{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"GAY   A VOLMY","gend":1,"add":"1422 OLIVER AVE","city":"CHESAPEAKE","state":"VA","zip":"23324-9998","dob":"1959-08-12","age":"","mstatus":"","insh":"900046167*01","cliId":"","pno":"757\/305-8292","cno":"","email":"","ename":"","eno":"","pphy":"MUSSELMANI, ZATTAM MD","ppno":"757\/543-3557","pcpadd":"1422 POINDEXTER ST","pcpcity":"CHESAPEAKE","pcpstate":"VA","pcpzip":23324,"pcpcounty":"","pcpid":"","pcpname":"ZATTAM MUSSELMANI","plan":"OHP","program":"MEDICARE","lob":"DSNP","region":"TIDEWATER","aligned":"Y","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/543-0053","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.42","E11.52","I73.9","I10.","T81.30XD","T81.30XA","M86.172","E11.51","M87.077","M79.675","Z89.412","H54.8","L97.529","F17.210","Z72.0","H40.1133","H04.123","G54.7","E11.9","F17.200","R31.21","H16.122","H04.121","H04.122"],"date":["2021-10-22","2021-05-13","2021-08-10","2021-05-26","2021-09-14","2021-07-16","2021-10-22","2021-10-22","2021-06-22","2021-06-22","2021-06-22","2021-10-22","2021-08-10","2021-08-10","2021-08-10","2021-12-06","2021-12-06","2021-07-16","2021-05-26","2021-05-26","2021-05-26","2021-09-13","2021-12-06","2021-12-06"],"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":[["","33342002208","LEVOFLOXACIN                                                          ","500MG","5","Select","Select",""],["","60432083704","BROMFED DM                                                            ","","120","Select","Select",""],["","65862042005","SULFAMETHOXAZOLE\/TRIMETHOPRIM DS                                      ","800-160","10","Select","Select",""],["","00006027731","JANUVIA                                                               ","100MG","90","Select","Select",""],["","69097081307","GABAPENTIN                                                            ","100MG","90","Select","Select",""],["","68180098103","LISINOPRIL                                                            ","20MG","30","Select","Select",""],["","55111019630","CLOPIDOGREL                                                           ","75MG","90","Select","Select",""],["","70727049725","RHOPRESSA                                                             ","0.02%","2","Select","Select",""],["","68382009401","CARVEDILOL                                                            ","12.5MG","60","Select","Select",""],["","65862029490","ROSUVASTATIN CALCIUM                                                  ","10MG","60","Select","Select",""],["","00065414727","SIMBRINZA                                                             ","1-0.2%","8","Select","Select",""],["","68645030059","METFORMIN HYDROCHLORIDE                                               ","1000MG","60","Select","Select",""],["","64380080807","IBUPROFEN                                                             ","600MG","90","Select","Select",""],["","68180072103","AMLODIPINE BESYLATE                                                   ","10MG","30","Select","Select",""],["","60758088010","FLUOROMETHOLONE                                                       ","0.1% OP","10","Select","Select",""],["","00023916360","RESTASIS                                                              ","0.05%","-180","Select","Select",""],["","00781183120","AMOXICILLIN\/CLAVULANATE POTASSIUM                                     ","500-125","14","Select","Select",""],["","00069046856","CHANTIX                                                               ","0.5MG","60","Select","Select",""],["","00527163201","TRIAMTERENE\/HYDROCHLOROTHIAZIDE                                       ","37.5-25","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":""}]}]}