{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"   YELHSANAGROM N","gend":1,"add":"DOOW 503TS ENIB","city":"HOPEWELL","state":"VA","zip":"23860-9998","dob":"1988-02-05","age":"","mstatus":"","insh":"5512210*47","cliId":"","pno":"27\/4080908-1","cno":"","email":"","ename":"","eno":"","pphy":"AMIR, ABDUL MD","ppno":"804\/621-7262","pcpadd":"280 CHARLES H DIMMOCK PKWAY SUITE 2","pcpcity":"COLONIAL HEIGHTS","pcpstate":"VA","pcpzip":23834,"pcpcounty":"","pcpid":"","pcpname":"DOMINION HEART AND VASCULAR CLINIC","plan":"OHP","program":"MEDICAID","lob":"M4","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":["N99.4","G57.81","R10.2","G89.4","F31.9","G56.01","M65.4","F17.200","M54.5","M51.26","M47.817","M25.9","M54.9","E87.6","S20.01XA","R23.8","F32.2","I87.023","I87.2","I83.893","I83.813","M79.641","R30.0","N39.0","Z51.81","H00.014","F17.210","Z79.899","NO DATA","K31.89","R10.13","M79.2","K80.20","G89.29","R10.9","E66.9","J45.909","G43.909","Z68.35","Z90.49","Z98.890","R29.898","K80.12","Z20.822","Z88.0","Z88.1","Z88.6","Z90.710","Z98.891","K80.10","M54.41","K21.9","Z79.891","M25.531","S62.001A","V54.12","M25.641","T40.2X5A","I87.001","F41.8","T78.40XA","G89.18","N30.90","B37.0","N60.02","H00.024","H05.012","L02.92","Z86.14","Z76.89","H04.302","F41.9","H57.12","H00.034","R42.","M53.3","M54.17","S61.011A"],"date":["2020-07-07","2021-12-27","2021-12-27","2021-12-27","2021-12-03","2020-07-10","2020-07-10","2020-05-12","2021-09-09","2021-12-27","2021-09-10","2020-12-16","2021-12-03","2021-04-04","2021-07-15","2021-07-15","2021-07-15","2021-10-19","2021-11-11","2021-11-11","2021-11-11","2020-07-10","2020-10-01","2020-10-01","2020-10-22","2021-02-19","2021-12-03","2021-02-19","2021-09-09","2021-12-03","2021-12-03","2020-11-24","2021-11-12","2021-12-20","2021-11-11","2021-12-03","2021-12-03","2021-12-03","2021-12-03","2021-12-03","2021-12-03","2020-06-19","2021-11-12","2021-11-12","2021-11-12","2021-11-12","2021-11-12","2021-11-12","2021-11-12","2021-11-13","2021-12-20","2021-12-20","2021-12-27","2020-03-05","2020-03-05","2020-05-21","2020-05-21","2021-03-01","2021-11-11","2020-05-12","2020-05-12","2020-05-12","2020-09-17","2020-04-21","2020-04-21","2020-10-18","2020-10-18","2021-05-19","2021-05-19","2021-05-19","2020-09-05","2020-09-05","2020-09-05","2020-10-18","2020-10-18","2020-12-01","2021-11-03","2019-11-11"],"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":[["","00378110101","PRAZOSIN","CAP 1MG","90","Select","Select",""],["","","CLONIDINE"," CLONIDINE ","60","Select","Select",""],["","","OXYCODONE","TAB 10MG","","Select","Select",""],["","57841130101","MOVANTIK","TAB 25MG","30","Select","Select",""],["","","CYCLOBENZAPR","TAB 5MG","","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","14","Select","Select",""],["","","ZOLPIDEM"," ZOLPIDEM ","30","Select","Select",""],["","59779030603","CVS","POW ","510","Select","Select",""],["","","ALPRAZOLAM"," ALPRAZOLAM ","60","Select","Select",""],["","","TOPIRAMATE"," TOPIRAMATE ","120","Select","Select",""],["","","DOXYCYCL","CAP 100MG","","Select","Select",""],["","","XTAMPZA","CAP 18MG","","Select","Select",""],["","","FLUVOXAMINE","TAB 25MG","","Select","Select",""],["","","ONDANSETRON"," ONDANSETRON ","30","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0","Select","Select",""],["","00143992801","CIPROFLOXACN","TAB 500MG","14","Select","Select",""],["","","OMEPRAZOLE","CAP 40MG","","Select","Select",""],["","00781317307","SUMATRIPTAN","INJ 6MG\/0.5","2","Select","Select",""],["","45802086803","POLYETH","POW 3350 NF","510","Select","Select",""],["","","DOXYCYC","CAP 100MG","","Select","Select",""],["","","MORPHINE","TAB 15MG ER","","Select","Select",""],["","","OXYCOD\/APAP","TAB 10-325MG","","Select","Select",""],["","","ERYTHROMYCIN","OIN 5MG\/GM","","Select","Select",""],["","","OXYBUTYNIN","TAB 5MG","","Select","Select",""],["","","NITROFURANTN","CAP 100MG","","Select","Select",""],["","","CLOMIPHENE","TAB 50MG","","Select","Select",""],["","","NYSTATIN","SUS 100000","","Select","Select",""],["","","METHYLPRED","TAB 4MG","","Select","Select",""],["","","TIZANIDINE","TAB 4MG","","Select","Select",""],["","","PHENAZOPYRID","TAB 200MG","","Select","Select",""],["","","PYRIDIUM","TAB 200MG","","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":""}]}]}