{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ROBERT  C POWELL","gend":0,"add":"104 N WITCHDUCK RD UNIT B","city":"VIRGINIA BEACH","state":"VA","zip":"23462-9998","dob":"1969-10-24","age":"","mstatus":"","insh":"6113230*01","cliId":"","pno":7573312706,"cno":7573312706,"email":"","ename":"","eno":"","pphy":"WARE, JENNIFER L MD","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":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7579658519,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["S83.241A","M22.41","U07.1","R06.02","R43.8","J96.01","I82.413","I82.443","NO DATA","J18.9","R09.02","E87.1","Z43.0","R05.8","R53.81","J84.10","Z09.","J44.9","G47.30","U09.9","E66.01","I10.","I50.32","I25.10","E11.65","E78.5","R79.89","Z86.718","J80.","I82.412","F17.210","G47.33","I12.9","R73.03","E66.9","Z79.01","Z79.82","J20.9","Z68.38","Z87.891","R53.83","J44.1","N17.9","Z12.11","F14.10","E78.00","F17.200","I51.7","R06.09","Z51.81","Z92.29","Z23.","R06.82","Z53.29","Z20.822","Z68.36","Z86.16","M79.89","H66.93","J01.00","Z82.49","Z83.3","K21.9","Z79.51","Z93.0","J06.9","R06.83","R06.81","J95.03","J34.89","J98.4","J47.9","I82.409","G47.19","Z91.89","Z43.1","R06.00","R73.9","H60.311","I82.593","R13.10","F33.9","Z98.890","R49.0","S53.401A","A41.89","R65.21","E44.0","I82.442","R07.1","R06.89","Z74.3","I82.5Z3","R41.840","F32.9","R60.9","I51.9","Z79.899"],"date":["2021-03-16","2021-03-16","2022-12-08","2022-11-24","2021-09-19","2022-11-28","2021-09-27","2021-09-27","2023-01-19","2021-11-01","2021-12-07","2021-10-19","2021-11-08","2022-07-02","2022-07-02","2022-10-03","2022-12-07","2022-12-07","2022-12-07","2022-12-07","2022-12-07","2022-12-07","2023-01-19","2022-12-07","2023-01-19","2023-01-19","2022-12-07","2022-12-07","2021-11-02","2021-11-02","2022-11-25","2022-11-08","2022-11-25","2021-11-02","2022-09-21","2022-11-25","2022-11-25","2022-07-02","2022-11-25","2022-11-03","2022-07-02","2022-11-28","2022-11-25","2021-01-27","2022-03-01","2022-11-25","2022-12-08","2021-10-08","2022-11-22","2021-11-11","2021-11-11","2021-11-11","2021-12-07","2021-12-07","2022-11-25","2021-12-07","2022-09-21","2022-09-21","2022-02-06","2022-02-06","2022-11-25","2022-11-25","2023-01-19","2022-11-25","2021-11-22","2022-10-20","2022-11-28","2022-11-28","2021-11-01","2022-10-20","2023-01-19","2023-01-19","2021-09-20","2021-02-18","2021-02-18","2021-10-25","2022-03-29","2022-03-01","2022-03-01","2022-03-01","2023-01-19","2023-01-19","2023-01-19","2023-01-19","2023-04-04","2021-09-19","2021-09-19","2021-09-19","2021-09-19","2021-09-28","2021-11-01","2021-11-01","2022-04-15","2022-04-15","2022-04-15","2021-03-08","2021-09-21","2022-11-03"],"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":[["","00172572860","FAMOTIDINE","TAB 20MG","180","Select","Select",""],["","45963070911","METOPROL SUC","TAB 25MG ER","90","Select","Select",""],["","68180098103","LISINOPRIL","20 MG","45","Select","Select",""],["","13668010401","ISOSORB MONO","TAB 30MG ER","90","Select","Select",""],["","00003089421","ELIQUIS","TAB 5MG","60","Select","Select",""],["","00363645014","ASPIRIN LOW","TAB 81MG EC","30","Select","Select",""],["","76204020030","ALBUTEROL","NEB 0.00083","90","Select","Select",""],["","00143993905","AMOXICILLIN","CAP 500MG","30","Select","Select",""],["","00045049660","TYLENOL","TAB 325MG","30","Select","Select",""],["","64380071206","BENZONATATE","CAP 100MG","30","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","68382050010","OMEPRAZOLE","40 MG","90","Select","Select",""],["","31722072320","LEVOFLOXACIN","TAB 750MG","10","Select","Select",""],["","63824004124","MUCINEX D","TAB 120-1200","24","Select","Select",""],["","27808023302","DOXYCYCL HYC","CAP 100MG","20","Select","Select",""],["","70954005920","PREDNISONE","TAB 10MG","15","Select","Select",""],["","62332025118","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","43598043611","NITROGLYCERN","SUB 0.4MG","25","Select","Select",""],["","00173069600","ADVAIR DISKU","AER 250\/50","60","Select","Select",""],["","31722088390","ROSUVASTATIN","TAB 10MG","30","Select","Select",""],["","83490031062","VIOS LC","MIS SPRINT","1","Select","Select",""],["","76204060030","IPRATROPIUM\/","SOL ALBUTER","360","Select","Select",""],["","68382070718","DOXYCYC MONO","CAP 100MG","6","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","00536589553","NICOTINE TD","DIS 14MG\/24H","7","Select","Select",""],["","70010049105","METFORMIN","TAB 500MG ER","60","Select","Select",""],["","00597007541","SPIRIVA","CAP HANDIHLR","30","Select","Select",""],["","53885091101","ONETOUCH","KIT ULT MINI","1","Select","Select",""],["","56151146001","TRUE METRIX","TES GLUCOSE","200","Select","Select",""],["","00054032756","FLUTIC\/SALME","AER 250\/50","60","Select","Select",""],["","53885000810","ONETOUCH DEL","MIS PLUS 33G","200","Select","Select",""],["","53885004401","ONE TOUCH","KIT VERIO FL","1","Select","Select",""],["","00597007541","SPIRIVA HANDIHALER","18 MCG","30","Select","Select",""],["","53885027150","ONETOUCH VERIO TEST STRIP","","50","Select","Select",""],["","76385012450","METHOCARBAMOL","750 MG","8","Select","Select",""],["","00363056314","ASPIRIN EC","81 MG","30","Select","Select",""],["","76204060030","IPRATROPIUM-ALBUTEROL","0.5-3MG\/3","360","Select","Select",""],["","76204020030","ALBUTEROL SULFATE","2.5 MG\/3ML","90","Select","Select",""],["","29300039810","AMLODIPINE BESYLATE","10 MG","90","Select","Select",""],["","53885024510","ONETOUCH ULTRA TEST STRIP","","100","Select","Select",""],["","31722088390","ROSUVASTATIN CALCIUM","10 MG","30","Select","Select",""],["","70010049105","METFORMIN HCL ER","500 MG","60","Select","Select",""],["","00173069600","ADVAIR DISKUS","250-50 MCG","60","Select","Select",""],["","16571020211","DICLOFENAC SODIUM","50 MG","14","Select","Select",""],["","00406012401","HYDROCODONE-ACETAMINOPHEN","7.5-325 MG","8","Select","Select",""],["","13668010401","ISOSORBIDE MONONITRATE ER","30 MG","90","Select","Select",""],["","53885000810","ONETOUCH DELICA PLUS LANCET","33 GAUGE","200","Select","Select",""],["","66993001968","ALBUTEROL SULFATE HFA","90 MCG","18","Select","Select",""],["","59746000103","METHYLPREDNISOLONE","4 MG","21","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":""}]}]}