{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"WALTER   SAMUEL ODIPO","gend":0,"add":"669 WESTMINSTER REACH","city":"SMITHFIELD","state":"VA","zip":"23430-9998","dob":"1939-12-30","age":"","mstatus":"","insh":"1733804*01","cliId":"","pno":"757\/390-0619","cno":"757\/390-0619","email":"","ename":"","eno":"","pphy":"SONI, PARIMAL J MD","ppno":"757\/483-3560","pcpadd":"SUITE E 3802 POPULAR HILL RD","pcpcity":"CHESAPEAKE","pcpstate":"VA","pcpzip":23321,"pcpcounty":"","pcpid":113361,"pcpname":"","plan":"OHP","program":"ACA","lob":"Individual","region":"TIDEWATER","aligned":"","ano":"757\/268-1242","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/483-4239","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N31.9","R33.9","N31.2","N39.0","K59.09","I10.","I48.91","D64.9","K59.00","R10.84","K59.03","R10.9","E55.9","E53.8","R73.03","K59.2","G60.3","Z68.27","N40.0","G47.00","M54.9","M47.816","Z78.9","R79.0","E03.9","K62.89","Z68.30","R82.81","R31.29","R80.9","E07.9","G52.9","R73.09","G62.9","R73.01","K62.9","M48.061","M48.07","M51.16","M46.06","Z98.890","M51.17","R20.8","R27.9"],"date":["2021-11-01","2021-11-01","2021-01-21","2021-10-06","2021-11-03","2021-11-03","2020-04-14","2020-03-31","2020-08-26","2020-08-26","2020-08-26","2020-08-26","2021-08-16","2021-08-16","2021-04-28","2021-05-21","2021-05-21","2021-05-21","2021-10-06","2021-02-08","2021-02-08","2021-05-21","2021-01-21","2021-04-28","2021-11-03","2020-05-18","2020-05-18","2020-10-08","2020-10-08","2020-10-08","2021-04-28","2020-11-17","2020-11-17","2020-11-17","2020-03-31","2020-04-14","2021-01-14","2021-01-14","2021-01-14","2021-01-14","2021-01-14","2021-01-14","2021-01-14","2021-11-03"],"priorHcc":[null,null,"",null,null,null,"","","","","","","","","","","","",null,"","","","","",null,"","","","","","","","","","","","","","","","","","",null]}},{"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":[["","00406048401","APAP\/CODEINE","300-30MG","28","Select","Select",""],["","42799011002","ALBENDAZOLE","200MG","10","Select","Select",""],["","68180072003","AMLODIPINE","5MG","90","Select","Select",""],["","00121057716","LACTULOSE","10GM\/15","450","Select","Select",""],["","55111046805","METOPROL","100MG ER","90","Select","Select",""],["","13811071910","NITROFURANTN","100MG","14","Select","Select",""],["","47781030801","NITROFUR","100MG","20","Select","Select",""],["","71093012204","GABAPENTIN","400MG","180","Select","Select",""],["","70700026894","FOSFOMYCIN","3GM","1","Select","Select",""],["","65162037210","OXYBUTYNIN","10MG ER","-90","Select","Select",""],["","49281012065","FLUZONE","PF 20-21","1","Select","Select",""],["","69238183001","LEVOTHYROXIN","25MCG","30","Select","Select",""],["","69452015120","VITAMIN","50000UNT","15","Select","Select",""],["","67877021620","CEFUROXIME","500MG","10","Select","Select",""],["","65862042001","SMZ\/TMP","800-160","20","Select","Select",""],["","00456430001","MONUROL","GRANULES","1","Select","Select",""],["","50111056103","TRAZODONE","100MG","90","Select","Select",""],["","00005197102","PREVNAR","","0","Select","Select",""],["","80777027399","MODERNA","COVID-19","0","Select","Select",""],["","55111046805","METOPROL ","100MG ER","30","Select","Select",""],["","68180072003","AMLODIPINE ","5MG","30","Select","Select",""],["","00406048401","APAP\/CODEINE ","300-30MG","-28","Select","Select",""],["","65862042001","SMZ\/TMP ","800-160","20","Select","Select",""],["","00121057716","LACTULOSE ","10GM\/15","450","Select","Select",""],["","42799011002","ALBENDAZOLE ","200MG","10","Select","Select",""],["","71093012204","GABAPENTIN ","400MG","180","Select","Select",""],["","47781030801","NITROFUR ","100MG","20","Select","Select",""],["","65162037210","OXYBUTYNIN ","10MG ER","-90","Select","Select",""],["","13811071910","NITROFURANTN ","100MG","14","Select","Select",""],["","49281012065","FLUZONE ","PF 20-21","1","Select","Select",""],["","67877021620","CEFUROXIME ","500MG","10","Select","Select",""],["","00005197102","PREVNAR ","","0","Select","Select",""],["","70700026894","FOSFOMYCIN ","3GM","1","Select","Select",""],["","00456430001","MONUROL ","GRANULES","1","Select","Select",""],["","50111056103","TRAZODONE ","100MG","90","Select","Select",""],["","80777027399","MODERNA ","COVID-19","0","Select","Select",""],["","69452015120","VITAMIN ","50000UNT","-15","Select","Select",""],["","69238183001","LEVOTHYROXIN ","25MCG","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","",""],["No","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":""}]}]}