{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"STEPHANIE M WALTER","gend":1,"add":"2309 LONDON POINTE DR","city":"VIRGINIA BEACH","state":"VA","zip":"23454-9998","dob":"1969-08-31","age":"","mstatus":"","insh":"20073869*01","cliId":"","pno":7577797945,"cno":7577797945,"email":"","ename":"","eno":"","pphy":"ALPER, JASON B DO","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":["N95.0","R87.810","T78.40XA","NO DATA","I08.8","Q21.0","Q21.1","Z95.818","I05.9","I08.3","F41.0","F41.1","F42.8","F43.11","I34.2","I51.7","I07.1","Z95.2","I47.1","I37.1","R55.","I48.0","R94.31","I35.0","R10.2","Z12.9","I08.2","M89.8X9","G44.209","I48.91","Z95.3","Z87.891","Z88.8","Z88.6","Z91.041","Z88.5","R11.0","Q23.1","I36.1","I46.9","K21.9","I83.813","I49.5","I44.30","Z95.0","F41.9","N64.4","R06.02","L71.8","L82.1","L81.2","L90.5","I45.10","R01.1","D48.5","Q24.8","D68.59","I05.0","Z01.810","I35.9","I44.7","Z01.419","L57.4","Z09.","T14.8XXA","Z79.01","L29.9","R09.81","J02.9","T49.6X5A","I73.00","I45.4","Z87.74","Z91.013","R00.2","I83.93","T82.897A","Z86.79","I45.2","D69.6","D72.819","E87.6","R07.89","I49.1","I44.0","G89.4","M53.3","Q24.9","M54.32","Z87.39","L30.4","K43.9","Z95.4","Z01.812","I50.43","R30.0","F32.1","Z01.818","Z92.29","K92.1","R06.09","Z00.6","Z86.14","Z79.2","Z80.3"],"date":["2021-09-01","2023-03-15","2021-11-13","2023-04-03","2022-01-03","2022-09-26","2022-08-08","2022-01-03","2023-06-28","2022-04-01","2023-04-05","2023-04-05","2023-04-05","2023-04-05","2023-03-14","2021-05-06","2022-08-08","2023-09-25","2023-09-21","2022-09-26","2023-09-21","2023-09-21","2023-07-19","2023-08-10","2021-07-26","2021-07-26","2021-12-10","2021-12-10","2022-08-08","2023-09-21","2023-09-07","2023-07-28","2023-07-28","2023-07-28","2022-08-08","2022-08-08","2023-08-22","2023-07-28","2022-08-08","2022-09-30","2023-07-28","2022-10-26","2023-07-28","2022-11-28","2023-09-21","2022-11-28","2022-11-28","2022-10-10","2022-09-22","2022-12-20","2022-09-22","2022-09-22","2022-11-15","2023-09-21","2023-04-12","2022-08-10","2022-08-10","2023-07-06","2023-07-19","2023-07-19","2023-01-05","2023-03-15","2022-12-20","2022-10-12","2021-04-29","2023-07-28","2021-11-13","2021-11-13","2021-11-13","2021-11-13","2023-07-28","2021-11-13","2023-07-28","2021-11-13","2022-04-01","2022-07-15","2022-08-08","2023-07-28","2023-09-21","2022-09-26","2022-09-26","2022-09-26","2022-09-26","2022-09-26","2022-09-26","2022-09-26","2022-09-26","2022-09-26","2023-04-03","2023-04-03","2023-04-12","2023-09-25","2023-09-25","2023-07-19","2023-07-19","2023-07-19","2023-06-30","2023-06-28","2023-09-25","2023-08-22","2023-08-10","2023-07-28","2023-07-28","2023-07-28","2023-07-28"],"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":[["","21922000201","CLINDAMYCIN","SOL 0.01","60","Select","Select",""],["","50742024890","DILTIAZEM","24HR ER (CD) 120 MG","90","Select","Select",""],["","45802096696","ERYTHROMYCIN","GEL 0.02","60","Select","Select",""],["","68382031601","MINOCYCLINE","CAP 50MG","60","Select","Select",""],["","10702005601","OXYCODONE","TAB 10MG","60","Select","Select",""],["","71205075505","PREDNISONE","50 MG","3","Select","Select",""],["","50742061510","METOPROL