{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DRAHCIRYRREB ","gend":0,"add":"NEF 0082EVA LLAD","city":"RICHMOND","state":"VA","zip":"23222-9998","dob":"1961-08-30","age":"","mstatus":"","insh":"98300210*57","cliId":"","pno":"89\/4088459-6","cno":"804\/325-9419","email":"","ename":"","eno":"","pphy":"BHAT, SHRIDHAR V M D","ppno":"804\/780-2610","pcpadd":"STE 304 110 N ROBINSON","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":23220,"pcpcounty":"","pcpid":"","pcpname":"CENTER FOR INTERNAL MEDICINE HYPERTENSION KIDNEY DISEASE INC","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":["M25.561","M25.461","M25.512","Z87.81","M79.672","M79.671","M79.641","M79.642","I10.","G89.4","S62.90XS","M25.642","F11.20","S62.304D","S62.306D","V54.12","S62.91XA","Z23.","M25.641","Z73.6","W20.8XXD","L90.5","V58.89","W31.2XXD","T14.8XXA","K11.20","K04.7","S61.211A","S61.203A","W31.2XXA","Z00.00","E78.5","E03.9","E55.9","J44.9","R11.0","S61.412A","X58.XXXA","V54.11","S60.352A","F17.210","S61.311A","S61.313A","Y99.0","Y92.89","Y93.89","S62.604A","S62.606A","M79.644","R20.2"],"date":["2019-10-14","2019-10-14","2021-12-13","2019-10-14","2020-10-29","2020-10-29","2021-12-13","2021-10-29","2021-12-13","2021-12-27","2021-10-18","2021-10-18","2021-12-27","2021-07-06","2021-07-06","2021-09-14","2021-05-04","2021-05-19","2021-09-14","2021-08-24","2021-08-24","2021-08-24","2021-11-17","2021-11-17","2021-11-17","2020-05-23","2020-05-23","2021-10-29","2021-10-29","2021-10-29","2021-09-27","2021-09-27","2021-09-27","2021-09-27","2021-09-27","2021-09-27","2021-11-04","2021-11-04","2019-06-27","2021-09-09","2021-09-09","2021-10-22","2021-10-22","2021-10-22","2021-10-22","2021-10-22","2021-04-28","2021-04-28","2021-09-14","2021-09-14"],"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":{"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":[["","","DICLOFENAC"," DICLOFENAC ","60","Select","Select",""],["","","ATORVASTATIN"," ATORVASTATIN ","30","Select","Select",""],["","","CLINDAMYCIN","CAP 150MG","","Select","Select",""],["","","CHLORHEX","SOL 0.0012","","Select","Select",""],["","","IBUPROFEN","TAB 600MG","","Select","Select",""],["","","VITAMIN","CAP 50000UNT","","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":""}]}]}