{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JODI  C WEIL","gend":1,"add":"1077 APPLE VALLEY CT","city":"VIRGINIA BEACH","state":"VA","zip":"23464-9998","dob":"1973-06-11","age":"","mstatus":"","insh":"20053967*01","cliId":"","pno":7579181459,"cno":7579181459,"email":"","ename":"","eno":"","pphy":"WILLIAMS, KEISHA J MD","ppno":7574137600,"pcpadd":"5320 PROVIDENCE RD STE 301","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":"23464-9998","pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Family Medicine Physicians - Providence Road","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7574137601,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z12.11","K63.5","F25.1","G24.01","F20.9","Z01.810","T84.84XA","Z96.669","Z23.","B35.1","L84.","I73.9","M79.671","M79.672","T25.321A","T31.0","F43.10","F41.1","F43.12","G89.18","N93.9","N39.46","R39.11","R39.14","R35.1","Z01.818","D72.829","F17.200","R06.02","F40.10","R39.9","Z01.419","Z12.31","Z12.12","R10.2","R30.9","N92.0","D25.9","K21.9","R13.14","R11.2","R19.4","N32.81","N39.41","N39.3","N39.8","Z20.828","R10.9","N95.1","N85.2","R13.10","R14.0","R14.2","F41.9","F31.9","E66.01","E78.00","Z91.02","Z79.899","Z68.43","R39.15","F25.9","E78.5","N95.0","R55.","R52.","M25.572","G89.29","R32.","Z00.00","N93.8","D12.3","Z96.9","E11.9","E03.9","G47.09","N81.2","Z87.42","Z98.890","N39.0","R31.9"],"date":["2022-08-23","2021-01-06","2023-04-21","2023-01-25","2021-04-14","2021-06-15","2021-07-21","2021-06-15","2022-11-17","2023-02-13","2023-02-13","2023-02-13","2022-12-01","2022-12-01","2022-11-07","2022-11-07","2023-01-25","2023-01-25","2022-06-02","2021-06-24","2023-03-02","2023-01-25","2023-01-25","2023-01-25","2023-01-25","2021-06-14","2021-06-14","2021-07-26","2021-07-26","2022-01-05","2022-10-19","2022-03-04","2022-03-04","2022-03-04","2023-03-02","2022-08-10","2022-12-13","2023-03-02","2023-04-14","2023-04-14","2023-02-08","2023-02-08","2023-04-18","2023-04-18","2023-04-18","2023-04-18","2021-01-02","2021-08-10","2021-08-10","2023-03-02","2022-02-10","2022-02-10","2022-02-10","2022-02-10","2023-02-28","2022-02-10","2022-02-10","2022-02-10","2022-02-10","2022-02-10","2023-01-25","2023-02-28","2023-02-28","2023-02-28","2023-04-20","2021-04-20","2021-09-27","2021-09-27","2021-06-08","2022-08-30","2023-03-02","2021-01-06","2021-06-17","2021-06-17","2021-06-24","2022-08-30","2023-03-02","2021-01-25","2021-09-27","2022-08-11","2022-08-11"],"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":[["","68180051202","LISINOPRIL","TAB 2.5MG","30","Select","Select",""],["","68546017260","AUSTEDO","12 MG","120","Select","Select",""],["","00185067601","HYDROXYZ PAM","CAP 50MG","60","Select","Select",""],["","68180046807","LOVASTATIN","20 MG","180","Select","Select",""],["","00093406701","PRAZOSIN HCL","1 MG","30","Select","Select",""],["","31722082730","ARIPIPRAZOLE","10 MG","30","Select","Select",""],["","68382080705","TRAZODONE","TAB 150MG","60","Select","Select",""],["","63402030230","LATUDA","TAB 20MG","30","Select","Select",""],["","68462030450","NORETHIN ACE","TAB 5MG","12","Select","Select",""],["","65162046650","IBUPROFEN","800 MG","90","Select","Select",""],["","55111064505","OMEPRAZOLE","40 MG","180","Select","Select",""],["","00093342510","LORAZEPAM","TAB 0.5MG","45","Select","Select",""],["","00069024430","TOVIAZ","TAB 8MG","30","Select","Select",""],["","00185012201","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","00406012301","HYDROCO\/APAP","TAB 5-325MG","15","Select","Select",""],["","43598016530","OLANZAPINE","7.5 MG","14","Select","Select",""],["","43598024830","FESOTERODINE","TAB 8MG ER","30","Select","Select",""],["","68001025320","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","00406051201","OXYCOD\/APAP","TAB 5-325MG","15","Select","Select",""],["","43386016106","MISOPROSTOL","TAB 200MCG","1","Select","Select",""],["","67877052890","SOLIFENACIN","TAB 10MG","30","Select","Select",""],["","72974041501","MYFEMBREE","TAB ","30","Select","Select",""],["","67877021905","CEPHALEXIN","500 MG","20","Select","Select",""],["","13668033201","TRAZODONE HCL","150 MG","60","Select","Select",""],["","16714043901","NITROFURANTOIN MONO-MACRO","100 MG","14","Select","Select",""],["","70010002703","TROSPIUM CHLORIDE ER","60 MG","90","Select","Select",""],["","68462038730","SOLIFENACIN SUCCINATE","10 MG","90","Select","Select",""],["","80777028299","MODERNA COVID BIVAL (","6Y UP)EUA 50 MCG\/0.5","0.5","Select","Select",""],["","57237002801","AMOXICILLIN","500 MG","21","Select","Select",""],["","68462030450","NORETHINDRONE ACETATE","5 MG","12","Select","Select",""],["","00115180401","HYDROXYZINE PAMOATE","50 MG","60","Select","Select",""],["","43547034703","PAROXETINE HCL","10 MG","90","Select","Select",""],["","00115164501","NITROFURANTOIN","100 MG","14","Select","Select",""],["","00555089902","ESTRADIOL","0.5 MG","90","Select","Select",""],["","00406051201","OXYCODONE-ACETAMINOPHEN","5 MG-325MG","20","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":""}]}]}