{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JOHN   R LEMLEY","gend":0,"add":"4323 TOWANDA ROAD","city":"CHESAPEAKE","state":"VA","zip":"23325-9998","dob":"1968-04-26","age":"","mstatus":"","insh":"1602767*01","cliId":"","pno":"757\/289-4738","cno":"757\/289-4738","email":"","ename":"","eno":"","pphy":"RILES JR, NATHAN L MD","ppno":"757\/424-4442","pcpadd":"6632 INDIAN RIVER RD","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":23464,"pcpcounty":"","pcpid":122066,"pcpname":"Nowcare Medical Associates","plan":"OHP","program":"ACA","lob":"Individual","region":"TIDEWATER","aligned":"","ano":"757\/289-4738","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I48.91","I10.","I42.9","F10.10","I50.22","I48.0","R06.02","I50.9","R55.","I48.19","I11.0","Z79.01","Z79.899","R07.9","I42.0","E66.01","Z68.35","R07.89","R06.00","Z09.","I48.11","H54.7","Z87.891","I51.7","R53.83","R06.09","I42.8","Z20.828","M22.41"],"date":["2021-01-20","2020-02-27","2020-01-23","2020-01-23","2021-01-20","2020-09-24","2020-01-20","2020-01-21","2020-01-21","2021-01-13","2021-01-20","2021-01-20","2021-01-20","2020-01-20","2021-01-13","2020-09-24","2020-09-24","2021-01-13","2021-01-13","2020-02-27","2020-01-22","2020-01-20","2020-01-22","2020-01-21","2020-01-29","2020-01-29","2020-09-09","2020-05-29","2021-07-09"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}},{"a":[]}]},{"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":[]}]},{"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":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","68382009301","CARVEDILOL","6.25MG","-120","Select","Select",""],["","00003089421","ELIQUIS","5MG","60","Select","Select",""],["","68382022714","AMIODARONE","200MG","30","Select","Select",""],["","00078065920","ENTRESTO","24-26MG","-60","Select","Select",""],["","33342006207","VALSARTAN","40MG","30","Select","Select",""],["","59746021601","SPIRONOLACT","25MG","30","Select","Select",""],["","00245014760","PACERONE","200MG","90","Select","Select",""],["","68382009301","CARVEDILOL ","6.25MG","120","Select","Select",""],["","00078065920","ENTRESTO ","24-26MG","60","Select","Select",""],["","00003089421","ELIQUIS ","5MG","-60","Select","Select",""],["","33342006207","VALSARTAN ","40MG","30","Select","Select",""],["","68382022705","AMIODARONE ","200MG","40","Select","Select",""],["","59746021601","SPIRONOLACT ","25MG","30","Select","Select",""],["","00245014760","PACERONE ","200MG","-90","Select","Select",""]]}},{"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":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[[["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""]]]},{"t":"Mini-Cog","q":[{"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":""}]}]}