{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"RACHEL   C SECHRIST","gend":1,"add":"3565 GOOD HOPE ROAD","city":"VIRGINIA BEACH","state":"VA","zip":"23452-9998","dob":"1972-02-16","age":"","mstatus":"","insh":"20053296*01","cliId":"","pno":"757\/343-8157","cno":"757\/343-8157","email":"","ename":"","eno":"","pphy":"CHARLES, MICHAEL G MD","ppno":"757\/395-1700","pcpadd":"3745 HOLLAND RD","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":23452,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/507-9004","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F31.9","F41.1","F90.2","F32.9","N17.9","F33.1","F90.0","I95.9","J44.9","I10.","Z12.31","M47.16","F17.210","F31.32","Z09.","D50.9","Z51.81","Z79.899","F31.81","R57.1","M62.82","N39.0","M51.37","M43.16","K21.9","Z82.49","Z83.3","H54.7","T50.2X5A","F51.01","E86.0","R00.2","R07.89"],"date":["2021-02-10","2022-04-12","2021-02-10","2021-02-10","2020-09-02","2022-04-12","2022-04-12","2020-08-25","2020-08-25","2020-08-24","2020-08-07","2020-08-07","2020-08-24","2020-09-02","2020-09-02","2020-09-02","2022-04-12","2022-04-12","2022-04-12","2020-08-24","2020-08-24","2020-08-24","2020-08-24","2020-08-24","2020-08-24","2020-08-24","2020-08-24","2020-08-24","2020-08-24","2021-02-10","2020-08-24","2020-08-24","2020-08-24"],"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":[["","00904759080","FEROSUL","TAB 325MG","90","Select","Select",""],["","00173086910","ANORO","AER 62.5-25","60","Select","Select",""],["","57237000830","MIRTAZAPINE","TAB 15MG","90","Select","Select",""],["","54092039101","ADDERALL","CAP 30MG","60","Select","Select",""],["","60432026415","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","00781107905","ALPRAZOLAM","TAB 1MG","30","Select","Select",""],["","63402030230","LATUDA","TAB 20MG","30","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","00228306111","AMPHET\/DEXTR","CAP 30MG ER","60","Select","Select",""],["","62756018488","OXCARBAZEPIN","TAB 300MG","60","Select","Select",""],["","68462039130","ESOMEPRA","CAP 40MG DR","30","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","00173068220","VENTOLIN","AER ","18","Select","Select",""],["","69547035302","NARCAN","SPR 4MG","2","Select","Select",""],["","00093216568","NALOXONE","SPR 4MG","2","Select","Select",""],["","64764073030","TRINTELLIX","TAB 10MG","30","Select","Select",""],["","00904759161","FERROUS","TAB 325MG","90","Select","Select",""],["","51991031133","DESVENLAFAX","TAB 50MG ER","30","Select","Select",""],["","16729017001","ESCITALOPRAM","TAB 20MG","30","Select","Select",""],["","60505257809","ATORVASTATIN","TAB 10MG","30","Select","Select",""],["","50228014605","HYDROCHLOROT","CAP 12.5MG","90","Select","Select",""],["","67877019905","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","51645075001","DOCUSATE","TAB 100MG","90","Select","Select",""],["","11822222590","RA","DIS 21MG\/24H","28","Select","Select",""],["","00591086201","LISINOP\/HCTZ","TAB 20-25MG","90","Select","Select",""],["","00904645760","DOK","CAP 100MG","90","Select","Select",""],["","00005197102","PREVNAR","INJ ","0","Select","Select",""],["","16714065204","CIPROFLOXACN","TAB 500MG","6","Select","Select",""],["","58160088552","FLUARIX","INJ 2020-21","0","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":""}]}]}