{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"L   AIRAMYAWNEERG ","gend":1,"add":"IHW S 7012RD LLIHET","city":"PETERSBURG","state":"VA","zip":"23803-9998","dob":"1980-09-06","age":"","mstatus":"","insh":"08600210*30","cliId":"","pno":"98\/4081712-5","cno":"804\/895-2171","email":"","ename":"","eno":"","pphy":"AHMED, IRSHAD MD","ppno":"804\/524-0524","pcpadd":"STE B 2801 BOULEVARD","pcpcity":"COLONIAL HEIGHTS","pcpstate":"VA","pcpzip":23834,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.8","F41.9","M54.5","R03.0","M51.36","Z98.1","N84.0","N92.0","Z01.818","A63.0","NO DATA","G89.29","R00.1","Z04.9","R42.","R53.1","N93.9","M54.16","M54.41","Z98.890","Z20.828","J18.9","Z01.419","Z12.72","F32.1","Z20.822","G89.4","F17.200","M43.16","M51.14","S46.811A","G57.11","Y93.89","M51.16","M96.1","S91.114A","J32.9","B96.89","F17.210","R09.81","R51.9","M54.17","M54.6","Z79.899","Z09.","Z01.812","S80.11XA","R60.0","K59.00","J45.909","K59.09","S16.1XXA","Z79.1","S67.192S","L85.8","L82.1","R60.9","J69.8","R26.9","S00.411A","H92.09","Z68.28","M54.40","M51.06","N76.0","E66.9","Z68.30","Z23.","V58.89","Z48.00","S91.119A","Z48.02","M54.9","M54.42","Z88.2","Z88.1","M54.31","M62.830","M62.838","R19.7","R20.2","R06.02","M79.89","R09.89"],"date":["2020-09-03","2020-09-03","2021-06-23","2020-09-03","2022-08-16","2022-11-21","2021-12-30","2021-12-30","2021-12-21","2021-12-30","2022-05-04","2022-05-04","2022-05-20","2022-05-20","2021-04-04","2021-04-04","2021-04-04","2022-08-17","2021-08-03","2021-08-03","2021-08-29","2022-05-20","2021-11-09","2021-11-09","2021-11-22","2022-05-20","2022-10-11","2022-05-04","2022-02-09","2022-02-09","2022-05-04","2022-05-04","2022-05-04","2022-08-16","2022-10-11","2020-08-08","2021-06-13","2021-06-13","2021-12-27","2021-06-13","2021-06-13","2022-07-11","2022-05-04","2022-09-14","2022-03-22","2022-02-07","2022-05-20","2022-05-20","2022-05-20","2022-05-20","2022-05-20","2021-02-01","2021-02-01","2021-07-13","2021-07-13","2021-08-05","2022-05-20","2022-05-20","2022-08-17","2021-12-27","2021-12-27","2022-01-18","2022-02-09","2022-08-16","2022-09-28","2022-09-28","2022-09-28","2022-09-28","2020-08-11","2020-08-11","2020-08-11","2020-08-17","2020-08-17","2021-06-23","2021-06-23","2021-06-23","2022-05-04","2022-05-04","2022-05-04","2022-05-04","2022-05-04","2022-05-20","2022-05-20","2022-05-20"],"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":[["","69097068205","PREGABALIN","CAP 150MG","60","Select","Select",""],["","00406051205","OXYCOD\/APAP","TAB 5-325MG","15","Select","Select",""],["","00406055201","OXYCODONE","TAB 5MG","14","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","00093216568","NALOXONE","SPR ","2","Select","Select",""],["","00406012305","HYDROCO\/APAP","TAB 5-325MG","10","Select","Select",""],["","70010075401","METHOCARBAM","TAB 500MG","40","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","10","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","55111018015","TIZANIDINE","TAB 4MG","30","Select","Select",""],["","16571020210","DICLOFENAC","TAB 50MG DR","30","Select","Select",""],["","52817033010","CYCLOBENZAPR","TAB 5MG","42","Select","Select",""],["","64380080807","IBUPROFEN","TAB 600MG","30","Select","Select",""],["","00591352530","LIDOCAINE","PAD 0.05","10","Select","Select",""],["","69097096507","NABUMETONE","TAB 500MG","60","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","00456074613","AERCHMBR","MIS LRG MASK","1","Select","Select",""],["","63824005632","MUCINEX","TAB 30-600ER","20","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","20","Select","Select",""],["","08373982700","OPTICHAMBER","MIS DIA LG","1","Select","Select",""],["","27241009803","DULOXETINE","CAP 30MG","30","Select","Select",""],["","00781185220","AMOX\/K","TAB 875-125","28","Select","Select",""],["","57237007710","ONDANSETRON","TAB 4MG ODT","10","Select","Select",""],["","00143980305","DOXYCYCL","CAP 100MG","14","Select","Select",""],["","52817019610","TRAMADOL","TAB 100MG","10","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","28","Select","Select",""],["","65862007701","CIPROFLOXACN","TAB 500MG","6","Select","Select",""],["","65862001305","SERTRALINE","TAB 100MG","30","Select","Select",""],["","00093506110","HYDROXYZ","TAB 25MG","28","Select","Select",""],["","00591544305","PREDNISONE","TAB 20MG","21","Select","Select",""],["","00115174801","METAXALONE","TAB 800MG","15","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":""}]}]}