{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DIA LOCKE","gend":1,"add":"263 A VIEW AVE APT 4","city":"NORFOLK","state":"VA","zip":"23503-9998","dob":"1968-06-26","age":"","mstatus":"","insh":"7984618*01","cliId":"","pno":7574708650,"cno":7574708650,"email":"","ename":"","eno":"","pphy":"LOCK, RACHEL DO","ppno":7573952500,"pcpadd":"1024 FIRST COLONIAL RD STE 102","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":"23454-9998","pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Family Medicine Physicians - First Colonial","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7572759700,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I61.1","G81.94","R26.9","R20.2","R41.4","R13.12","E66.01","I10.","I12.9","M62.838","M25.551","L23.7","I12.0","N18.5","I62.9","I13.0","I50.9","N18.4","D63.1","I69.391","R13.10","E78.5","K21.9","F17.210","I69.354","Z74.09","Z73.6","N18.6","E87.5","E87.2","D64.9","R00.0","U07.1","NO DATA","Z49.01","N17.9","V58.89","Z48.02","S81.801A","I13.2","Z99.2","Z79.899","Z87.891","Z91.040","Z91.014","Z88.8","Z91.048","R06.02","E87.3","I61.9","I16.1","R41.89","I67.89","I08.1","I27.20","I70.0","E86.0","Z91.018","R50.9","I51.7","N18.9","T82.41XA","Z45.2","F41.9","Z86.73","T82.590A","I87.8","M25.472","R79.89","S81.811A","Z23.","Z86.16","N25.81","L03.011","I69.154","R09.89","Z95.828","T82.838A","T82.530A","S60.222A","I16.9","Z68.41","I69.191","I69.119","R77.8","M25.552","M89.49","F11.90","Z86.14","J18.9","I50.32","I48.91","D50.9","Z20.822","R26.89","L97.909","I63.50","E66.9","R60.0","I77.0","I61.0","D62.","J81.1","R29.711","R29.810","T50.1X6A","I63.9","I11.0","Z91.89","Z68.35","T82.42XA","F14.90","Z91.09","F32.5","T82.510A","L76.32","Z68.30","T82.898A","G47.33","I48.0","M89.8X6","I69.854","R53.1","R51.9","R68.89","F32.9","Z01.818","T82.858A","N19.","F33.3","I97.89","G62.9","K92.1","Z76.82"],"date":["2021-07-16","2021-07-17","2021-07-16","2021-07-16","2021-07-16","2021-07-16","2022-01-18","2023-04-01","2021-07-16","2022-09-24","2022-11-12","2021-07-16","2023-04-28","2021-09-12","2021-07-28","2021-08-16","2023-04-28","2021-08-16","2022-12-05","2021-08-16","2021-08-16","2021-08-16","2021-08-16","2021-08-16","2022-02-26","2021-12-17","2021-12-17","2023-05-15","2021-11-26","2021-09-24","2022-12-08","2021-09-24","2021-09-28","2023-05-15","2021-11-26","2021-12-15","2022-02-26","2022-02-26","2022-03-29","2023-04-28","2023-04-28","2022-09-24","2023-04-28","2022-11-12","2022-11-12","2022-11-12","2022-11-12","2022-09-19","2021-06-22","2023-03-17","2021-06-26","2021-06-25","2021-07-05","2021-06-30","2021-06-30","2021-06-30","2021-09-12","2022-09-24","2021-09-12","2021-09-22","2021-11-26","2021-11-26","2023-04-12","2022-01-25","2022-01-25","2022-08-25","2022-08-25","2022-10-07","2021-06-19","2022-02-10","2022-02-10","2023-04-28","2022-12-05","2022-03-29","2022-11-12","2022-10-08","2022-11-12","2022-12-07","2022-12-07","2023-01-11","2021-06-22","2021-06-26","2021-06-26","2021-06-26","2021-09-21","2021-06-26","2021-12-09","2021-12-09","2022-02-26","2021-09-14","2022-01-18","2021-09-21","2021-09-21","2021-09-21","2022-01-10","2022-03-31","2021-07-17","2022-12-05","2022-12-27","2022-12-27","2021-06-19","2022-12-05","2021-06-19","2021-06-19","2021-06-19","2021-06-19","2023-03-17","2022-01-18","2021-07-26","2022-01-18","2021-11-26","2021-12-09","2021-11-26","2022-01-18","2023-04-25","2022-12-05","2022-12-05","2023-04-25","2022-12-05","2022-12-05","2021-08-26","2021-10-08","2023-03-17","2021-10-08","2021-10-08","2021-12-09","2021-12-15","2022-03-21","2022-08-09","2022-08-31","2022-12-07","2023-03-17","2023-04-28","2023-04-28"],"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":[["","64380073706","VITAMIN