{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MONICA M MCDAVITT","gend":1,"add":"913 VIRGINIA BEACH BLVD LOT 125","city":"VIRGINIA BEACH","state":"VA","zip":"23451-9998","dob":"1991-07-17","age":"","mstatus":"","insh":"20048242*01","cliId":"","pno":7576424104,"cno":7576424104,"email":"","ename":"","eno":"","pphy":"LOCK, RACHEL DO","ppno":7573952500,"pcpadd":"1024 FIRST COLONIAL RD STE 102,","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":["C50.912","Z20.828","Z17.1","F33.1","Z85.3","N64.4","I10.","Z08.","F31.0","F51.01","F90.0","Z00.00","Z12.4","E66.01","E55.9","Z90.13","J45.20","Z68.41","M20.12","M25.872","F41.1","F31.9","F90.9","Z79.899","Z86.2","Z22.39","H40.9","Z86.79","Z87.442","Z87.440","H54.7","Z97.3","Z87.448","Z87.891","N64.81","E66.9","Z15.01","F32.9","F33.2","F51.05","Z51.81","Z68.42","C50.919","U07.1","J06.9","N39.0","N65.0","C50.412","S09.90XA","S00.01XA","Z79.1","Z88.8","Z91.048","R51.9","S66.911A","Z40.01","R59.9","Z80.3","R11.0","S16.1XXA","S80.02XA","R20.2","M79.609","M77.52","Z01.818","I42.7","Z15.02","J45.909","M79.672","M21.612","G89.18","Z20.822","Z17.0","L03.115","Z91.041","E66.09","F31.30","I16.0","M43.6","R55.","I44.0","F42.9","G47.30","Z79.3","Z45.2","M79.641","R03.0","Z30.46","Z91.09","J34.89","R53.83"],"date":["2023-02-16","2021-01-02","2023-02-16","2023-09-17","2023-09-18","2021-05-18","2023-07-05","2023-06-20","2023-03-29","2023-03-29","2023-09-14","2022-11-28","2023-01-24","2023-03-01","2022-11-28","2023-09-18","2022-12-15","2023-03-01","2023-03-07","2023-02-20","2023-06-01","2023-09-14","2023-03-01","2021-10-19","2021-01-06","2021-01-06","2021-11-03","2021-01-06","2022-02-07","2021-01-06","2021-10-19","2021-10-19","2021-01-06","2023-09-18","2021-01-06","2022-11-14","2023-09-18","2021-03-30","2022-09-28","2021-04-15","2023-03-29","2021-11-03","2021-03-30","2021-11-03","2021-11-03","2021-11-08","2023-09-11","2021-08-04","2023-09-18","2021-10-19","2021-10-19","2023-03-01","2022-07-13","2022-07-13","2023-06-27","2021-01-06","2021-01-06","2021-01-06","2021-07-28","2022-02-28","2022-02-28","2022-07-13","2022-07-13","2023-01-17","2023-02-16","2021-03-15","2021-03-23","2023-03-01","2023-03-03","2022-12-20","2023-03-03","2021-03-26","2021-07-22","2022-02-07","2023-03-01","2023-09-11","2022-07-12","2023-05-22","2023-05-22","2023-09-18","2023-09-18","2023-03-01","2022-07-13","2021-01-18","2021-02-24","2021-06-24","2022-01-25","2021-07-26","2021-11-03","2021-11-03","2022-07-13"],"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":[["","66993059902","AMPHET\/DEXTR","CAP 30MG ER","60","Select","Select",""],["","54092039101","ADDERALL XR","30 MG","60","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","61874016030","VRAYLAR","CAP 6MG","30","Select","Select",""],["","70069023101","BRIMONIDINE","SOL 0.2% OP","5","Select","Select",""],["","63304069205","CLINDAMYCIN","CAP 150MG","45","Select","Select",""],["","00456114030","VIIBRYD","TAB 40MG","30","Select","Select",""],["","00406996201","TEMAZEPAM","CAP 30MG","60","Select","Select",""],["","50228014605","HYDROCHLOROT","CAP 12.5MG","90","Select","Select",""],["","68180044701","QUETIAPINE","TAB 100MG","30","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","17","Select","Select",""],["","00555076802","ADDERALL","TAB 30MG","60","Select","Select",""],["","00173068220","VENTOLIN HFA","90 MCG","18","Select","Select",""],["","42806054701","VITAMIN D","2 1250 MCG","4","Select","Select",""],["","68645051554","AMLODIPINE","TAB 5MG","90","Select","Select",""],["","59746017310","PREDNISONE","TAB 10MG","21","Select","Select",""],["","29300014901","QUETIAPINE FUMARATE","100 MG","30","Select","Select",""],["","70069023101","BRIMONIDINE TARTRATE","0.2 %","5","Select","Select",""],["","66993059902","DEXTROAMPHETAMINE-AMPHET ER","30 MG","60","Select","Select",""],["","00406051201","OXYCODONE-ACETAMINOPHEN","5 MG-325MG","15","Select","Select",""],["","68645051554","AMLODIPINE BESYLATE","5 MG","30","Select","Select",""],["","29300041319","CYCLOBENZAPRINE HCL","5 MG","20","Select","Select",""],["","29300013005","HYDROCHLOROTHIAZIDE","12.5 MG","180","Select","Select",""],["","68645055354","LISINOPRIL","20 MG","30","Select","Select",""],["","00591352530","LIDOCAINE","5 %","30","Select","Select",""],["","00536117201","ACETAMINOPHEN","500 MG","30","Select","Select",""],["","65162019011","NAPROXEN","500 MG","20","Select","Select",""],["","57664037708","TRAMADOL HCL","50 MG","20","Select","Select",""],["","43547028211","ESCITALOPRAM OXALATE","20 MG","30","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":""}]}]}