{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TAYLOR   M LORD","gend":0,"add":"813 SHIRLEY AVE APT 5B","city":"NORFOLK","state":"VA","zip":"23517-9998","dob":"1989-10-26","age":"","mstatus":"","insh":"20064807*01","cliId":"","pno":"757\/613-0824","cno":"757\/613-0824","email":"","ename":"","eno":"","pphy":"ABLASEAU, RALPH K NP","ppno":"757\/467-9500","pcpadd":"5265 PROVIDENCE RD STE 500","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":23464,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/467-9560","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F43.25","F43.29","F31.81","F41.1","F17.210","F41.0","F43.12","R53.83","T50.901A","F51.04","F51.5","Z71.89","F31.60","F32.9","F43.21","R10.9","R35.0","NO DATA","F31.9","M94.20","M54.5","G89.29","V62.84","Z62.810","M19.072","M19.071","M79.671","M79.672","T40.2X1A","T40.601A","R41.82"],"date":["2022-06-24","2022-11-18","2022-09-07","2022-09-07","2022-10-23","2022-09-07","2022-09-07","2020-07-28","2021-05-13","2020-06-23","2020-03-31","2020-07-14","2020-07-14","2020-07-14","2020-07-14","2022-08-21","2022-08-21","2022-08-21","2022-04-13","2021-09-08","2021-09-08","2021-09-08","2020-07-27","2020-07-27","2022-06-22","2022-06-22","2022-06-22","2022-06-22","2022-10-23","2022-10-23","2022-10-23"],"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":[["","29300011316","LAMOTRIGINE","TAB 150MG","30","Select","Select",""],["","00093083205","CLONAZEPAM","TAB 0.5MG","15","Select","Select",""],["","33342007007","OLANZAPINE","TAB 10MG","30","Select","Select",""],["","65862001705","AMOXICILLIN","CAP 500MG","21","Select","Select",""],["","00406012405","HYDROCO\/APAP","TAB 7.5-325","12","Select","Select",""],["","65862050220","AMOX\/K","TAB 500-125","20","Select","Select",""],["","69292053001","PROPRANOLOL","TAB 10MG","60","Select","Select",""],["","65862001205","SERTRALINE","TAB 50MG","30","Select","Select",""],["","64380080807","IBUPROFEN","TAB 600MG","20","Select","Select",""],["","68462010530","ONDANSETRON","TAB 4MG","9","Select","Select",""],["","12496120803","SUBOXONE","MIS 8-2MG","20","Select","Select",""],["","29300046810","CLONIDINE","TAB 0.1MG","90","Select","Select",""],["","00115180301","HYDROXYZ","CAP 25MG","30","Select","Select",""],["","00093216568","NALOXONE","SPR ","2","Select","Select",""],["","43598058230","BUPREN\/NALOX","MIS 8-2MG","20","Select","Select",""],["","60505265401","TRAZODONE","TAB 100MG","5","Select","Select",""],["","65862018501","CLINDAMYCIN","CAP 150MG","56","Select","Select",""],["","68382005105","MELOXICAM","TAB 15MG","30","Select","Select",""],["","52817033010","CYCLOBENZAPR","TAB 5MG","15","Select","Select",""],["","59651015201","PROGESTERONE","CAP 100MG","30","Select","Select",""],["","00555088702","ESTRADIOL","TAB 2MG","30","Select","Select",""],["","68462013801","OXCARBAZEPIN","TAB 300MG","60","Select","Select",""],["","00591024105","LORAZEPAM","TAB 1MG","7","Select","Select",""],["","59676058015","JANSSEN","INJ COVID-19","0","Select","Select",""],["","68462022110","LITHIUM","CAP 300MG","30","Select","Select",""],["","42806040021","METHYLPRED","TAB 4MG","21","Select","Select",""],["","67877024901","QUETIAPINE","TAB 50MG","30","Select","Select",""],["","67877043203","ARIPIPRAZOLE","TAB 10MG","30","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":""}]}]}