{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"   ECAESOR C","gend":0,"add":" YVI 2531D TPA LRT","city":"CHESAPEAKE","state":"VA","zip":"23320-9998","dob":"2000-05-11","age":"","mstatus":"","insh":"97500210*29","cliId":"","pno":"","cno":"","email":"","ename":"","eno":"","pphy":"CHASTANET, RACHEL I MD","ppno":"757\/312-9444","pcpadd":"221 MT PLEASANT RD SUITE A-1","pcpcity":"CHESAPEAKE","pcpstate":"VA","pcpzip":23322,"pcpcounty":"","pcpid":"","pcpname":"CHESAPEAKE WEIGHT LOSS CONSULTANTS PLLC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F31.30","F72.","E78.2","E03.9","K21.9","G80.9","M79.673","NO DATA","F39.","F90.2","S80.02XA","S80.212A","H66.91","H60.92","R06.02","F90.9","J06.9","F31.9","R03.0","F25.0","J02.9","G80.8","Z83.3","R19.7","N39.44","E66.9","M54.5","R00.0","F79.","F91.3","F71.","Z00.129","Z11.1","Z68.41","E55.9","E78.1","R10.9","I10.","R31.0","R73.09","G80.2","M67.01","R31.9","R53.83","F32.9"],"date":["2020-12-07","2022-05-10","2022-07-22","2022-08-22","2022-03-08","2021-11-04","2021-11-04","2022-07-01","2022-10-08","2022-10-08","2020-08-20","2020-08-20","2020-09-11","2020-09-27","2020-09-27","2020-09-27","2021-04-16","2022-08-22","2022-07-22","2019-07-19","2021-04-22","2022-08-22","2022-01-10","2020-06-23","2020-06-23","2022-01-07","2021-02-09","2021-03-30","2019-05-17","2019-05-17","2019-07-09","2020-03-03","2020-03-03","2021-01-21","2022-08-22","2022-08-22","2022-05-23","2022-03-08","2022-05-23","2022-02-14","2022-07-01","2022-07-01","2022-01-07","2022-07-22","2022-07-22"],"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":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"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":[["","","DESMOPRESSIN","TAB 0.2MG","","Select","Select",""],["","51267089099","CONTRAVE","TAB 8-90MG","120","Select","Select",""],["","","TRAZODONE"," TRAZODONE ","60","Select","Select",""],["","","SERTRALINE"," SERTRALINE ","30","Select","Select",""],["","","RISPERIDONE"," RISPERIDONE ","90","Select","Select",""],["","","CLONIDINE"," CLONIDINE ","90","Select","Select",""],["","70010013901","NAPROXEN","TAB 500MG","20","Select","Select",""],["","","DIVALPROEX"," DIVALPROEX ","60","Select","Select",""],["","","OMEPRAZOLE","CAP 20MG","","Select","Select",""],["","65862059801","TAMSULOSIN","CAP 0.4MG","30","Select","Select",""],["","","LEVOTHYROXIN","TAB 25MCG","","Select","Select",""],["","16714043901","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","68382005101","MELOXICAM","TAB 15MG","30","Select","Select",""],["","65862057490","MONTELUKAST","TAB 10MG","90","Select","Select",""],["","","BENZONATATE","CAP 100MG","","Select","Select",""],["","65162046650","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","31722054501","LITHIUM","CAP 300MG","60","Select","Select",""],["","69097012403","TOPIRAMATE","TAB 100MG","60","Select","Select",""],["","00228306111","AMPHET\/DEXTR","CAP 30MG ER","30","Select","Select",""],["","","LORATADINE","TAB 10MG","","Select","Select",""],["","54092039101","ADDERALL","CAP 30MG","30","Select","Select",""],["","58160088552","FLUARIX","INJ 2020-21","0","Select","Select",""],["","","CIPRO\/DEXA","SUS 0.3-0.1%","","Select","Select",""],["","","OFLOXACIN","DRO 0.3%OTIC","","Select","Select",""],["","","AMOX\/K","TAB 875-125","","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":""}]}]}