SUC","TAB 25MG ER","30","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","10","Select","Select",""],["","00093310905","AMOXICILLIN","CAP 500MG","4","Select","Select",""],["","50428033020","ALLERGY REL","CAP 25MG","24","Select","Select",""],["","00024414260","MULTAQ","TAB 400MG","60","Select","Select",""],["","00003089421","ELIQUIS","5 MG","60","Select","Select",""],["","00187516420","RETIN-A","CRE 0.001","20","Select","Select",""],["","00574220120","TRETINOIN","0.1 %","20","Select","Select",""],["","59011041510","OXYCONTIN","15 MG","60","Select","Select",""],["","00093216568","NALOXONE HCL","SPR 4MG","2","Select","Select",""],["","43547040111","FUROSEMIDE","20 MG","90","Select","Select",""],["","72888015205","CLONAZEPAM","0.5 MG","30","Select","Select",""],["","00054001025","FLECAINIDE","TAB 50MG","60","Select","Select",""],["","27241009706","DULOXETINE","CAP 20MG","30","Select","Select",""],["","69097083412","SERTRALINE","TAB 50MG","30","Select","Select",""],["","13668013501","ESCITALOPRAM","TAB 5MG","30","Select","Select",""],["","13107008405","LORAZEPAM","TAB 1MG","1","Select","Select",""],["","00054001025","FLECAINIDE ACETATE","50 MG","60","Select","Select",""],["","27241009706","DULOXETINE HCL","20 MG","30","Select","Select",""],["","68382031601","MINOCYCLINE HCL","50 MG","60","Select","Select",""],["","00054418425","DEXAMETHASONE","4 MG","6","Select","Select",""],["","13668013601","ESCITALOPRAM OXALATE","10 MG","30","Select","Select",""],["","00603188016","LIDOCAINE","5 %","30","Select","Select",""],["","51672404806","CLOTRIMAZOLE-BETAMETHASONE","1 %-0.05 %","60","Select","Select",""],["","50742024990","DILTIAZEM CAP","180MG ER","30","Select","Select",""],["","00093310905","AMOXICILLIN CAP","500MG","4","Select","Select",""],["","68382031601","MINOCYCLINE CAP","50MG","60","Select","Select",""],["","00024414260","MULTAQ TAB","400MG","60","Select","Select",""],["","59011041510","OXYCONTIN TAB","15MG CR","60","Select","Select",""],["","00003089421","ELIQUIS TAB","5MG","60","Select","Select",""],["","00574222545","TRETINOIN CRE","0.025%","45","Select","Select",""],["","10702005601","OXYCODONE TAB","10MG","15","Select","Select",""],["","00187516420","RETIN-A CRE","0.1%","20","Select","Select",""],["","00093216568","NALOXONE HCL SPR","4MG","2","Select","Select",""],["","00093083205","CLONAZEPAM TAB","0.5MG","30","Select","Select",""],["","69097083412","SERTRALINE TAB","50MG","30","Select","Select",""],["","43547040111","FUROSEMIDE TAB","20MG","30","Select","Select",""],["","00054001025","FLECAINIDE TAB","50MG","180","Select","Select",""],["","27241009706","DULOXETINE CAP","20MG","90","Select","Select",""],["","13668013501","ESCITALOPRAM TAB","5MG","30","Select","Select",""],["","13107008405","LORAZEPAM TAB","1MG","1","Select","Select",""],["","52959004304","DIPHENHYDRAMINE HCL","25 MG","2","Select","Select",""],["","49483070110","FLUOXETINE HCL","10 MG","90","Select","Select",""],["","65862035790","CLOPIDOGREL","75 MG","90","Select","Select",""],["","00378668877","PANTOPRAZOLE SODIUM","20 MG","90","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":""}]}]}