{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LE DEMAHOMIUOIDDAH ","gend":0,"add":"UQSUS 3735RD ANNAHE","city":"VIRGINIA BEACH","state":"VA","zip":"23462-9998","dob":"1954-01-01","age":"","mstatus":"","insh":"3417120*89","cliId":"","pno":"7275756867","cno":"","email":"","ename":"","eno":"","pphy":"RODGERS, PATRICIA DO","ppno":5407869771,"pcpadd":"12006 KILARNEY DRIVE","pcpcity":"FREDERICKSBURG","pcpstate":"VA","pcpzip":"22408-9998","pcpcounty":"","pcpid":"","pcpname":"MARY WASHINGTON HEALTHCARE PHYSICIANS","plan":"OHP","program":"ACA","lob":"Individual","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":["Z94.0","I10.","Z71.9"],"date":["2023-04-04","2023-04-04","2023-04-04"],"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":[["","65862059801","TAMSULOSIN","CAP 0.4MG","30","Select","Select",""],["","00093735201","CALCITRIOL","CAP 0.25MCG","15","Select","Select",""],["","50111039701","HYDRALAZINE","TAB 100MG","90","Select","Select",""],["","67877019905","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","57896070310","IRON","TAB 325MG","90","Select","Select",""],["","00143992950","CIPROFLOXACN","TAB 750MG","14","Select","Select",""],["","00406012305","HYDROCO\/APAP","TAB 5-325MG","15","Select","Select",""],["","60258016001","RENA-VITE","TAB ","29","Select","Select",""],["","00536730001","NEPHRO-VITE","TAB ","90","Select","Select",""],["","60432053716","NYSTATIN","SUS 100000","420","Select","Select",""],["","11822316500","RA","CAP 100MG","90","Select","Select",""],["","60505258009","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","67877021901","CEPHALEXIN","CAP 500MG","2","Select","Select",""],["","51293062601","PHENOBARB","TAB 32.4MG","30","Select","Select",""],["","60505296507","MYCOPHENOLIC","TAB 180MG DR","240","Select","Select",""],["","59746017206","PREDNISONE","5 MG","60","Select","Select",""],["","16729004101","TACROLIMUS","0.5 MG","180","Select","Select",""],["","60505258008","ATORVASTATIN CALCIUM","40 MG","90","Select","Select",""],["","16729026129","MYCOPHENOLIC ACID","180 MG","180","Select","Select",""],["","67877084210","FAMOTIDINE","20 MG","90","Select","Select",""],["","68382013210","TAMSULOSIN HCL","0.4 MG","30","Select","Select",""],["","69097012805","AMLODIPINE BESYLATE","10 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":""}]}]}