{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BEVERLY  L PINKNEY","gend":1,"add":"223 E VIRGINIA BEACH BLVD","city":"NORFOLK","state":"VA","zip":"23510-9998","dob":"1962-07-21","age":"","mstatus":"","insh":"4852990*01","cliId":"","pno":7575159855,"cno":7575159855,"email":"","ename":"","eno":"","pphy":"TISDALE, JENNIFER N PAC","ppno":7573889925,"pcpadd":"7401 GRANBY ST","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":"23505-9998","pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Internal Medicine Physicians - Wards Corner","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7579658519,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R91.1","J43.2","Z72.0","C34.91","C34.31","I11.0","I50.9","F17.210","E78.1","Z79.82","Z79.51","Z79.899","Z88.8","J44.1","I42.8","I50.22","I10.","E78.5","I25.10","Z92.3","Z85.118","J44.9","R07.89","K04.7","K08.89","J98.4","K76.0","R07.9","R91.8","R06.02","I25.118","F10.10","I70.1","Z23.","I50.43","I42.0","E53.8","Z71.89","F10.20","Z12.31","R73.03","R94.39","Z09.","J43.9","R51.9","R06.89","J45.40","R07.2","E87.1","R11.2","R10.13","Z01.419","Z12.4","K02.9","R52.","J98.8","R05.8","F51.01","N64.4","Z87.09","R94.2","K21.9"],"date":["2023-03-16","2023-01-30","2023-04-27","2022-07-19","2023-03-16","2023-04-04","2023-04-04","2023-04-04","2021-04-14","2021-04-14","2021-10-26","2023-03-08","2023-01-04","2021-04-24","2023-04-27","2023-04-27","2023-04-27","2023-04-27","2023-04-27","2023-03-16","2023-03-16","2023-04-04","2023-03-08","2021-03-01","2021-06-15","2022-04-11","2022-04-11","2023-03-08","2023-04-04","2023-04-04","2023-01-30","2021-10-21","2023-01-30","2021-10-21","2021-10-21","2022-02-03","2021-10-21","2021-10-21","2023-01-30","2023-01-30","2023-01-30","2022-06-01","2022-07-19","2023-01-04","2023-01-04","2021-04-24","2021-10-26","2022-05-30","2022-11-10","2022-11-10","2022-11-10","2023-02-16","2023-02-16","2021-06-15","2021-03-01","2021-10-26","2021-10-26","2022-02-03","2023-03-08","2023-03-08","2023-04-04","2023-04-04"],"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":[["","68645059090","CLOPIDOGREL","TAB 75MG","90","Select","Select",""],["","16714068403","SIMVASTATIN","TAB 40MG","90","Select","Select",""],["","70700015010","OMEPRAZOLE","20 MG","30","Select","Select",""],["","00173069700","ADVAIR DISKU","AER 500\/50","60","Select","Select",""],["","66993058697","FLUTIC\/SALME","AER 500\/50","60","Select","Select",""],["","00597007541","SPIRIVA","CAP HANDIHLR","30","Select","Select",""],["","00904549280","THERA-M","TAB ","90","Select","Select",""],["","68382009405","CARVEDILOL","12.5 MG","180","Select","Select",""],["","16571082201","LORATADINE","10 MG","30","Select","Select",""],["","31722052101","HYDRALAZINE","TAB 50MG","90","Select","Select",""],["","16729022501","SPIRONOLACT","TAB 25MG","90","Select","Select",""],["","00904679480","ASPIRIN LOW","CHW 81MG","30","Select","Select",""],["","49035061246","ALLERGY RELF","TAB 10MG","30","Select","Select",""],["","68462063945","NITROGLYCERN","SUB 0.4MG","25","Select","Select",""],["","00781261305","AMOXICILLIN","CAP 500MG","30","Select","Select",""],["","80681002000","MULTIVITAMIN","TAB ","30","Select","Select",""],["","76204020060","ALBUTEROL","NEB 0.00083","180","Select","Select",""],["","31722059690","FENOFIBRATE","145 MG","90","Select","Select",""],["","68645056354","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","50111078751","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","00173068220","VENTOLIN HFA","90 MCG","18","Select","Select",""],["","00143924920","AMOX\/K CLAV","TAB 875-125","14","Select","Select",""],["","00536466110","THEREMS-M","9MG-400MCG","30","Select","Select",""],["","31722094201","HYDROCO\/APAP","TAB 7.5-325","15","Select","Select",""],["","00904679480","ASPIRIN","81 MG","30","Select","Select",""],["","59746017509","PREDNISONE","TAB 20MG","15","Select","Select",""],["","50268052415","MELATONIN","TAB 3MG","30","Select","Select",""],["","13668010401","ISOSORB MONO","TAB 30MG ER","30","Select","Select",""],["","00536589488","NICOTINE TD","DIS 7MG\/24HR","30","Select","Select",""],["","00093505898","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","11877001140","BINAXNOW COV","KIT HOME TES","2","Select","Select",""],["","49281042250","FLUZONE QUAD","INJ 2022-23","0","Select","Select",""],["","69238110002","DOXYCYCL HYC","CAP 100MG","14","Select","Select",""],["","13668010401","ISOSORBIDE MONONITRATE ER","30 MG","60","Select","Select",""],["","00597007541","SPIRIVA HANDIHALER","18 MCG","30","Select","Select",""],["","00093505898","ATORVASTATIN CALCIUM","40 MG","30","Select","Select",""],["","53746051101","SPIRONOLACTONE","25 MG","90","Select","Select",""],["","76204020060","ALBUTEROL SULFATE","2.5 MG\/3ML","90","Select","Select",""],["","00173069700","ADVAIR DISKUS","500-50 MCG","60","Select","Select",""],["","31722052101","HYDRALAZINE HCL","50 MG","90","Select","Select",""],["","72578005518","DOXYCYCLINE HYCLATE","100 MG","20","Select","Select",""],["","49035061246","ALLERGY RELIEF","10 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":""}]}]}