{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BETTY   A SMITH","gend":1,"add":"120 HOWARD ST APT 3","city":"PORTSMOUTH","state":"VA","zip":"23707-9998","dob":"1958-08-26","age":"","mstatus":"","insh":"900045863*01","cliId":"","pno":"757\/391-2882","cno":"","email":"","ename":"","eno":"","pphy":"BHOWMIK, NIHAR MD","ppno":"757\/399-0701","pcpadd":"301 GOODE WAY #103","pcpcity":"PORTSMOUTH","pcpstate":"VA","pcpzip":23704,"pcpcounty":"","pcpid":"","pcpname":"BHOWMIK MEDICAL PRACTICE","plan":"OHP","program":"MEDICARE","lob":"DSNP","region":"TIDEWATER","aligned":"Y","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/399-3731","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.9","H25.813","H40.053","Z79.84","Z23.","I10.","F32.9","E78.00","F25.9","M17.0","Z68.36","Z12.31","Z12.11"],"date":["2021-11-16","2021-11-16","2021-11-16","2021-01-25","2021-06-02","2021-11-08","2021-11-08","2021-11-08","2021-11-08","2021-11-08","2021-11-08","2021-11-11","2021-05-23"],"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":[["","68180098003","LISINOPRIL                                                            ","10MG","90","Select","Select",""],["","68180072003","AMLODIPINE BESYLATE                                                   ","5MG","90","Select","Select",""],["","67877012450","SILVER SULFADIAZINE                                                   ","1%","50","Select","Select",""],["","69238115409","EZETIMIBE                                                             ","10MG","90","Select","Select",""],["","68382076010","METFORMIN HYDROCHLORIDE                                               ","1000MG","180","Select","Select",""],["","69097082112","GEMFIBROZIL                                                           ","600MG","180","Select","Select",""],["","00093727198","PIOGLITAZONE HYDROCHLORIDE                                            ","15MG","90","Select","Select",""],["","70377000712","ROSUVASTATIN CALCIUM                                                  ","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":""}]}]}