D","CAP 50000UNT","12","Select","Select",""],["","69238149001","BUMETANIDE","TAB 1MG","180","Select","Select",""],["","67877019905","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","00093735201","CALCITRIOL","CAP 0.25MCG","90","Select","Select",""],["","50742026101","NIFEDIPINE","TAB 60MG ER","180","Select","Select",""],["","82891038801","BP MONITOR","MIS AUTOMATI","1","Select","Select",""],["","29300041301","CYCLOBENZAPR","TAB 5MG","60","Select","Select",""],["","50111091701","TORSEMIDE","20 MG","180","Select","Select",""],["","00406012301","HYDROCO\/APAP","TAB 5-325MG","28","Select","Select",""],["","57896010201","ACETAMINOPHE","TAB 325MG","30","Select","Select",""],["","00536104710","SODIUM BICAR","TAB 650MG","90","Select","Select",""],["","50111032801","HYDRALAZINE","TAB 50MG","180","Select","Select",""],["","70010010801","GABAPENTIN","CAP 100MG","30","Select","Select",""],["","67877084201","FAMOTIDINE","20 MG","90","Select","Select",""],["","70377006212","LABETALOL","TAB 300MG","180","Select","Select",""],["","29033002602","CALC ACETATE","CAP 667MG","180","Select","Select",""],["","13668010601","ISOSORB MONO","TAB 120MG ER","90","Select","Select",""],["","69238110005","DOXYCYCL HYC","CAP 100MG","27","Select","Select",""],["","13811052501","TRIPHROCAPS","1 MG","30","Select","Select",""],["","49348003210","SM GENTLE","TAB LAXATIVE","30","Select","Select",""],["","29300046805","CLONIDINE","TAB 0.1MG","180","Select","Select",""],["","70010075401","METHOCARBAM","TAB 500MG","90","Select","Select",""],["","58657050916","GUAIFENESIN","LIQ 100\/5ML","118","Select","Select",""],["","00121077516","GG\/CODEINE","SOL 100-10\/5","118","Select","Select",""],["","50111078710","AZITHROMYCIN","TAB 250MG","4","Select","Select",""],["","57896020110","PAIN RELIEF","TAB 500MG","30","Select","Select",""],["","65862052790","VENLAFAXINE","CAP 37.5 ER","30","Select","Select",""],["","59267100001","PFIZER VACC","INJ COVID-19","0","Select","Select",""],["","65162005827","SEVELAMER","TAB 800MG","90","Select","Select",""],["","69367027204","CODEINE\/GG","SOL 10-100\/5","118","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","20","Select","Select",""],["","58468013001","RENVELA","TAB 800MG","180","Select","Select",""],["","42806071401","BENZONATATE","100 MG","64","Select","Select",""],["","50383070016","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","50383066730","LIDO\/PRILOCN","CRE 2.5-2.5%","30","Select","Select",""],["","67877021901","CEPHALEXIN","CAP 500MG","10","Select","Select",""],["","00536478701","B COMPLEX","CAP ","90","Select","Select",""],["","80777028299","MODERNA BIVA","INJ BA4\/BA5","0","Select","Select",""],["","72888001405","CYCLOBENZAPRINE HCL","10 MG","15","Select","Select",""],["","65862039010","ONDANSETRON ODT","4 MG","30","Select","Select",""],["","31722010330","CINACALCET HCL","30 MG","30","Select","Select",""],["","50111039701","HYDRALAZINE HCL","100 MG","60","Select","Select",""],["","65162005827","SEVELAMER CARBONATE","800 MG","210","Select","Select",""],["","50742026101","NIFEDIPINE ER","60 MG","180","Select","Select",""],["","16571040110","CETIRIZINE HCL","5 MG","2","Select","Select",""],["","65162079108","LIDOCAINE","5 %","30","Select","Select",""],["","11534016501","FOLIC ACID","1 MG","90","Select","Select",""],["","70377006212","LABETALOL HCL","300 MG","180","Select","Select",""],["","64380076921","PEG","3350-ELECTROLYTE 420G","4000","Select","Select",""],["","00536116361","MUCUS RELIEF ER","600 MG","30","Select","Select",""],["","00054327099","FLUTICASONE PROPIONATE","50 MCG","16","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":""}]}]}