{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" H  TTOCSMULBNESOR","gend":0,"add":" DR36 712A TINU TS","city":"VIRGINIA BEACH","state":"VA","zip":"23451-9998","dob":"1967-03-19","age":"","mstatus":"","insh":"0807410*19","cliId":"","pno":"9475737536","cno":7576210175,"email":"","ename":"","eno":"","pphy":"BARAKOTI, PRASHANT MD","ppno":7576276220,"pcpadd":"STE 100 400 W BRAMBLETON AVE","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":"23510-9998","pcpcounty":"","pcpid":"","pcpname":"VA Beach Internal Medicine","plan":"OHP","program":"ACA","lob":"Small Group","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["D68.9","R68.89","E78.5","R73.01","Z12.5","Z23.","K46.9","K42.9","D47.2","R73.03","D64.9","C88.0","Z00.00","G47.30","D12.6","E78.49","I10.","D68.00","Z02.83"],"date":["2022-02-03","2023-02-06","2023-06-15","2023-06-15","2023-06-15","2021-10-27","2021-10-27","2021-11-02","2023-02-09","2023-06-15","2023-06-15","2022-12-07","2023-06-21","2023-06-15","2022-12-07","2022-11-30","2022-11-30","2023-02-02","2023-06-21"],"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":[["","68180063609","ATORVASTATIN","TAB 20MG","90","Select","Select",""],["","64380073706","VITAMIN","CAP 50000UNT","6","Select","Select",""],["","58160089652","FLUARIX","INJ 2019-20","0","Select","Select",""],["","58160081912","SHINGRIX","INJ 50\/0.5ML","1","Select","Select",""],["","80777027398","MODERNA","INJ COVID-19","0","Select","Select",""],["","60505081500","DESMOPRESSIN SPR","0.01%","5","Select","Select",""],["","60505257809","ATORVASTATIN TAB","10MG","30","Select","Select",""],["","70461032203","FLUCLVX QUAD INJ","2022-23","0","Select","Select",""],["","59267030402","PFIZER BIVAL INJ BA","4\/BA5","0","Select","Select",""],["","63304082990","ATORVASTATIN CALCIUM","40 MG","90","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":""}]}]}