{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"GRETCHEN   L SCHMIDT","gend":1,"add":"2218 LANDING ROAD","city":"PROVIDENCE FORGE","state":"VA","zip":"23140-9998","dob":"1974-08-30","age":"","mstatus":"","insh":"20034603*01","cliId":"","pno":"443\/834-8620","cno":"804\/887-9909","email":"","ename":"","eno":"","pphy":"MAYER, BRUCE MD","ppno":"757\/566-2045","pcpadd":"7151 RICHMOND ROAD SUITE 403","pcpcity":"WILLIAMSBURG","pcpstate":"VA","pcpzip":23188,"pcpcounty":"","pcpid":"","pcpname":"BRUCE M MAYER MD PC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/741-2735","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I47.1","Z01.810","Z01.818","R10.9","R19.7","R11.0","K74.60","R16.0","R16.1","E66.9","Z86.19","G43.009","G44.221","I10.","F41.9","K21.9","M79.7","G47.00","T14.90XA","M25.512","M25.522","M79.641","W01.0XXA","D64.9","R41.3","Z79.899","K92.1","R19.5","Q65.89","M91.41","M25.552","L03.115","K76.89","N28.1","G43.909","Z23.","R30.0","R10.11","Z11.59","R07.2","R00.2","I49.1","K76.9","K82.8","R16.2","K86.89","M25.551","Z01.812","Z20.822","R21.","W57.XXXA","J20.9"],"date":["2020-11-03","2020-05-08","2020-05-10","2021-10-21","2021-10-21","2020-09-21","2021-10-21","2021-02-17","2021-02-17","2021-02-17","2021-10-21","2020-03-05","2020-03-05","2020-03-05","2021-05-12","2020-03-05","2021-12-15","2020-03-05","2020-06-03","2020-06-03","2020-06-03","2020-06-03","2020-06-03","2021-02-16","2021-02-16","2021-10-21","2021-04-23","2021-04-23","2021-05-12","2021-05-12","2021-05-12","2021-06-24","2020-09-21","2020-09-21","2021-12-15","2021-10-20","2020-10-26","2020-10-26","2020-11-27","2020-03-02","2020-09-30","2020-09-30","2020-11-17","2021-02-17","2021-02-17","2021-02-17","2021-05-28","2021-04-21","2021-04-21","2021-07-13","2021-07-13","2021-07-13"],"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":[["","69315090410","LORAZEPAM","TAB 0.5MG","60","Select","Select",""],["","00093031805","DILTIAZEM","TAB 30MG","90","Select","Select",""],["","72205001490","PREGABALIN","CAP 100MG","120","Select","Select",""],["","65862016001","ZOLPIDEM","TAB 10MG","5","Select","Select",""],["","11523723403","MIRALAX","POW 3350 NF","238","Select","Select",""],["","65862055990","PANTOPRAZOLE","TAB 20MG","30","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8","Select","Select",""],["","68382013905","TOPIRAMATE","TAB 50MG","90","Select","Select",""],["","00023650110","UBRELVY","TAB 100MG","10","Select","Select",""],["","65862014836","SUMATRIPTAN","TAB 100MG","9","Select","Select",""],["","43547028211","ESCITALOPRAM","TAB 20MG","30","Select","Select",""],["","16729017317","AMITRIPTYLIN","TAB 50MG","60","Select","Select",""],["","68180098003","LISINOPRIL","TAB 10MG","30","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","00023611001","ZENPEP","CAP 10000UNT","90","Select","Select",""],["","45802086802","POLYETH","POW 3350 NF","238","Select","Select",""],["","23155050001","HYDROXYZ","TAB 10MG","20","Select","Select",""],["","00591544305","PREDNISONE","TAB 20MG","4","Select","Select",""],["","00597007541","SPIRIVA","CAP HANDIHLR","30","Select","Select",""],["","29300034905","ALLOPURINOL","TAB 100MG","30","Select","Select",""],["","43598081115","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","65862053820","LEVOFLOXACIN","TAB 750MG","7","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","28","Select","Select",""],["","00173068220","VENTOLIN","AER ","18","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":""}]}]}