{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MELLANESSA   J RHODES","gend":1,"add":"1797 CHESTWOOD DR APT 108","city":"VIRGINIA BEACH","state":"VA","zip":"23453-9998","dob":"1971-04-24","age":"","mstatus":"","insh":"1852043*01","cliId":"","pno":"757\/367-4446","cno":"","email":"","ename":"","eno":"","pphy":"GAGLIONE, MARGARET M MD","ppno":"757\/644-6819","pcpadd":"1405 KEMPSVILLE ROAD","pcpcity":"CHESAPEAKE","pcpstate":"VA","pcpzip":23320,"pcpcounty":"","pcpid":"","pcpname":"COASTAL INTERNAL MEDICINE AND TIDEWATER BARIATRICS","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/644-6816","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G47.33","Z47.89","M62.81","M25.671","R26.2","Z00.00","I10.","F41.8","L30.9","J45.20","Z11.59","M79.671","Z98.890","M21.41","M67.01","N62.","Z11.4","Z20.828","Z20.822","M19.071","M25.571","Z82.0","G47.00","R68.2","R06.5","Z71.89","Z72.821","R40.0","T88.7XXA","M21.42","J45.31","E66.01","E55.9","M25.371","Z01.810","M79.672","M24.574","M67.873","M21.6X1","M25.471","E66.9","Z12.11","M72.2","M25.572","M19.072","M21.6X2","Z01.818","R06.83","R06.81","R53.83","E66.2","G47.8","Z68.41","Z79.899","Z88.8","Z91.013","Z91.02","Z91.048","M67.02"],"date":["2021-04-15","2021-10-25","2021-10-25","2021-07-08","2021-10-25","2021-06-15","2021-12-09","2021-12-09","2021-12-09","2021-06-15","2021-06-15","2021-10-18","2021-12-13","2021-10-25","2021-10-20","2020-05-18","2020-05-18","2020-12-15","2021-01-29","2021-10-20","2021-12-13","2020-12-14","2021-02-18","2021-02-18","2021-02-18","2021-02-18","2021-02-18","2021-02-18","2021-02-18","2021-09-15","2021-12-09","2021-12-09","2021-12-09","2021-09-30","2020-12-08","2021-06-24","2020-12-17","2020-12-17","2020-12-17","2021-07-12","2021-10-12","2021-10-12","2021-12-13","2021-12-13","2020-09-28","2020-09-28","2020-12-15","2020-10-28","2020-12-06","2020-10-28","2020-10-28","2020-10-28","2020-12-06","2020-12-06","2020-12-06","2020-12-06","2020-12-06","2020-12-06","2021-09-30"],"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":[["","","FLUOXETINE","CAP 40MG","","Select","Select",""],["","","ATENOLOL","TAB 100MG","","Select","Select",""],["","","AMLODIPINE","TAB 5MG","","Select","Select",""],["","","TRIAMT\/HCTZ","TAB 37.5-25","","Select","Select",""],["","","OXYCODONE","TAB 5MG","","Select","Select",""],["","","TRIAMCINOLON","CRE 0.001","","Select","Select",""],["","","FLOVENT","AER 110MCG","","Select","Select",""],["","","ZOLPIDEM","TAB 5MG","","Select","Select",""],["","","EQ","CAP SOFTENER","","Select","Select",""],["","","DOK","CAP 100MG","","Select","Select",""],["","","ONDANSETRON","TAB 4MG","","Select","Select",""],["","31722099601","HYDROCO\/APAP","TAB 5-325MG","30","Select","Select",""],["","68645056354","IBUPROFEN","TAB 800MG","60","Select","Select",""],["","49281042150","FLUZONE","INJ 2021-22","0","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0","Select","Select",""],["","00591299801","URSODIOL","TAB 250MG","60","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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}