{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JOHN W MOSS","gend":0,"add":"25921 WEAKLY RD","city":"PETERSBURG","state":"VA","zip":"23803-9998","dob":"1958-02-13","age":"","mstatus":"","insh":"900039688*01","cliId":"","pno":"804\/862-4974","cno":"","email":"","ename":"","eno":"","pphy":"JIN, XIAO H MD","ppno":"804\/732-0648","pcpadd":"15 GOODRICH AVE","pcpcity":"PETERSBURG","pcpstate":"VA","pcpzip":23805,"pcpcounty":"","pcpid":"","pcpname":"XIAO HONG JIN","plan":"OHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"N","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/861-6846","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K80.20","R10.84","R10.11","Z86.16","J20.9","Z12.11","E11.9","I10.","E78.5","J30.9","K81.0","E86.0","R11.0","I12.9","N18.9","R53.83","R11.2","M79.673","E11.621","M54.9","H04.123","Z01.812","Z20.822","K80.51","E78.00","Z12.5","D51.9","K57.30","K64.8","M54.5","R10.9","K59.09","K81.1","K80.10","U07.1","J45.909","E66.9","Z83.3","Z82.49","Z79.899","Z79.84","Z80.0","Z00.01","R10.10","E03.9","R79.9","G89.3","R97.8","E11.49","L85.1","B35.1","K80.50","K83.8","F70.","F28."],"date":["2020-12-26","2020-12-28","2020-08-26","2021-02-01","2021-02-01","2021-05-23","2021-10-07","2021-08-24","2021-08-24","2021-05-26","2020-12-28","2020-12-26","2020-12-26","2020-12-26","2020-12-26","2020-12-26","2020-12-26","2021-10-07","2021-10-07","2021-10-07","2021-10-07","2021-03-15","2021-03-15","2021-03-05","2021-10-07","2021-10-07","2021-10-07","2021-03-19","2021-03-19","2020-08-31","2020-12-26","2020-08-31","2020-08-31","2020-12-28","2021-01-25","2021-03-05","2021-03-05","2021-03-05","2021-03-05","2021-03-19","2021-03-05","2020-12-28","2021-01-13","2021-01-13","2021-05-26","2021-05-26","2021-05-26","2021-05-26","2021-07-26","2021-07-26","2021-07-26","2021-03-05","2021-03-05","2021-05-20","2021-05-20"],"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":[["","00121087316","LACTULOSE ","10GM\/15","-900","Select","Select",""],["","68180098103","LISINOPRIL ","20MG","90","Select","Select",""],["","00378032701","HALOPERIDOL ","5MG","-45","Select","Select",""],["","68382014005","TOPIRAMATE ","100MG","60","Select","Select",""],["","70461032003","FLUCELVAX QUADRIVALENT 2020-2021 ","2020-21","0","Select","Select",""],["","57237007710","ONDANSETRON ODT ","4MG ODT","10","Select","Select",""],["","64380080707","IBUPROFEN ","800MG","180","Select","Select",""],["","50111033402","METRONIDAZOLE ","500MG","21","Select","Select",""],["","74312019377","VITAMIN D3 ","5000UNIT","30","Select","Select",""],["","70377000415","SIMVASTATIN ","40MG","-90","Select","Select",""],["","65862053750","LEVOFLOXACIN ","500MG","7","Select","Select",""],["","00597015337","JARDIANCE ","25MG","60","Select","Select",""],["","11917007478","VITAMIN C\/ROSE HIPS TR ","1000MG","30","Select","Select",""],["","65862064290","AZITHROMYCIN ","500MG","5","Select","Select",""],["","74312002060","ZINC ","50MG","60","Select","Select",""],["","43386006019","GAVILYTE-C ","","4000","Select","Select",""],["","45802041954","AMMONIUM LACTATE ","12%","-225","Select","Select",""],["","16571040250","CETIRIZINE HYDROCHLORIDE ","10MG","90","Select","Select",""],["","65862001705","AMOXICILLIN ","500MG","15","Select","Select",""],["","00378718705","METFORMIN HYDROCHLORIDE ","1000MG","180","Select","Select",""],["","00006027731","JANUVIA ","100MG","90","Select","Select",""],["","60505014202","GLIPIZIDE ","10MG","90","Select","Select",""],["","47469016068","MELATONIN ","3MG","60","Select","Select",""],["","00169430713","RYBELSUS ","7MG","90","Select","Select",""],["","31722072690","MONTELUKAST SODIUM ","10MG","90","Select","Select",""],["","00310621030","FARXIGA ","10MG","90","Select","Select",""],["","68462019005","NAPROXEN ","500MG","60","Select","Select",""],["","11917011701","ARTIFICIAL TEARS ","TEARS","30","Select","Select",""],["","69452015120","VITAMIN D ","50000UNT","12","Select","Select",""],["","70461032103","FLUCELVAX QUADRIVALENT 2021-2022 ","2021-22","0","Select","Select",""],["","49281012165","FLUZONE HIGH-DOSE PF 2021-2022 ","2021-22","-1","Select","Select",""],["","11917020061","ANEFRIN NASAL SPRAY\/NO DRIP ","0.05%","15","Select","Select",""],["","00031875718","ROBITUSSIN COUGH+CHEST CONGESTION DM ","20-200","300","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":""}]}]}