{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" YMALLAH","gend":1,"add":"OB OP434 X","city":"CALLAO","state":"VA","zip":"22435-9998","dob":"1976-09-23","age":"","mstatus":"","insh":"24500210*09","cliId":"","pno":"54\/4081401-0","cno":"804\/450-1041","email":"","ename":"","eno":"","pphy":"AZZAM, YAHYA DO","ppno":"804\/529-6141","pcpadd":"17452 RICHMOND RD","pcpcity":"CALLAO","pcpstate":"VA","pcpzip":22435,"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":["K04.7","L72.3","M47.816","M79.7","F17.210","M89.49","Z68.35","R19.7","R11.0","L03.115","L97.212","Z79.899","V58.89","M51.36","E66.9","M54.5","J01.90","R05.","Z20.828","F41.8","J40.","H66.90","NO DATA","R53.83","R61.","S63.501A","R20.0","R20.2","S81.801S","M79.604","Z22.322","L03.031","L03.032","L02.612","F43.10","E78.2","Z12.31","S30.0XXA","W01.0XXA","Y93.E5","R09.89","R05.9","R07.9","R53.82","M54.42","M54.41","G89.29","C44.90","F41.9","E78.5","E55.9","Z11.59","E87.6","J10.1","J01.40","K21.9","F32.9","F51.01","M79.641","M79.642","R23.2","Z82.61","H00.015","L85.3","D48.5","S81.801A","F41.0","Z72.0","I08.1","H66.002","H60.502","R11.2","R10.9","L97.912","G43.019","R21.","Z11.52","H83.09","R09.81","R60.0","J30.89","S96.911A","W19.XXXA","H66.001","N92.6","M25.531","H10.32","T74.91XA","Y07.499"],"date":["2022-06-24","2021-01-18","2022-07-05","2021-08-11","2022-07-05","2021-08-11","2022-06-24","2021-09-10","2021-09-10","2021-12-02","2022-01-26","2022-07-05","2022-02-16","2022-06-24","2022-06-24","2020-07-13","2022-09-15","2021-02-24","2020-12-16","2022-07-05","2021-02-24","2021-05-06","2022-10-14","2022-06-21","2021-05-06","2021-06-08","2021-06-08","2021-06-08","2021-12-30","2021-12-30","2021-12-16","2021-10-23","2021-11-03","2021-11-03","2022-08-03","2022-02-28","2022-08-03","2022-03-15","2022-03-15","2022-03-15","2022-04-25","2022-04-25","2022-07-05","2022-08-23","2022-07-05","2022-07-05","2022-07-05","2022-07-05","2022-10-14","2022-08-03","2022-08-03","2022-08-03","2022-08-03","2020-01-17","2020-06-19","2022-06-02","2020-07-13","2020-07-13","2020-07-13","2020-07-13","2020-07-13","2020-07-13","2021-08-23","2021-08-23","2021-08-23","2022-02-16","2022-04-26","2022-06-24","2022-06-24","2020-09-29","2020-07-31","2021-07-29","2021-07-29","2022-02-09","2020-01-08","2021-04-01","2021-09-07","2021-09-07","2021-09-07","2022-06-02","2022-08-23","2022-08-29","2022-08-29","2020-02-06","2020-09-29","2021-06-08","2021-06-11","2022-10-14","2022-10-14"],"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":[["","68382039801","POT  CHLORIDE","TAB 20MEQ ER","90","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","10","Select","Select",""],["","71921017209","VENLAFAXINE","CAP 37.5 ER","30","Select","Select",""],["","00054429731","FUROSEMIDE","TAB 20MG","90","Select","Select",""],["","00456112030","VIIBRYD","TAB 20MG","90","Select","Select",""],["","00378395005","ATORVASTATIN","TAB 10MG","30","Select","Select",""],["","59762040101","SUCRALFATE","TAB 1GM","270","Select","Select",""],["","65862067799","ALPRAZOLAM","TAB 0.5MG","60","Select","Select",""],["","68382080510","TRAZODONE","TAB 50MG","60","Select","Select",""],["","00143993905","AMOXICILLIN","CAP 500MG","30","Select","Select",""],["","00093216568","NALOXONE","SPR ","2","Select","Select",""],["","65862056090","PANTOPRAZOLE","TAB 40MG","90","Select","Select",""],["","64380080707","IBUPROFEN","TAB 800MG","180","Select","Select",""],["","31722088290","ROSUVASTATIN","TAB 5MG","90","Select","Select",""],["","68462015813","ONDANSETRON","TAB 8MG ODT","20","Select","Select",""],["","00406051205","OXYCOD\/APAP","TAB 5-325MG","10","Select","Select",""],["","27808003502","HYDROCO\/APAP","TAB 5-325MG","15","Select","Select",""],["","00591352530","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","62037099901","POT  CL MICRO","TAB 20MEQ ER","30","Select","Select",""],["","16729044315","BUPROPN","TAB 150MG XL","90","Select","Select",""],["","55111017915","TIZANIDINE","TAB 2MG","60","Select","Select",""],["","68180029506","DULOXETINE","CAP 30MG","30","Select","Select",""],["","57237004105","PENICILLN","TAB 500MG","40","Select","Select",""],["","69097081312","GABAPENTIN","CAP 100MG","60","Select","Select",""],["","63304069301","CLINDAMYCIN","CAP 300MG","28","Select","Select",""],["","00781808926","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","28","Select","Select",""],["","57237000299","HYDROCHLOROT","CAP 12.5MG","30","Select","Select",""],["","65862050320","AMOX\/K","TAB 875-125","14","Select","Select",""],["","64380071206","BENZONATATE","CAP 100MG","42","Select","Select",""],["","00472037915","CLOTRIM\/BETA","CRE DIPROP","15","Select","Select",""],["","13668044101","CELECOXIB","CAP 100MG","60","Select","Select",""],["","00574402435","ERYTHROMYCIN","OIN 5MG\/GM","4","Select","Select",""],["","16571020150","DICLOFENAC","TAB 75MG DR","60","Select","Select",""],["","69097015915","MELOXICAM","TAB 15MG","30","Select","Select",""],["","00591544305","PREDNISONE","TAB 20MG","11","Select","Select",""],["","62756052169","SUMATRIPTAN","TAB 50MG","18","Select","Select",""],["","10702000350","PROMETHAZINE","TAB 25MG","15","Select","Select",""],["","60758018805","GENTAMICIN","SOL 0.3% OP","15","Select","Select",""],["","61314064705","TOBRA\/DEXAME","SUS 0.3-0.1%","5","Select","Select",""],["","57237000511","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","69238126601","OSELTAMIVIR","CAP 75MG","10","Select","Select",""],["","00115180401","HYDROXYZ","CAP 50MG","30","Select","Select",""],["","52817033200","CYCLOBENZAPR","TAB 10MG","30","Select","Select",""],["","65162062711","TRAMADOL","TAB 50MG","20","Select","Select",""],["","68382091634","METHYLPRED","TAB 4MG","21","Select","Select",""],["","61314064610","NEO\/POLY\/HC","SOL 1% OTIC","10","Select","Select",""],["","59746012106","MECLIZINE","TAB 25MG","21","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":""}]}]}