{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ANTHONY   J REYNOLDS","gend":0,"add":"1812 N STREAMLINE DR APT 1A","city":"VIRGINIA BEACH","state":"VA","zip":"23454-9998","dob":"2002-02-13","age":"","mstatus":"","insh":"1149933*01","cliId":"","pno":"607\/345-2429","cno":"","email":"","ename":"","eno":"","pphy":"PACHECO, PARIS MD","ppno":"757\/352-2030","pcpadd":"1168 FIRST COLONIAL RD STE 200","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":23454,"pcpcounty":"","pcpid":"","pcpname":"Bayview Hospitalist","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/352-2031","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F34.1","F41.9","F41.1","F40.10","R74.01","K76.0","L03.317","F32.9","M67.439","R74.8","R73.01","E78.2","Z23.","Z48.89","Z00.00","L05.01","Z68.31","R03.0","R61.","M25.512","L05.91","Z48.817","Z87.891","E88.81","Z11.3","M67.431","J02.9","Z20.822","J35.1"],"date":["2021-11-17","2022-11-07","2021-11-17","2021-11-17","2022-05-02","2022-05-02","2022-05-24","2022-11-21","2021-05-20","2022-11-07","2022-11-07","2022-11-07","2022-09-26","2022-07-21","2022-03-07","2022-06-14","2022-06-01","2022-06-01","2022-06-01","2022-06-01","2022-07-18","2022-07-21","2022-07-21","2022-11-07","2022-09-26","2021-05-24","2022-10-20","2021-05-20","2022-11-07"],"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":[["","00169280015","SAXENDA","INJ 18MG\/3ML","15","Select","Select",""],["","70436001002","BUPROPN","TAB 150MG XL","90","Select","Select",""],["","65862050220","AMOX\/K","TAB 500-125","20","Select","Select",""],["","69097083512","SERTRALINE","TAB 100MG","90","Select","Select",""],["","57664037718","TRAMADOL","TAB 50MG","18","Select","Select",""],["","00169413212","OZEMPIC","INJ 2\/1.5ML","2","Select","Select",""],["","13668013701","ESCITALOPRAM","TAB 20MG","90","Select","Select",""],["","49483060450","IBUPROFEN","TAB 800MG","21","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","18","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","50111056001","TRAZODONE","TAB 50MG","30","Select","Select",""],["","00096070735","DRYSOL","SOL 0.2","35","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":""}]}]}