{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"   IRREHSRENSOC L","gend":1,"add":"SDER 1001EVA TRAT","city":"CHESAPEAKE","state":"VA","zip":"23324-9998","dob":"1963-03-27","age":"","mstatus":"","insh":"85200210*71","cliId":"","pno":"69\/7576999-9","cno":"","email":"","ename":"","eno":"","pphy":"MUSSELMANI, ZATTAM MD","ppno":"757\/543-3557","pcpadd":"1422 POINDEXTER ST","pcpcity":"CHESAPEAKE","pcpstate":"VA","pcpzip":23324,"pcpcounty":"","pcpid":"","pcpname":"ZATTAM MUSSELMANI","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","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":["G89.29","M54.16","M47.816","M79.7","F11.20","G89.4","G43.719","M06.9","Z79.891","NO DATA","M51.36","M54.5","M62.838","G24.3","R50.9","J44.9","Z72.0","R05.","M15.9","M19.041","M19.042","N76.0","M25.529","M62.830","J44.1","E66.9","F17.200","R07.9","R06.00","R06.01","M25.50","Z79.899","F11.23","Z68.41","J06.9","J45.909"],"date":["2021-02-26","2021-02-26","2021-01-29","2021-02-26","2021-04-26","2021-12-17","2021-12-17","2021-12-17","2021-12-17","2021-12-17","2021-12-17","2021-09-21","2021-12-17","2021-12-17","2021-01-18","2019-11-25","2019-11-25","2019-11-25","2021-05-07","2021-05-07","2021-05-07","2021-05-07","2021-09-21","2021-09-21","2021-01-18","2021-01-18","2021-01-18","2021-01-12","2021-01-12","2021-01-12","2019-11-21","2019-11-21","2019-11-21","2019-11-21","2019-04-23","2019-04-23"],"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":[["","","DOK"," DOK ","60","Select","Select",""],["","","OXYCOD\/APAP"," OXYCOD\/APAP ","120","Select","Select",""],["","","METHADONE"," METHADONE ","270","Select","Select",""],["","","ALBUTEROL"," ALBUTEROL ","8","Select","Select",""],["","","PREDNISONE"," PREDNISONE ","21","Select","Select",""],["","","VENTOLIN"," VENTOLIN ","18","Select","Select",""],["","","PROVENTIL"," PROVENTIL ","7","Select","Select",""],["","","FOLIC"," FOLIC ","30","Select","Select",""],["","","METHOCARBAM"," METHOCARBAM ","90","Select","Select",""],["","","NARCAN"," NARCAN ","2","Select","Select",""],["","","FLUCONAZOLE"," FLUCONAZOLE ","1","Select","Select",""],["","","METAXALONE","TAB 800MG","","Select","Select",""],["","","PROAIR","AER ","","Select","Select",""],["","","GABAPENTIN","CAP 300MG","","Select","Select",""],["","","DULOXETINE","CAP 30MG","","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":""}]}]}