"email":"","ename":"","eno":"","pphy":"BRADLEY, CONNIE S NP","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":["F11.20","I87.333","L03.031","I87.313","L97.919","L97.929","L03.115","M86.171","I96.","L97.519","E11.42","Z79.899","NO DATA","I10.","I50.32","I48.0","J44.9","D50.9","E78.2","L23.9","S98.111A","Z48.00","E11.51","L03.116","I89.0","G89.4","Z89.411","Z79.84","E66.01","Z68.41","I86.8","M79.605","I87.2","L98.499","M54.42","W19.XXXA","M54.41","G89.29","K29.70","R19.7","R11.0","D64.9","I13.0","E11.22","I50.30","N18.9","Z83.3","Z82.49","Z90.49","Z90.5","Z98.1","Z87.891","Z88.5","Z91.14","M86.071","E11.40","G47.33","T81.30XA","V58.89","R09.89","Z00.00","H91.93","M48.8X2","E11.622","I12.9","D63.1","M19.91","Z98.890","Z86.79","L97.811","L97.821","E11.621","I50.9","N18.4","I48.91","R60.0","T14.8XXA","I73.9","K21.9","L08.9","Z79.4","S81.812A","M79.661","M79.662","L97.229","L97.219","M19.90","Z68.42","Z87.440","Z79.2","Z79.51","Z79.82","N39.0","M48.02","E11.610","L60.3","B35.1","I25.83","Q82.0","L97.222","M79.604","L89.892","L89.92","L85.3","M86.9","Z09.","T87.81","B96.4","Z20.822","R26.89","E11.9","Z28.89","S81.819A","L29.9","R30.0","Z12.5","F17.200","I70.1","I70.0","Z23.","E11.52","E11.69","M14.672","L97.901","L89.893"],"date":["2023-04-10","2022-10-05","2022-09-28","2023-03-10","2023-03-10","2023-03-10","2022-12-06","2022-12-16","2022-10-10","2022-10-09","2023-01-11","2022-12-06","2022-12-16","2023-03-10","2022-12-16","2022-12-16","2022-12-06","2022-12-06","2022-12-16","2022-12-06","2023-01-11","2023-03-10","2023-03-10","2023-04-13","2023-03-10","2023-03-10","2023-03-10","2023-03-10","2023-03-10","2023-03-10","2021-10-18","2022-02-17","2022-10-05","2022-07-29","2021-11-04","2021-11-04","2021-11-04","2021-11-04","2022-01-28","2022-01-28","2022-01-28","2023-02-10","2022-12-16","2022-11-03","2022-07-17","2022-07-17","2022-07-17","2022-07-17","2022-07-17","2022-07-17","2022-07-17","2022-07-17","2022-07-17","2022-07-17","2022-10-10","2022-12-16","2022-12-16","2022-11-03","2023-01-16","2022-05-04","2022-06-02","2022-10-05","2022-06-02","2022-06-28","2022-06-28","2022-10-28","2022-06-28","2022-11-30","2022-07-17","2022-10-05","2022-10-05","2022-10-05","2022-10-05","2022-10-05","2022-10-05","2022-10-06","2022-11-03","2023-01-11","2022-11-03","2022-11-03","2022-11-03","2021-07-01","2021-11-11","2021-11-11","2021-11-30","2021-11-30","2022-05-03","2022-10-28","2022-05-03","2022-05-03","2022-05-03","2022-05-03","2021-01-11","2021-01-11","2023-03-06","2022-09-06","2022-09-06","2021-11-11","2022-03-03","2021-12-17","2021-12-17","2022-08-26","2022-08-29","2022-09-06","2022-10-09","2022-10-13","2022-10-28","2022-10-28","2022-10-28","2022-11-03","2021-07-01","2021-07-01","2021-07-01","2022-03-03","2022-05-03","2022-05-03","2022-05-11","2022-05-11","2022-05-11","2022-06-02","2022-10-05","2022-10-05","2022-04-27","2022-04-27","2023-04-13"],"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":[["","63304061650","DOXYCYC MONO","CAP 100MG","60","Select","Select",""],["","70700026894","FOSFOMYCIN","POW 3GM","1","Select","Select",""],["","57664050658","METOPROL TAR","TAB 25MG","30","Select","Select",""],["","00456430001","MONUROL","PAK GRANULES","1","Select","Select",""],["","68645058459","METFORMIN","TAB 1000MG","60","Select","Select",""],["","49035056314","ASPIRIN LOW","TAB 81MG EC","90","Select","Select",""],["","00832532411","POT CL MICRO","TAB 10MEQ ER","60","Select","Select",""],["","60505009300","DOXAZOSIN","TAB 1MG","90","Select","Select",""],["","68645055254","LISINOPRIL","TAB 10MG","30","Select","Select",""],["","31722071390","PANTOPRAZOLE","TAB 40MG","90","Select","Select",""],["","50228018105","GABAPENTIN","400 MG","60","Select","Select",""],["","00093505998","ATORVASTATIN","TAB 20MG","90","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","67877021905","CEPHALEXIN","500 MG","56","Select","Select",""],["","49348098023","SM ASPIRIN","TAB 81MG EC","30","Select","Select",""],["","00173086910","ANORO ELLIPT","AER 62.5-25","60","Select","Select",""],["","68382005005","MELOXICAM","TAB 7.5MG","14","Select","Select",""],["","00093031101","LOPERAMIDE","CAP 2MG","15","Select","Select",""],["","55111015330","ONDANSETRON","TAB 4MG","15","Select","Select",""],["","51672129802","KETOCONAZOLE","CRE 0.02","30","Select","Select",""],["","43547040111","FUROSEMIDE","TAB 20MG","30","Select","Select",""],["","00143992701","CIPROFLOXACN","TAB 250MG","10","Select","Select",""],["","65162027250","SMZ\/TMP DS","TAB 800-160","14","Select","Select",""],["","00904759160","FEROSUL","TAB 325MG","30","Select","Select",""],["","00093727156","PIOGLITAZONE","TAB 15MG","30","Select","Select",""],["","68645051054","HYDROCHLOROT","TAB 25MG","30","Select","Select",""],["","10631028608","LAC-HYDRIN","LOT FIVE","226","Select","Select",""],["","45802041954","AMMONIUM LAC","LOT 0.12","225","Select","Select",""],["","69238149001","BUMETANIDE","TAB 1MG","30","Select","Select",""],["","56151146104","RELION TRUE","TES METRIX","50","Select","Select",""],["","56151014260","TRUPLUS LANC","MIS 28G","100","Select","Select",""],["","53885027150","ONETOUCH","TES VERIO","50","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","30","Select","Select",""],["","16714047802","AMOX\/K CLAV","TAB 875-125","20","Select","Select",""],["","56151146004","TRUE METRIX","TES GLUCOSE","50","Select","Select",""],["","53885001110","ONETOUCH DEL","MIS PLUS 30G","100","Select","Select",""],["","50111032801","HYDRALAZINE","TAB 50MG","90","Select","Select",""],["","42806040021","METHYLPRED","TAB 4MG","21","Select","Select",""],["","81131009371","SV IRON","TAB 325MG","90","Select","Select",""],["","53885004401","ONE TOUCH","KIT VERIO FL","1","Select","Select",""],["","42858000201","OXYCODONE","TAB 10MG","15","Select","Select",""],["","42632002727","BLOOD PRESSU","MIS MONITOR","1","Select","Select",""],["","63304069301","CLINDAMYCIN","CAP 300MG","30","Select","Select",""],["","16714008210","HYDROXYZ HCL","TAB 25MG","60","Select","Select",""],["","53885059501","ONETOUCH DELICA","30 GAUGE","100","Select","Select",""],["","53885027025","ONETOUCH VERIO TEST STRIP","","25","Select","Select",""],["","31722052101","HYDRALAZINE HCL","50 MG","90","Select","Select",""],["","53885001110","ONETOUCH DELICA PLUS LANCET","30 GAUGE","100","Select","Select",""],["","72578005518","DOXYCYCLINE HYCLATE","100 MG","28","Select","Select",""],["","63304061650","DOXYCYCLINE MONOHYDRATE","100 MG","20","Select","Select",""],["","68645058459","METFORMIN HCL","1000 MG","180","Select","Select",""],["","53885004401","ONETOUCH VERIO FLEX METER","","1","Select","Select",""],["","00406012301","HYDROCODONE-ACETAMINOPHEN","5 MG-325MG","6","Select","Select",""],["","68180096301","ALBUTEROL SULFATE HFA","90 MCG","8.5","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":""}]}]}