{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JOHN   S HANCOCK","gend":0,"add":"3770 SURRY ROAD","city":"VIRGINIA BEACH","state":"VA","zip":"23455-9998","dob":"1976-01-25","age":"","mstatus":"","insh":"20051566*01","cliId":"","pno":7572733350,"cno":7572733350,"email":"","ename":"","eno":"","pphy":"WEBSTER, ELIZABETH MD","ppno":7579755200,"pcpadd":"7401 WARWICK BLVD","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":"23607-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7572230829,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.1","F31.5","F10.20","F41.9","F33.2","F90.9","F39.","F31.9","F32.89","I45.5","R41.82","F12.20","V62.84","Z91.19","I49.1","R00.1","F41.1","F43.10","E78.1","E55.9","D22.9","Z23.","Z12.11","U07.1","F10.10","K64.4","R19.7","R46.89","F32.9","F33.9","F10.229","F17.210","F25.9","Z59.00","Z79.899","Z02.2","F10.929","F10.19","F19.939","F10.14","R03.0","M25.561","Z13.220","Z13.1","Z11.3","Z11.4","Z13.21","F12.90","R11.0","Z20.822","R45.1","F10.120","F43.9","Z59.01","Z56.0","Z13.30","F10.129","Z04.6","R94.31","NO DATA","F23.","V62.85","R45.851","T14.91XA","F19.90","Z76.89","F11.10","F25.1","S00.83XA","F19.10","Z72.89","F43.23","Z86.16","Z09.","F10.920","F60.9","G47.00","F10.239","I49.8","Z87.891","F29.","F10.24"],"date":["2022-10-10","2021-02-19","2022-10-02","2023-01-11","2022-11-03","2023-01-11","2022-07-11","2023-01-13","2022-06-08","2022-03-28","2022-03-28","2022-08-01","2023-02-19","2022-07-25","2022-07-26","2022-07-26","2022-10-02","2022-10-02","2022-11-09","2022-11-09","2022-11-09","2022-11-09","2022-11-09","2022-12-27","2022-12-27","2022-07-05","2022-07-05","2022-07-25","2023-02-15","2023-01-08","2022-12-27","2022-12-27","2022-12-27","2023-01-11","2022-12-27","2022-10-18","2021-08-29","2021-06-04","2021-11-04","2022-01-17","2022-03-10","2022-06-25","2022-03-10","2022-03-10","2022-03-10","2022-03-10","2022-03-10","2023-01-11","2022-05-03","2022-06-30","2022-07-03","2022-06-30","2022-03-04","2022-03-04","2022-03-04","2022-06-25","2023-02-19","2022-06-30","2022-07-11","2023-01-11","2021-08-29","2022-01-15","2021-06-07","2022-07-03","2022-07-13","2022-06-24","2022-07-25","2023-01-04","2021-04-29","2021-06-08","2021-11-03","2022-01-12","2022-06-08","2022-01-19","2022-10-17","2023-01-11","2023-01-11","2021-03-01","2021-06-08","2022-06-08","2022-07-03","2022-07-06"],"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":[["","16729013800","CLONAZEPAM","2 MG","40","Select","Select",""],["","70436001102","BUPROPN HCL","TAB 300MG XL","30","Select","Select",""],["","51991031190","DESVENLAFAX","TAB 50MG ER","30","Select","Select",""],["","00591354260","BUPROPION","TAB 200MG SR","28","Select","Select",""],["","00406889401","AMPHET\/DEXTR","TAB 30MG","60","Select","Select",""],["","55111016330","OLANZAPINE","TAB 2.5MG","14","Select","Select",""],["","68462013701","OXCARBAZEPIN","TAB 150MG","60","Select","Select",""],["","64764072030","TRINTELLIX","TAB 5MG","30","Select","Select",""],["","31722082730","ARIPIPRAZOLE","10 MG","30","Select","Select",""],["","50111056101","TRAZODONE","TAB 100MG","30","Select","Select",""],["","16714008310","HYDROXYZ HCL","TAB 50MG","30","Select","Select",""],["","80681008600","MELATONIN","TAB 3MG","112","Select","Select",""],["","65862019299","FLUOXETINE","CAP 10MG","30","Select","Select",""],["","65757030001","VIVITROL","INJ 380MG","1","Select","Select",""],["","42847010630","SILENOR","TAB 6MG","14","Select","Select",""],["","49483034010","ACETAMIN","TAB 325MG","20","Select","Select",""],["","62332063831","DOXEPIN HCL","CAP 25MG","14","Select","Select",""],["","10702010101","METHYLPHENID","TAB 10MG","6","Select","Select",""],["","65162036111","FOLIC ACID","TAB 1MG","7","Select","Select",""],["","64380080807","IBUPROFEN","TAB 600MG","20","Select","Select",""],["","00115180401","HYDROXYZ PAM","CAP 50MG","30","Select","Select",""],["","13107008501","LORAZEPAM","TAB 2MG","30","Select","Select",""],["","50268085115","VITAMIN B1","TAB 100MG","14","Select","Select",""],["","65862015901","ZOLPIDEM","TAB 5MG","30","Select","Select",""],["","67877014801","TEMAZEPAM","CAP 7.5MG","30","Select","Select",""],["","57844013001","ADDERALL","TAB 30MG","60","Select","Select",""],["","59417010610","VYVANSE","60 MG","30","Select","Select",""],["","68382005001","MELOXICAM","TAB 7.5MG","30","Select","Select",""],["","80777027399","MODERNA VAC","INJ COVID-19","0","Select","Select",""],["","82607066026","FLOWFLEX","KIT TEST","8","Select","Select",""],["","57237007730","ONDANSETRON","TAB 4MG ODT","20","Select","Select",""],["","00378210001","LOPERAMIDE","CAP 2MG","12","Select","Select",""],["","00904530660","BANOPHEN","CAP 25MG","2","Select","Select",""],["","00172572860","FAMOTIDINE","TAB 20MG","15","Select","Select",""],["","45802091987","CETIRIZINE","TAB 10MG","10","Select","Select",""],["","31604002674","VITAMIN D","3 50 MCG","14","Select","Select",""],["","00173068220","VENTOLIN HFA","AER ","18","Select","Select",""],["","00555015902","CHLORDIAZEP","CAP 25MG","9","Select","Select",""],["","70436001104","BUPROPION XL","300 MG","30","Select","Select",""],["","00093406701","PRAZOSIN HCL","1 MG","30","Select","Select",""],["","50228018001","GABAPENTIN","300 MG","90","Select","Select",""],["","62756018488","OXCARBAZEPINE","300 MG","28","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":""}]}]}