{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"RICHARD   D SMALLWOOD","gend":0,"add":"2217 CHEMIN ROAD","city":"PETERSBURG","state":"VA","zip":"23805-9998","dob":"1965-04-20","age":"","mstatus":"","insh":"900039028*01","cliId":"","pno":"804\/733-0791","cno":"","email":"","ename":"","eno":"","pphy":"GEORGE, LEELAMMA MD","ppno":"804\/526-8640","pcpadd":"215 TEMPLE AVE","pcpcity":"COLONIAL HEIGHTS","pcpstate":"VA","pcpzip":23834,"pcpcounty":"","pcpid":"","pcpname":"LEELAMMA GEORGE MD","plan":"OHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/526-4321","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I11.0","I50.22","I42.8","Z95.810","Z87.891","E78.2","D72.829","Z12.5","Z12.11","Z72.0","I10.","R94.5","Z71.9","I50.9","I42.9","I44.7","F10.20","F32.0","K21.9","I48.92","J43.9","F41.1","F19.20","I25.10","I25.2","Z45.02","F33.1","S61.412A","F41.8","J44.9","R06.02","R91.8","E78.5","F17.210","Z71.6","Z45.09","G47.33","E53.8","E66.3","G47.30"],"date":["2021-06-29","2021-06-29","2021-06-29","2021-03-30","2021-03-30","2021-09-10","2021-09-01","2021-04-20","2021-05-23","2021-09-10","2021-09-10","2021-09-10","2021-09-10","2021-04-28","2021-11-11","2021-11-11","2021-06-29","2021-06-29","2021-06-29","2021-06-29","2021-06-29","2021-06-29","2021-06-29","2021-06-29","2021-06-29","2021-11-11","2021-03-23","2020-06-01","2020-06-01","2020-12-07","2020-09-08","2020-09-08","2020-12-22","2020-12-22","2020-12-22","2021-02-18","2020-08-18","2020-09-12","2020-09-12","2020-09-12"],"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":[["","45802002683","AZELASTINE HCL                                                        ","0.15%","30","Select","Select",""],["","63481068447","VOLTAREN                                                              ","1%","100","Select","Select",""],["","50111064801","FLUOXETINE HCL                                                        ","20MG","30","Select","Select",""],["","00378875006","DICLOFENAC SODIUM                                                     ","1%","100","Select","Select",""],["","68180098003","LISINOPRIL                                                            ","10MG","-90","Select","Select",""],["","45963067611","METOPROLOL SUCCINATE ER                                               ","50MG ER","90","Select","Select",""],["","69097084805","ESCITALOPRAM OXALATE                                                  ","10MG","-30","Select","Select",""],["","00173071520","ADVAIR HFA                                                            ","45\/21","12","Select","Select",""],["","00054429931","FUROSEMIDE                                                            ","40MG","90","Select","Select",""],["","68462013801","OXCARBAZEPINE                                                         ","300MG","60","Select","Select",""],["","55111012205","ATORVASTATIN CALCIUM                                                  ","20MG","90","Select","Select",""],["","53746051105","SPIRONOLACTONE                                                        ","25MG","45","Select","Select",""],["","69238110005","DOXYCYCLINE HYCLATE                                                   ","100MG","20","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":""}]}]}