{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"RAYSHAWN   D CHAPMAN","gend":0,"add":"3314 ILLINOIS AVE","city":"NORFOLK","state":"VA","zip":"23513-9998","dob":"1992-08-07","age":"","mstatus":"","insh":"20041167*01","cliId":"","pno":"757\/228-3881","cno":"","email":"","ename":"","eno":"","pphy":"BONEY, ARON MD","ppno":"757\/278-2240","pcpadd":"155 KINGSLEY LN STE 400","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":"23505","pcpcounty":"","pcpid":"","pcpname":"DEPAUL MEDICAL ASSOCIATES","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/489-6469","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I10.","J45.41","S39.012S","J30.1","F33.9","E66.01","J40.","F25.1","Z00.00","Z51.81","F31.70","Z68.36","J45.21"],"date":["2021-10-25","2021-10-25","2020-09-22","2020-09-22","2021-10-25","2020-09-22","2021-10-25","2021-12-21","2020-03-12","2020-03-12","2020-03-12","2020-03-12","2021-02-10"],"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":[["","00173069600","ADVAIR","AER 250\/50","60","Select","Select",""],["","66993058597","FLUTIC\/SALME","AER 250\/50","60","Select","Select",""],["","60505015801","BUPROPION","TAB 75MG","30","Select","Select",""],["","69097012805","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","27241000506","RISPERIDONE","TAB 3MG","30","Select","Select",""],["","69097097107","LISINOP\/HCTZ","TAB 20-25MG","30","Select","Select",""],["","55111015330","ONDANSETRON","TAB 4MG","10","Select","Select",""],["","16571040210","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","16714048501","DIVALPROEX","TAB 500MG ER","90","Select","Select",""],["","55111046601","METOPROL","TAB 25MG ER","30","Select","Select",""],["","76385012401","METHOCARBAM","TAB 750MG","40","Select","Select",""],["","00603188016","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","68180016013","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","00378064110","PREDNISONE","TAB 10MG","30","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","69842080601","CVS","TAB 600MG","20","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":""}]}]}