{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ANTHONY BUTLER","gend":0,"add":"4213 GADWALL PL","city":"VIRGINIA BEACH","state":"VA","zip":"23462-9998","dob":"1990-09-06","age":"","mstatus":"","insh":"20075351*01","cliId":"","pno":7574692910,"cno":7574692910,"email":"","ename":"","eno":"","pphy":"BELARDO, BETYSHIA J MD","ppno":7574137600,"pcpadd":"STE 301 5320 PROVIDENCE RD","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":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N17.9","Z99.2","N18.6","T82.838A","J45.21","I13.2","I50.9","NO DATA","E66.01","Z68.42","Z88.8","Z91.09","Z86.19","Z83.3","R06.2","F43.23","T82.49XA","E83.51","Z94.9","I12.0","T82.590A","Z20.822","T82.42XA","I10.","T82.898A","Z82.49","Z91.048","J45.901","R07.89","R77.8","E66.9","J81.1"],"date":["2023-01-01","2023-04-12","2023-04-12","2021-08-02","2021-08-02","2023-04-12","2023-04-12","2023-02-09","2023-02-09","2023-04-12","2023-02-09","2021-08-24","2021-08-02","2021-08-02","2023-04-12","2021-08-31","2021-08-24","2021-08-24","2021-08-02","2023-02-09","2023-02-09","2021-05-29","2021-08-03","2023-03-01","2023-02-09","2023-02-09","2023-02-09","2023-04-12","2023-04-12","2023-04-12","2023-04-12","2023-04-12"],"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":[["","69097086283","CALC ACETATE","CAP 667MG","240","Select","Select",""],["","50742026201","NIFEDIPINE","TAB 90MG ER","90","Select","Select",""],["","29300013701","CLONIDINE","TAB 0.3MG","90","Select","Select",""],["","29300022019","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","23155072401","LABETALOL","TAB 200MG","60","Select","Select",""],["","49884025701","MINOXIDIL","TAB 10MG","30","Select","Select",""],["","00185560001","METOLAZONE","TAB 10MG","30","Select","Select",""],["","00406051201","OXYCOD\/APAP","TAB 5-325MG","30","Select","Select",""],["","00093505898","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","42799012001","BUMETANIDE","TAB 1MG","30","Select","Select",""],["","65862092127","SEVELAMER","TAB 800MG","270","Select","Select",""],["","31722052001","HYDRALAZINE","TAB 25MG","90","Select","Select",""],["","13811052501","TRIPHROCAPS","1 MG","90","Select","Select",""],["","00536730001","NEPHRO-VITE","TAB ","90","Select","Select",""],["","31722070290","LOSARTAN POTASSIUM","100 MG","90","Select","Select",""],["","29300013701","CLONIDINE HCL","0.3 MG","180","Select","Select",""],["","50742062201","NIFEDIPINE ER","90 MG","30","Select","Select",""],["","16571081320","CALCIUM ACETATE","667 MG","810","Select","Select",""],["","31722052101","HYDRALAZINE HCL","50 MG","270","Select","Select",""],["","55111064530","OMEPRAZOLE","40 MG","60","Select","Select",""],["","73796045801","COMP-AIR NEBULIZER COMPRESSOR","","1","Select","Select",""],["","00173068220","VENTOLIN HFA","90 MCG","18","Select","Select",""],["","00378827052","ALBUTEROL SULFATE","2.5 MG\/3ML","75","Select","Select",""],["","59746017509","PREDNISONE","20 MG","12","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":""}]}]}