{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"HTEBAZILEAZRAG G ","gend":1,"add":"           NL SNIBBOR 214                         ","city":"VIRGINIA BEACH           ","state":"VA","zip":"23452-9998","dob":"1981-04-27","age":"","mstatus":"","insh":"10119229","cliId":"","pno":"1675724867","cno":7579955835,"email":"","ename":"","eno":"","pphy":"HAMBAZ, NASSER","ppno":7576717777,"pcpadd":"4876 BAXTER RD,","pcpcity":"Virginia Beach","pcpstate":"VA","pcpzip":234624404,"pcpcounty":"","pcpid":"","pcpname":"FIRST CHOICE MEDICAL CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"TIDEWATER","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"412 ROBBINS LN                                    ","madd2":"                                                  ","madd3":"","mcity":"VIRGINIA BEACH           ","mstate":"VA","mzip":"23452-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.9","F41.1","F43.10","F39","Z76.0","G43.709","M54.2","Z79.899","F33.2","F43.12","F90.0","L70.9","Z71.9","M79.18","G44.86","I10","E78.5","G43.009"," "],"date":["2022-11-29","2022-11-29","2022-11-29","2022-03-22","2022-03-22","2022-12-01","2022-10-20","2022-07-29","2022-08-29","2022-08-29","2022-08-29","2022-05-16","2022-05-16","2022-08-01","2022-08-01","2022-10-14","2022-10-14","2022-10-20","2022-12-01"],"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":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"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":[["","27241005103","ARIPIPRAZOLE","TAB 2MG","30","Select","Select",""],["","43975035003","PALIPERIDONE","TAB ER 3MG","30","Select","Select",""],["","00093506201","HYDROXYZ","TAB 50MG","30","Select","Select",""],["","68180032002","BUPROPN","TAB 300MG XL","30","Select","Select",""],["","00093354756","ATOMOXETINE","CAP 80MG","30","Select","Select",""],["","59267030402","PFIZER","INJ BA4\/BA5","0.3","Select","Select",""],["","31722072610","MONTELUKAST","TAB 10MG","90","Select","Select",""],["","16729013616","CLONAZEPAM","TAB 0.5MG","30","Select","Select",""],["","00472011745","TRETINOIN","CRE 0.00025","45","Select","Select",""],["","16729022616","SPIRONOLACT","TAB 50MG","270","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","12","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":""}]}]}