{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JANET   M AKERS","gend":1,"add":"7071 COLD HARBOR ROAD","city":"MECHANICSVILLE","state":"VA","zip":"23111-9998","dob":"1959-04-22","age":"","mstatus":"","insh":"900035828*01","cliId":"","pno":"804\/837-3248","cno":"","email":"","ename":"","eno":"","pphy":"FALCAO, RAQUEL APPA MD","ppno":"804\/764-1253","pcpadd":"8200 MEADOWBRIDGE ROAD","pcpcity":"MECHANICSVILLE","pcpstate":"VA","pcpzip":23116,"pcpcounty":"","pcpid":"","pcpname":"MEMORIAL MEDICAL CENTER","plan":"OHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/764-1259","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J96.11","J96.12","J44.9","J98.4","M79.89","M79.605","E78.00","E78.2","I26.99","J96.10","Z00.00","R35.0","M54.5","K21.9","J41.8","Z68.24","Z12.31","Z78.0","M81.0","Z13.820","E55.9","Z87.891","R94.2","M41.9","E66.3","R06.02","Z92.29","Z71.89","Z71.9","Z12.2","J44.1","Z68.25","L03.116","J43.9","I87.2","J41.1"],"date":["2021-09-04","2021-09-16","2021-12-10","2021-09-04","2021-09-16","2021-02-26","2021-03-16","2021-07-20","2020-05-30","2020-05-30","2019-08-13","2019-08-13","2019-11-18","2021-06-15","2019-11-18","2019-08-13","2021-08-23","2021-08-23","2021-08-23","2021-08-23","2021-08-23","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2021-05-12","2021-05-12","2021-05-12","2021-05-12","2021-08-23","2020-03-12","2020-03-12","2021-02-26","2021-06-15","2021-07-20","2021-07-20"],"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":[]}]},{"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":[["","68645014059","FAMOTIDINE                                                            ","20MG","90","Select","Select",""],["","68645056854","ATORVASTATIN CALCIUM                                                  ","40MG","90","Select","Select",""],["","66993058597","FLUTICASONE PROPIONATE\/SALMETEROL DISKUS                              ","250\/50","180","Select","Select",""],["","63304061650","DOXYCYCLINE MONOHYDRATE                                               ","100MG","14","Select","Select",""],["","00597007541","SPIRIVA HANDIHALER                                                    ","HANDIHLR","90","Select","Select",""],["","59746017509","PREDNISONE                                                            ","20MG","15","Select","Select",""],["","00487020103","IPRATROPIUM BROMIDE\/ALBUTEROL SULFATE                                 ","ALBUTER","90","Select","Select",""],["","49035065082","EQ FAMOTIDINE MAXIMUM STRENGTH                                        ","20MG","90","Select","Select",""],["","49281072010","FLUBLOK QUADRIVALENT 2020-2021                                        ","2020-21","0","Select","Select",""],["","59310057922","PROAIR HFA                                                            ","","8","Select","Select",""],["","67877021905","CEPHALEXIN                                                            ","500MG","-40","Select","Select",""],["","43547040111","FUROSEMIDE                                                            ","20MG","30","Select","Select",""],["","58160082311","SHINGRIX                                                              ","50\/0.5ML","1","Select","Select",""],["","42806054701","VITAMIN D                                                             ","1.25MG","12","Select","Select",""],["","49281072110","FLUBLOK QUADRIVALENT 2021-2022                                        ","2021-22","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":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"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":""}]}]}