{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JEAN E CAESAR","gend":1,"add":"5101 MONTPELIER ST","city":"HENRICO","state":"VA","zip":"23231-9998","dob":"1933-06-06","age":"","mstatus":"","insh":"900039835*01","cliId":"","pno":"917\/273-2667","cno":"","email":"","ename":"","eno":"","pphy":"AVULA, JONATHAN MD","ppno":"804\/226-2444","pcpadd":"8200 MEADOWBRIDGE RD STE 203","pcpcity":"MECHANICSVILLE","pcpstate":"VA","pcpzip":23116,"pcpcounty":"","pcpid":"","pcpname":"LABURNUM MEDICAL CENTER ","plan":"OHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/222-0458","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K56.600","N17.9","E11.21","I10.","E83.52","E78.5","Z88.6","Z88.8","Z79.4","Z79.899","Z90.49","R10.9","K56.609","R11.2","Z23.","Z09.","Z68.28","E11.69","I73.9","L30.9","E11.51","E11.3393","E11.59","Z00.00","I12.9","N18.31","Z87.19","N39.41","R41.3","R22.0","K14.6","R39.81","I87.2","Z20.828","B34.9","D64.9","R10.84","I87.331","J30.9","K13.0","K91.2","Z91.89","Z79.84","H25.13","B35.1","M48.061","K14.5","L60.0","M79.89","E11.42"],"date":["2020-11-12","2020-11-27","2021-02-17","2021-09-22","2020-11-12","2020-11-12","2020-11-12","2020-11-12","2021-10-21","2021-09-22","2020-11-12","2020-11-12","2020-11-27","2020-11-13","2021-09-22","2020-11-27","2021-09-22","2021-10-21","2021-09-22","2020-11-27","2021-06-17","2021-06-17","2021-06-17","2021-09-22","2021-09-22","2021-10-21","2021-09-22","2021-10-21","2021-10-21","2021-09-22","2021-10-21","2020-09-30","2021-10-21","2021-10-28","2021-10-28","2021-01-06","2020-11-12","2021-05-10","2021-02-17","2021-02-17","2021-05-26","2021-05-26","2020-10-29","2020-10-29","2021-09-20","2021-01-06","2021-01-06","2020-09-04","2021-05-10","2021-09-20"],"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":[["","68180012202","CEPHALEXIN ","500MG","28","Select","Select",""],["","00088221905","LANTUS SOLOSTAR ","100\/ML","9","Select","Select",""],["","31722052110","HYDRALAZINE HYDROCHLORIDE ","50MG","60","Select","Select",""],["","74312031644","ADVANCED PROBIOTIC 10 ","ADVANCED","30","Select","Select",""],["","68382013706","LOSARTAN POTASSIUM ","100MG","90","Select","Select",""],["","65862006399","METOPROLOL TARTRATE ","50MG","180","Select","Select",""],["","00172208380","HYDROCHLOROTHIAZIDE ","25MG","90","Select","Select",""],["","68180051703","LISINOPRIL ","40MG","90","Select","Select",""],["","00832003810","OXYBUTYNIN CHLORIDE ","5MG","48","Select","Select",""],["","57237007710","ONDANSETRON ODT ","4MG ODT","10","Select","Select",""],["","08290320122","BD PEN NEEDLE\/NANO\/ULTRA -FINE\/32G X 4MM ","32GX4MM","100","Select","Select",""],["","08396900718","PEN NEEDLES 32GX4MM ","32GX4MM","100","Select","Select",""],["","00904693181","PEG 3350 ","","30","Select","Select",""],["","43598081115","CETIRIZINE HYDROCHLORIDE ","10MG","30","Select","Select",""],["","45802004935","TRIAMCINOLONE ACETONIDE ","0.50%","30","Select","Select",""],["","62332054715","CLOBETASOL PROPIONATE ","0.05%","15","Select","Select",""],["","13668009390","PRAMIPEXOLE DIHYDROCHLORIDE ","0.5MG","60","Select","Select",""],["","53885004401","ONETOUCH VERIO FLEX BLOOD GLUCOSE MONITORING SYSTEM ","VERIO FL","-1","Select","Select",""],["","0"," ","","480","Select","Select",""],["","53885027210","ONETOUCH VERIO TEST STRIPS ","VERIO","200","Select","Select",""],["","75834002001","VITAMIN D3 ","50000UNT","8","Select","Select",""],["","13668011830","LOSARTAN POTASSIUM\/HYDROCHLOROTHIAZIDE ","100-25","90","Select","Select",""],["","68645047854","METOPROLOL SUCCINATE ER ","50MG ER","90","Select","Select",""],["","53191036201","D3-50 ","50000UNT","8","Select","Select",""],["","08290320550","BD PEN NEEDLE\/NANO 2ND GEN\/32G X 5\/32\" ","32GX5\/32","100","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":""}]}]}