{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CHRISTINE   F JOHNSON","gend":1,"add":"3501 FORREST CT","city":"PORTSMOUTH","state":"VA","zip":"23707-9998","dob":"1940-03-15","age":"","mstatus":"","insh":"900045838*01","cliId":"","pno":"757\/397-3974","cno":"","email":"","ename":"","eno":"","pphy":"RAMOLIA, MANSUKHLAL R MD","ppno":"757\/483-6401","pcpadd":"4035 TAYLOR RD #K","pcpcity":"CHESAPEAKE","pcpstate":"VA","pcpzip":23321,"pcpcounty":"","pcpid":"","pcpname":"FIRST CARE PC","plan":"OHP","program":"MEDICARE","lob":"DSNP","region":"TIDEWATER","aligned":"N","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/686-3025","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I27.20","N18.30","H61.21","Z68.29","E89.0","I12.9","J84.10","I50.22","Z12.31","I42.0","I10.","E78.5","I45.2","Z68.25","Z68.26"],"date":["2021-10-07","2021-11-15","2021-10-07","2021-10-07","2021-06-11","2021-06-11","2021-06-03","2021-11-15","2021-10-15","2021-11-15","2021-11-15","2021-11-15","2021-11-15","2021-07-27","2021-11-15"],"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":[["","00054429931","FUROSEMIDE                                                            ","40MG","60","Select","Select",""],["","00074929690","SYNTHROID                                                             ","112MCG","30","Select","Select",""],["","64380071306","BENZONATATE                                                           ","200MG","30","Select","Select",""],["","00093729001","RALOXIFENE HYDROCHLORIDE                                              ","60MG","90","Select","Select",""],["","33342017910","OLMESARTAN MEDOXOMIL                                                  ","20MG","90","Select","Select",""],["","16729013401","ALLOPURINOL                                                           ","100MG","90","Select","Select",""],["","68462016405","CARVEDILOL                                                            ","12.5MG","-180","Select","Select",""],["","43547034050","RISPERIDONE                                                           ","0.5MG","30","Select","Select",""],["","16729000617","SIMVASTATIN                                                           ","40MG","90","Select","Select",""],["","00078077720","ENTRESTO                                                              ","49-51MG","60","Select","Select",""],["","59651000101","OMEPRAZOLE DR                                                         ","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":""}]}]}