{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"GUILLERMO   A ANGELES","gend":0,"add":"3349 SUNSET ROAD","city":"COLLINSVILLE                  ","state":"VA","zip":"24078-1568","dob":"2003-07-18","age":"","mstatus":"","insh":4396345,"cliId":"","pno":4342273892,"cno":"","email":"","ename":"","eno":"","pphy":"CHAN M PARK FAMILY PRACTICE","ppno":2769562047,"pcpadd":"6460 Greensboro Rd,","pcpcity":"Ridgeway                      ","pcpstate":"VA","pcpzip":241483478,"pcpcounty":"","pcpid":"","pcpname":"PARK MD CHAN M FAMILY PRACTICE","plan":"VPHP","program":"MEDICAID","lob":"MLTSS","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"3349 SUNSET ROAD","add3":"","madd1":"3349 SUNSET ROAD","madd2":"LOT 12","madd3":"","mcity":"COLLINSVILLE                  ","mstate":"VA","mzip":"24078-1568","pcpfaxno":"                    ","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J20.9","J02.9","R05","J01.90","J06.9","Z20.828","S92.411A","S93.111A","W20.8XXA","S99.921A","W22.8XXA","Y92.39","S93.101A","S92.411D","S97.81XA","S97.111A","Z98.890","R22.41","Z23","D49.89","C49.20","M79.604","M79.89","M79.10","M79.651","C80.1","R22.31","R51.9","M79.661","R50.9","G44.209","C49.21","Z20.822","R91.8","Z03.89","A41.9","C49.9","J18.9","R09.02","R50.81","R00.0","R59.0","R06.02","R94.31","C92.00","D48.5","J18.0","R20.0","R05.9","R06.09","Z99.81","I34.0","R26.89","C40.21","J98.11","J98.4","C41.9","Z68.54","A42.0","Z79.899","C78.01","G89.3","R11.2","T45.1X5A","R21","C78.02","C77.5","R91.1","Z51.11","C78.00","Z85.830","Z01.812","L98.8","L98.9","Z85.831","Z85.9","R53.83","R78.81","T80.219A","T80.212A","Y92.89","T80.211A","K75.9","A49.8","A42.9","T80.212D","A49.9","I38","Z45.2","Z79.2","Z79.891","L03.114","U07.1","R60.0","M79.602","L03.90","Y84.8","D84.821","D61.810","D61.818","T80.219D","A49.1","L08.9","L03.113","R16.0","F32.A","Z01.818"],"date":["2020-08-19","2020-08-19","2020-08-19","2020-08-19","2021-01-11","2021-01-11","2021-06-02","2021-04-07","2021-04-06","2021-04-06","2021-04-06","2021-04-06","2021-04-08","2021-06-02","2021-04-14","2021-04-21","2021-06-02","2021-10-13","2021-10-10","2021-09-15","2021-09-21","2021-10-10","2021-10-06","2021-10-09","2021-10-06","2021-10-09","2021-10-09","2021-10-09","2021-10-09","2022-01-24","2021-10-10","2022-03-01","2021-10-10","2022-03-03","2021-10-09","2021-10-13","2022-03-03","2021-10-13","2021-10-13","2021-10-13","2022-01-21","2021-10-10","2021-10-10","2021-10-10","2021-10-11","2021-10-11","2021-10-11","2021-10-11","2022-01-19","2021-10-11","2021-10-13","2021-10-12","2021-12-19","2022-03-28","2021-11-05","2021-11-05","2022-04-04","2022-02-08","2022-03-25","2021-11-10","2022-03-01","2022-03-01","2022-03-01","2022-03-01","2021-11-15","2022-01-20","2021-12-01","2021-11-16","2022-03-25","2022-02-17","2021-12-06","2021-12-21","2021-12-22","2021-12-22","2021-12-22","2021-12-22","2022-01-05","2022-01-07","2022-01-24","2022-02-02","2022-01-05","2022-01-05","2022-01-05","2022-01-06","2022-01-24","2022-01-07","2022-01-07","2022-01-08","2022-03-03","2022-02-17","2022-02-17","2022-02-17","2022-01-24","2022-01-20","2022-01-20","2022-01-20","2022-01-20","2022-01-20","2022-03-01","2022-01-20","2022-01-24","2022-01-24","2022-01-24","2022-03-25","2022-03-03","2022-03-25","2022-04-04"],"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":[["","65862042005","SMZ\/TMP","TAB 800-160","40","Select","Select",""],["","00115169449","EPINEPHRINE","INJ 0.3MG","2","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","30.00","Select","Select",""],["","59746011506","PROCHLORPER","TAB 10MG","30.00","Select","Select",""],["","67108356509","MESNEX","TAB 400MG","24.00","Select","Select",""],["","68462010630","ONDANSETRON","TAB 8MG","30.00","Select","Select",""],["","57237016199","OMEPRAZOLE","CAP 20MG","30.00","Select","Select",""],["","13107008305","LORAZEPAM","TAB 0.5MG","12.00","Select","Select",""],["","00093310905","AMOXICILLIN","CAP 500MG","180.00","Select","Select",""],["","65162018910","NAPROXEN","TAB 375MG","20.00","Select","Select",""],["","49483060450","IBUPROFEN","TAB 800MG","30.00","Select","Select",""],["","33342002332","LEVOFLOXACIN","TAB 750MG","21.00","Select","Select",""],["","24658031205","DOXYCYCL","TAB 100MG","20.00","Select","Select",""],["","66993068030","OLANZAPINE","TAB 2.5MG","30.00","Select","Select",""],["","50383066730","LIDO\/PRILOCN","CRE 2.5-2.5%","30.00","Select","Select",""],["","00054001925","PREDNISONE","TAB 50MG","6.00","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","28.00","Select","Select",""],["","45802048678","DOCUSATE","CAP 100MG","30.00","Select","Select",""],["","69547035302","NARCAN","SPR ","2.00","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":""}]}]}