{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"STEPHEN PATTON","gend":0,"add":"3524 LONGWOOD DR","city":"TOANO","state":"VA","zip":"23168-9998","dob":"1963-04-26","age":"","mstatus":"","insh":"900052274*01","cliId":"","pno":7572883131,"cno":"","email":"","ename":"","eno":"","pphy":"RAUCHWARG, GLENN MD","ppno":7573452071,"pcpadd":"STE 201 5424 DISCOVERY PARK BLVD","pcpcity":"WILLIAMSBURG","pcpstate":"VA","pcpzip":"23188-9998","pcpcounty":"","pcpid":"","pcpname":"TIDEWATER PHYSICIANS MULTISPECIALTY GROUP PC","plan":"OHP","program":"MEDICARE","lob":"MA-Non DSNP","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7579034877,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G47.33","I10.","F01.50","D68.61","Z93.2","K63.1","K56.609","Z20.822","S46.212A","F90.0","F34.1","I42.9","Z79.899","E78.2","R41.841","M06.4","H11.153","Z00.00","H16.042","I42.0","I25.10","N18.32","Z79.01","I25.84","F10.20","Z12.5","Z12.11","D50.9","L72.0","L82.1","Z71.9","J20.9","R03.0"],"date":["2022-06-03","2022-12-09","2022-05-03","2023-04-06","2023-02-21","2023-02-21","2023-02-21","2023-01-06","2023-03-10","2022-01-19","2022-01-19","2022-01-19","2023-03-03","2022-12-09","2022-03-21","2022-04-20","2022-04-20","2022-04-20","2022-06-02","2023-04-20","2022-03-08","2022-03-08","2022-03-08","2022-03-08","2022-12-09","2022-12-09","2022-07-13","2023-03-03","2023-03-20","2023-03-20","2023-03-20","2023-03-14","2023-03-14"],"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":[["","13668010510","ISOSORB MONO TAB","60MG ER","90","Select","Select",""],["","16729048001","METHYLPHENID TAB","20MG","180","Select","Select",""],["","65862056099","PANTOPRAZOLE TAB","40MG","90","Select","Select",""],["","69097012815","AMLODIPINE TAB","10MG","90","Select","Select",""],["","65862022701","LAMOTRIGINE TAB","25MG","360","Select","Select",""],["","60505015701","BUPROPION TAB","100MG","270","Select","Select",""],["","60505267108","ATORVASTATIN TAB","80MG","90","Select","Select",""],["","00093172110","WARFARIN TAB","5MG","135","Select","Select",""],["","16729048516","HYDROXYCHLOR TAB","200MG","180","Select","Select",""],["","57237010099","METOPROL TAR TAB","25MG","45","Select","Select",""],["","80777027399","MODERNA VAC INJ COVID-","19","0","Select","Select",""],["","24208083060","NEO\/POLY\/DEX SUS","0.1% OP","5","Select","Select",""],["","24208035805","ZYLET SUS","0.5-0.3%","5","Select","Select",""],["","00116200116","CHLORHEX GLU SOL","0.12%","473","Select","Select",""],["","70461032203","FLUCLVX QUAD INJ","2022-23","0","Select","Select",""],["","49281042250","FLUZONE QUAD INJ","2022-23","0","Select","Select",""],["","80777028299","MODERNA BIVA INJ BA","4\/BA5","0","Select","Select",""],["","52817036000","METOPROLOL TARTRATE","25 MG","45","Select","Select",""],["","00406114601","METHYLPHENIDATE HCL","20 MG","180","Select","Select",""],["","68382000610","LAMOTRIGINE","25 MG","360","Select","Select",""],["","82009004505","HYDROXYCHLOROQUINE SULFATE","200 MG","180","Select","Select",""],["","82607066027","FLOWFLEX COVID-","19 AG HOME TEST","8","Select","Select",""],["","82009001190","PANTOPRAZOLE SODIUM","40 MG","90","Select","Select",""],["","42806071505","BENZONATATE","200 MG","20","Select","Select",""],["","59746000103","METHYLPREDNISOLONE","4 MG","21","Select","Select",""],["","42806066405","BUSPIRONE HCL","15 MG","60","Select","Select",""],["","60505015701","BUPROPION HCL","100 MG","270","Select","Select",""],["","61314064705","TOBRAMYCIN-DEXAMETHASONE","0.3 %-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":""}]}]}