{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SAMDEO RAMLATCHAN","gend":0,"add":"3531 BUNYAN ROAD","city":"VIRGINIA BEACH","state":"VA","zip":"23462-9998","dob":"1978-11-17","age":"","mstatus":"","insh":"20073763*01","cliId":"","pno":7577527105,"cno":7577527105,"email":"","ename":"","eno":"","pphy":"VANDENHOFF, STEPHEN E MD","ppno":7573951700,"pcpadd":"3745 HOLLAND RD STE 200,","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":"23452-9998","pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Family Medicine Physicians - Chimney Hill","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7575079004,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F31.2","F31.30","F90.0","F40.10","K80.20","F25.0","F41.1","Z71.3","F34.0","Z00.00","J45.20","F31.60","Z86.19","E78.2","Z23.","G47.00","F31.81","F43.23","Z13.6","Z11.59","Z11.4","K21.9","K81.1","K80.12","R94.5","B18.2","R74.8","R10.13","R93.2","F31.9","N52.9"],"date":["2021-10-22","2023-09-13","2023-09-13","2023-09-13","2022-03-28","2022-06-09","2022-06-09","2023-08-24","2021-08-23","2022-05-02","2022-05-02","2022-05-02","2022-05-02","2022-05-02","2023-09-05","2023-01-18","2023-03-06","2023-03-06","2021-11-02","2021-11-02","2021-11-02","2023-04-21","2022-02-22","2022-03-28","2023-04-21","2023-04-21","2022-02-18","2022-02-18","2022-09-12","2021-08-07","2023-09-05"],"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":[["","61874011530","VRAYLAR","1.5 MG","30","Select","Select",""],["","00074262528","MAVYRET","TAB 100-40MG","84","Select","Select",""],["","00172572860","FAMOTIDINE","TAB 20MG","60","Select","Select",""],["","54092038701","ADDERALL XR","20 MG","60","Select","Select",""],["","23155025001","VENLAFAXINE","TAB 100MG","90","Select","Select",""],["","51672413101","LAMOTRIGINE","100 MG","30","Select","Select",""],["","00228306111","AMPHET\/DEXTR","CAP 30MG ER","30","Select","Select",""],["","00116200116","CHLORHEX GLU","SOL 0.0012","473","Select","Select",""],["","50111056001","TRAZODONE","TAB 50MG","30","Select","Select",""],["","31722094901","OXYCOD\/APAP","TAB 5-325MG","15","Select","Select",""],["","68462039610","OMEPRAZOLE","20 MG","30","Select","Select",""],["","11822331520","LORATADINE","10 MG","90","Select","Select",""],["","00093916301","VENLAFAXINE HCL","100 MG","90","Select","Select",""],["","00228306011","DEXTROAMPHETAMINE-AMPHET ER","20 MG","60","Select","Select",""],["","66993001968","ALBUTEROL SULFATE HFA","90 MCG","18","Select","Select",""],["","50111056001","TRAZODONE HCL","50 MG","30","Select","Select",""],["","00173071920","FLOVENT HFA","110 MCG","12","Select","Select",""],["","66993007996","FLUTICASONE PROPIONATE HFA","110 MCG","12","Select","Select",""],["","61874011530","VRAYLAR CAP","1.5MG","30","Select","Select",""],["","00172572860","FAMOTIDINE TAB","20MG","60","Select","Select",""],["","23155025001","VENLAFAXINE TAB","100MG","90","Select","Select",""],["","00074262528","MAVYRET TAB","100-40MG","84","Select","Select",""],["","54092038701","ADDERALL XR CAP","20MG","60","Select","Select",""],["","51672413101","LAMOTRIGINE TAB","100MG","90","Select","Select",""],["","00228306011","AMPHET\/DEXTR CAP","20MG ER","60","Select","Select",""],["","00116200116","CHLORHEX GLU SOL","0.12%","473","Select","Select",""],["","50111056001","TRAZODONE TAB","50MG","90","Select","Select",""],["","31722094901","OXYCOD\/APAP TAB","5-325MG","15","Select","Select",""],["","68462039610","OMEPRAZOLE CAP","20MG","30","Select","Select",""],["","31722071101","SILDENAFIL CITRATE","100 MG","10","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":""}]}]}