{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CARLYSLE   P CAESAR","gend":0,"add":"5101 MONTPELIER ST","city":"HENRICO","state":"VA","zip":"23231-9998","dob":"1925-06-13","age":"","mstatus":"","insh":"900039836*01","cliId":"","pno":"804\/236-8007","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":["R40.4","R55.","R77.8","F03.91","R41.82","R41.0","F03.90","G30.9","F02.80","B35.1","I73.9","L84.","G93.40","D32.9","R91.1","J18.9","Z20.828","H04.123","H02.105","H02.102","Z96.1","Z20.822","G93.9","R90.89","M79.674","M79.675","N40.1","N39.41","R07.89","I50.9","G93.89","I67.82","E66.09","L72.0","R93.0","Z09.","G45.9"],"date":["2021-07-19","2021-07-16","2021-07-20","2021-07-19","2021-07-20","2021-07-19","2021-08-05","2021-07-19","2021-07-19","2021-09-20","2021-09-20","2021-09-20","2021-07-20","2021-07-20","2021-07-20","2021-11-01","2021-10-28","2021-03-12","2021-03-12","2021-03-12","2021-03-12","2021-07-17","2021-07-19","2021-07-19","2021-02-10","2021-02-10","2021-08-05","2020-09-10","2021-07-17","2021-07-17","2021-07-17","2021-07-19","2021-07-19","2021-02-03","2021-07-19","2021-08-05","2021-08-05"],"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":[["","43547027503","DONEPEZIL HYDROCHLORIDE                                               ","5MG","90","Select","Select",""],["","69315011710","FUROSEMIDE                                                            ","40MG","90","Select","Select",""],["","00245531915","KLOR-CON M20                                                          ","20MEQ ER","90","Select","Select",""],["","68382013210","TAMSULOSIN HYDROCHLORIDE                                              ","0.4MG","180","Select","Select",""],["","68462045535","CICLOPIROX                                                            ","0.77%","30","Select","Select",""],["","55111015834","OMEPRAZOLE                                                            ","20MG","90","Select","Select",""],["","16729009016","FINASTERIDE                                                           ","5MG","90","Select","Select",""],["","68180063609","ATORVASTATIN CALCIUM                                                  ","20MG","90","Select","Select",""],["","65862064169","AZITHROMYCIN                                                          ","250MG","6","Select","Select",""],["","67877021560","CEFUROXIME AXETIL                                                     ","250MG","20","Select","Select",""],["","43547027603","DONEPEZIL HCL                                                         ","10MG","90","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":""}]}]}