{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"   EILLASREGGUD A","gend":1,"add":"OB OP525 X","city":"LAWRENCEVILLE","state":"VA","zip":"23868-9998","dob":"1956-08-09","age":"","mstatus":"","insh":"76200210*22","cliId":"","pno":"48\/4342124-8","cno":"","email":"","ename":"","eno":"","pphy":"ACKERMAN, CHRISTOPHER J MD","ppno":"434\/848-0771","pcpadd":"203 SHARP ST","pcpcity":"LAWRENCEVILLE","pcpstate":"VA","pcpzip":23868,"pcpcounty":"","pcpid":"","pcpname":"LAWRENCEVILLE PRIMARY CARE PC","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":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R07.89","I10.","E78.5","R00.2","R30.0","R35.0","R19.5","K62.5","D50.9","K21.9","Z80.0","M06.4","I87.2","G43.109","R10.9","E66.3","J45.20","I78.1","R94.39","Z01.812","Z20.822","R09.1","K64.8","K29.60","M43.6","M25.512","I51.7","H25.13","H40.023","H52.4","A04.8","K59.04","K57.30","R07.9","N39.9","Z86.19","M79.604","M79.605","R22.43","M79.606","R22.40","E87.6","F32.9","N17.9","K27.9","F41.9","Z79.899","J45.909","N89.8","I45.81","Z04.9","I11.9","I44.4","Z87.19","T50.2X5A","E66.9","Z68.33","G47.33","R06.00","R53.83","J15.9","M81.0","R31.9"],"date":["2021-11-17","2021-11-17","2021-11-17","2021-10-27","2021-02-26","2021-02-26","2021-02-26","2021-03-30","2021-10-12","2021-03-30","2021-03-30","2021-12-03","2021-05-14","2021-08-21","2021-08-21","2021-11-17","2021-12-20","2021-05-14","2020-10-15","2021-04-12","2021-04-12","2020-09-11","2021-07-12","2021-04-16","2020-06-12","2020-06-12","2020-08-06","2021-03-02","2021-03-02","2021-03-02","2021-07-12","2021-10-12","2021-10-12","2020-09-11","2021-09-20","2021-10-12","2021-12-16","2021-12-16","2021-12-16","2021-12-16","2021-12-16","2019-10-12","2019-10-12","2019-10-12","2019-10-12","2019-10-12","2019-10-12","2019-12-19","2019-06-25","2019-10-12","2019-10-12","2019-08-22","2019-10-12","2019-10-12","2019-10-12","2019-10-12","2019-10-12","2019-10-12","2019-11-06","2019-11-06","2019-09-30","2019-09-30","2019-11-25"],"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":[["","00378235193","ESOMEPRA","CAP 40MG DR","30","Select","Select",""],["","29300014901","QUETIAPINE","TAB 100MG","30","Select","Select",""],["","16729018201","HYDROCHLOROT","TAB 12.5MG","30","Select","Select",""],["","58160082311","SHINGRIX","INJ 50\/0.5ML","1","Select","Select",""],["","23155076701","TETRACYCLINE","CAP 500MG","28","Select","Select",""],["","59762135001","RIFABUTIN","CAP 150MG","28","Select","Select",""],["","65862019301","FLUOXETINE","CAP 20MG","30","Select","Select",""],["","31722071390","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","61442012201","FAMOTIDINE","TAB 40MG","60","Select","Select",""],["","60505017009","PRAVASTATIN","TAB 40MG","30","Select","Select",""],["","","LORATADINE","TAB 10MG","","Select","Select",""],["","45802086803","POLYETH","POW 3350 NF","510","Select","Select",""],["","80777027398","MODERNA","INJ COVID-19","0","Select","Select",""],["","69097081307","GABAPENTIN","CAP 100MG","30","Select","Select",""],["","00456120130","LINZESS","CAP 145MCG","30","Select","Select",""],["","00832712311","DIVALPROEX","TAB 250MG DR","60","Select","Select",""],["","70461012103","FLUAD","INJ 2021-22","0","Select","Select",""],["","00093220301","METOCLOPRAM","TAB 10MG","8","Select","Select",""],["","68462010340","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","59746017206","PREDNISONE","TAB 5MG","50","Select","Select",""],["","16714043901","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","65162068210","PHENAZOPYRID","TAB 200MG","4","Select","Select",""],["","","CYCLOBENZAPR","TAB 5MG","","Select","Select",""],["","","SMZ\/TMP","TAB 800-160","","Select","Select",""],["","","BACLOFEN","TAB 5MG","","Select","Select",""],["","67877032105","IBUPROFEN","TAB 800MG","20","Select","Select",""],["","","IPRATROPIUM\/","SOL ALBUTER","","Select","Select",""],["","","LACTULOSE","SOL 10GM\/15","","Select","Select",""],["","","PROAIR","AER ","","Select","Select",""],["","27241011003","RANITIDINE","CAP 300MG","30","Select","Select",""],["","","DICLOFENAC","TAB 25MG DR","","Select","Select",""],["","58160089652","FLUARIX","INJ 2019-20","0","Select","Select",""],["","","ALBUTEROL","AER HFA","","Select","Select",""],["","00093322308","ESTRADIOL","TAB 10MCG","14","Select","Select",""],["","11822511120","RA","TAB 5MG","30","Select","Select",""],["","65862018601","CLINDAMYCIN","CAP 300MG","14","Select","Select",""],["","74312015745","MELATONIN","CAP 5MG","30","Select","Select",""],["","50111078766","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","00006483703","PNEUMOVAX","INJ 25\/0.5","0","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":""}]}]}