{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"RETSEHCTTARP ","gend":0,"add":"TNRUB 3194EVIRD KAO ","city":"NORTH CHESTERFIEL        ","state":"VA","zip":"23234-2990","dob":"1965-03-12","age":"","mstatus":"","insh":"10111877","cliId":"","pno":"7204554213","cno":5404193947,"email":"","ename":"","eno":"","pphy":"QURESHI, SHABANA N","ppno":5716599387,"pcpadd":"5808 MAPLEDALE PLZ,","pcpcity":"Dale City","pcpstate":"VA","pcpzip":221934535,"pcpcounty":"","pcpid":"","pcpname":"EASY CARE URGENT CARE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"APT 204","add3":"","madd1":"4913 BURNT OAK DRIVE","madd2":"APT 204","madd3":"","mcity":"NORTH CHESTERFIEL        ","mstate":"VA","mzip":"23234-2990","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I20.9","I25.708","I10","E78.5","F31.70","M48.02","I65.21","Z68.41","E66.01","I20.8","Z72.0","M54.9","I25.110","R09.89","M25.512","M51.36","M54.51","M54.16","M51.34","M54.14","M47.816","M54.50","M79.18","R07.9","G89.4","R07.89","R06.02","I12.9","I25.10","I21.9","E11.22","N18.9","D69.6","F11.20","G89.29","M54.12","N17.9","F31.9","D51.9","E55.9","E11.9","E03.9","E78.00","N39.0","B18.2","B17.9","Z95.1","Z95.5","R06.00","R94.31","R00.1","G43.909","M50.222","M25.511","M53.3","M54.5","M46.1","J32.9","J34.2","F17.200","Z12.2","F17.210","H25.13","Z20.822","I50.30","E11.65","I45.10","M48.061","Z79.4","Z79.82","Z79.84","G57.11","M79.651","R07.2","T81.718A","I72.9","B35.6","M79.606","M54.2","G43.719","J98.09","J98.4","M79.604"],"date":["2022-09-23","2022-09-23","2022-09-23","2022-09-23","2022-09-23","2022-09-23","2022-09-23","2022-09-23","2022-09-23","2022-09-07","2022-09-07","2022-09-07","2022-09-06","2022-08-04","2022-10-25","2022-10-25","2022-10-25","2022-10-25","2022-10-25","2022-10-25","2022-10-25","2022-10-25","2022-10-25","2022-10-25","2022-10-25","2022-09-01","2022-07-15","2022-07-15","2022-09-07","2022-07-15","2022-09-01","2022-07-15","2022-07-15","2022-07-15","2022-09-01","2022-07-15","2022-07-15","2022-09-01","2022-08-18","2022-08-18","2022-09-07","2022-08-18","2022-08-18","2022-08-18","2022-08-18","2022-08-18","2022-09-06","2022-09-06","2022-08-23","2022-09-01","2022-09-01","2022-04-21","2022-07-14","2022-06-09","2021-04-14","2021-04-14","2021-04-14","2022-07-11","2022-07-11","2022-07-11","2022-08-15","2022-08-23","2022-06-28","2022-09-01","2022-09-01","2022-09-01","2022-09-01","2022-09-01","2022-09-01","2022-09-01","2022-09-01","2022-06-21","2022-06-21","2022-07-15","2022-04-06","2022-04-06","2022-04-06","2022-04-25","2022-07-14","2021-04-22","2022-07-16","2022-07-16","2022-04-06"],"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":[["","70710113908","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","33342011507","CANDESARTAN","TAB 8MG","180","Select","Select",""],["","53746051101","SPIRONOLACT","TAB 25MG","90","Select","Select",""],["","42858030101","HYDROMORPHON","TAB 2MG","12","Select","Select",""],["","67877056310","METFORMIN","TAB 1000MG","180","Select","Select",""],["","11534018701","BUT\/APAP\/CAF","CAP ","30","Select","Select",""],["","00093310905","AMOXICILLIN","CAP 500MG","21","Select","Select",""],["","00193731221","CONTOUR","TES NEXT","100","Select","Select",""],["","08290320550","BD  PEN NEEDL","MIS 32GX5\/32","30","Select","Select",""],["","00193658621","MICROLET","MIS LANCETS","100","Select","Select",""],["","00597015230","JARDIANCE","TAB 10MG","90","Select","Select",""],["","68180023209","FENOFIBRATE","TAB 160MG","90","Select","Select",""],["","65862035790","CLOPIDOGREL","TAB 75MG","90","Select","Select",""],["","68180072003","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","70377003012","ATORVASTATIN","TAB 80MG","30","Select","Select",""],["","00088221905","LANTUS","INJ 100\/ML","15","Select","Select",""],["","57599000101","FREESTYLE    KIT SENSOR","KIT SENSOR","2","Select","Select",""],["","76385011250","CARVEDILOL","TAB 12.5MG","180","Select","Select",""],["","47781022901","OXYCOD\/APAP","TAB 7.5-325","30","Select","Select",""],["","57664050318","TIZANIDINE","TAB 4MG","30","Select","Select",""],["","69238131109","PREGABALIN","CAP 50MG","30","Select","Select",""],["","59011041010","OXYCONTIN","TAB 10MG ER","60","Select","Select",""],["","57599000200","FREESTYLE    MIS READER","MIS READER","1","Select","Select",""],["","59267030402","PFIZER","INJ BA4\/BA5","0.3","Select","Select",""],["","43547040211","FUROSEMIDE","TAB 40MG","90","Select","Select",""],["","69238115409","EZETIMIBE","TAB 10MG","60","Select","Select",""],["","65862086001","FAMOTIDINE","TAB 40MG","90","Select","Select",""],["","70010077001","METHOCARBAM","TAB 750MG","60","Select","Select",""],["","42858080101","MORPHINE","TAB 15MG ER","60","Select","Select",""],["","00121087316","LACTULOSE","SOL 10GM\/15","400","Select","Select",""],["","43598043611","NITROGLYCERN","SUB 0.4MG","25","Select","Select",""],["","71930005552","APAP\/CODEINE","TAB 300-30MG","5","Select","Select",""],["","65162052110","PROMETHAZINE","TAB 25MG","20","Select","Select",""],["","00378911293","NITROGLYCER","DIS 0.4MG\/HR","30","Select","Select",""],["","68382037003","NYSTATIN","POW 100000","60","Select","Select",""],["","70461032203","FLUCLVX","INJ 2022-23","0.5","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":{"indx":[["","",""],[""],[""],[""],[""]],"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":""}]}]}