{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DEQUAWN  L PARKER","gend":0,"add":"738 17TH ST","city":"NEWPORT NEWS","state":"VA","zip":"23607-9998","dob":"1990-03-17","age":"","mstatus":"","insh":"2348799*01","cliId":"","pno":7575098616,"cno":7575098616,"email":"","ename":"","eno":"","pphy":"WELSH, CATHERINE C NP","ppno":7577363700,"pcpadd":"2104 EXECUTIVE DRIVE,","pcpcity":"HAMPTON","pcpstate":"VA","pcpzip":"23666-9998","pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Family Medicine Physicians - Peninsula Towne","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7578279978,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R59.0","B20.","J45.909","I10.","F17.210","Z88.6","Z91.018","Z79.1","Z79.899","R22.41","L03.211","R10.84","K50.90","Z21.","Z91.09","Z53.8","K62.89","R10.2","F90.9","R59.9","R59.1","R10.32","R06.2","K50.80","L73.9","Z11.3","Z23.","B37.0","E87.6","R21.","K52.9","R19.7","K62.5","L30.9","L28.0","Z71.9","Z20.828","D69.6","R51.9","H10.33","K63.5","S16.1XXA","S00.83XA","S29.012A","S39.012A","K02.9","NO DATA","K51.50","D12.8","M62.838","M53.2X7","R20.2","M25.551","R73.9","Z72.0","M25.552","D84.9","K51.20","N31.9","F33.1","R63.8","S29.019A","G44.89","V89.2XXS","M54.2","F07.81","G44.301","V49.50XS","G47.00","A53.9","H40.013","H10.45","G44.321","V58.89","S01.80XA"],"date":["2022-12-09","2023-04-25","2022-12-03","2022-12-03","2023-03-26","2022-12-03","2022-12-03","2022-12-03","2022-12-03","2022-12-03","2023-02-10","2022-03-21","2023-03-26","2022-12-09","2021-11-16","2021-11-16","2021-12-26","2022-05-11","2021-12-26","2021-12-26","2022-07-01","2022-06-01","2022-06-01","2022-12-09","2022-12-27","2022-12-27","2022-12-27","2023-02-12","2023-02-12","2023-03-17","2022-04-13","2021-01-28","2021-01-28","2021-02-16","2021-02-16","2021-02-16","2021-08-30","2022-12-09","2023-03-26","2021-04-27","2021-11-30","2023-03-19","2023-03-19","2023-03-19","2023-03-19","2023-03-19","2023-04-19","2022-01-11","2021-03-01","2022-01-27","2022-01-27","2022-03-21","2021-12-16","2021-12-16","2022-04-25","2021-12-16","2021-12-21","2022-01-11","2022-05-11","2022-05-26","2023-02-12","2023-03-19","2023-03-31","2023-03-31","2023-05-02","2023-05-02","2023-04-25","2023-04-25","2023-04-25","2023-04-25","2023-05-02","2023-05-02","2023-05-02","2023-03-26","2023-03-26"],"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":[["","00472033730","HYDROCORT","CRE 0.025","30","Select","Select",""],["","61958190101","GENVOYA","TAB ","30","Select","Select",""],["","68682011102","PIMECROLIMUS","CRE 0.01","60","Select","Select",""],["","65649040130","ANUSOL-HC","CRE 0.025","30","Select","Select",""],["","00093005301","BUSPIRONE","TAB 5MG","15","Select","Select",""],["","00074055402","HUMIRA PEN","INJ 40\/0.4ML","2","Select","Select",""],["","21922001707","CLOBETASOL","OIN 0.0005","30","Select","Select",""],["","24208091055","ERYTHROMYCIN","OIN 5MG\/GM","4","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","31722099601","HYDROCO\/APAP","TAB 5-325MG","18","Select","Select",""],["","51862058001","BUDESONIDE","CAP 3MG DR","90","Select","Select",""],["","68462015713","ONDANSETRON","TAB 4MG ODT","12","Select","Select",""],["","42806040021","METHYLPRED","TAB 4MG","21","Select","Select",""],["","49035023814","EQ STOOL","CAP SOFTENER","20","Select","Select",""],["","69238110002","DOXYCYCL HYC","CAP 100MG","20","Select","Select",""],["","00904699880","DOCUSATE SOD","CAP 100MG","20","Select","Select",""],["","43386006019","GAVILYTE-C","SOL ","4000","Select","Select",""],["","00009005604","MEDROL","TAB 4MG","21","Select","Select",""],["","49035032712","GENTLE LAXAT","TAB 5MG EC","6","Select","Select",""],["","59267102504","PFIZER VACC","INJ ADLT RTU","0","Select","Select",""],["","00143122701","DICYCLOMINE","TAB 20MG","30","Select","Select",""],["","49035030603","EQ CLEARLAX","POW ","527","Select","Select",""],["","00093005805","TRAMADOL HCL","TAB 50MG","15","Select","Select",""],["","39328002430","LIDOCAINE","CRE 0.04","30","Select","Select",""],["","60505024701","MIRTAZAPINE","TAB 15MG","30","Select","Select",""],["","00406051201","OXYCOD\/APAP","TAB 5-325MG","10","Select","Select",""],["","65162027250","SMZ\/TMP DS","TAB 800-160","30","Select","Select",""],["","00093317431","ALBUTEROL SULFATE HFA","90 MCG","8.5","Select","Select",""],["","65162027250","SULFAMETHOXAZOLE-TRIMETHOPRIM","800-160 MG","30","Select","Select",""],["","00074055402","HUMIRA(CF) PEN","40MG\/0.4ML","2","Select","Select",""],["","00832532511","POTASSIUM CHLORIDE","20 MEQ","4","Select","Select",""],["","42806040021","METHYLPREDNISOLONE","4 MG","21","Select","Select",""],["","67877021905","CEPHALEXIN","500 MG","15","Select","Select",""],["","70074064118","ENSURE ACTIVE PROTEIN-MUSCLE","","5688","Select","Select",""],["","59746017310","PREDNISONE","10 MG","42","Select","Select",""],["","60432053716","NYSTATIN","100000\/ML","200","Select","Select",""],["","29300041519","CYCLOBENZAPRINE HCL","10 MG","15","Select","Select",""],["","69367020301","BUTALBITAL-ACETAMINOPHEN-CAFFE","50-325-40","30","Select","Select",""],["","00093081101","NORTRIPTYLINE HCL","25 MG","60","Select","Select",""],["","64380015801","MEGESTROL ACETATE","20 MG","30","Select","Select",""],["","00781261305","AMOXICILLIN","500 MG","30","Select","Select",""],["","59310057922","PROAIR HFA AER","","8","Select","Select",""],["","00074055402","HUMIRA PEN INJ","40\/0.4ML","2","Select","Select",""],["","61958190101","GENVOYA TAB","","30","Select","Select",""],["","31722099601","HYDROCO\/APAP TAB","5-325MG","18","Select","Select",""],["","00093005301","BUSPIRONE TAB","5MG","15","Select","Select",""],["","49035032712","GENTLE LAXAT TAB","5MG EC","6","Select","Select",""],["","49035030603","EQ CLEARLAX POW","","527","Select","Select",""],["","59267100001","PFIZER VACC INJ COVID-","19","0","Select","Select",""],["","59267102504","PFIZER VACC INJ ADLT RTU","","0","Select","Select",""],["","00093317431","ALBUTEROL AER HFA","","8","Select","Select",""],["","00143122701","DICYCLOMINE TAB","20MG","30","Select","Select",""],["","00093005805","TRAMADOL HCL TAB","50MG","15","Select","Select",""],["","42291040030","LIDOCAINE CRE","5%","30","Select","Select",""],["","60505024701","MIRTAZAPINE TAB","15MG","30","Select","Select",""],["","65162027250","SMZ\/TMP DS TAB","800-160","30","Select","Select",""],["","00406051201","OXYCOD\/APAP TAB","5-325MG","10","Select","Select",""],["","61314063006","NEOMYCIN-POLYMYXIN-DEXAMETH","0.1 %","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":""}]}]}