{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ABDELAZIZ   M ABDOU","gend":0,"add":"614 DRESDEN DR","city":"NEWPORT NEWS","state":"VA","zip":"23601-9998","dob":"1954-09-20","age":"","mstatus":"","insh":"20022816*01","cliId":"","pno":"757\/591-0291","cno":"","email":"","ename":"","eno":"","pphy":"REMCHUK, DEBORAH M MD","ppno":"757\/594-1803","pcpadd":"SUITE 140 11803 JEFFERSON AVE","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":23606,"pcpcounty":"","pcpid":"","pcpname":"SENTARA MEDICAL GROUP","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/510-9225","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.39","I10.","E78.00","R71.8","Z11.4","Z12.5","Z00.00","Z79.4","E11.42","R60.0","M14.671","I83.11","M14.672","R26.81","R29.6","E10.3512","H43.12","H33.051","H17.9","Z12.11","E11.65","R80.9","N18.2","E55.9","M47.816","M51.36","M17.12","M75.42","M79.661","I70.201","I70.202","M79.662","I73.9"],"date":["2019-03-07","2019-03-15","2019-03-07","2019-03-07","2019-03-07","2019-03-07","2019-03-15","2019-03-07","2019-04-29","2019-04-29","2019-04-29","2019-04-29","2019-04-29","2019-03-18","2019-03-18","2019-04-04","2019-04-04","2019-04-04","2019-04-04","2019-03-15","2019-03-15","2019-03-15","2019-03-15","2019-03-15","2019-04-25","2019-04-25","2019-04-25","2019-04-25","2019-03-28","2019-04-15","2019-04-15","2019-03-28","2019-03-28"],"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":[]},{"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":[["","91237000117","EASY","MIS EJECT","1","Select","Select",""],["","08463520350","INFINITY","TES BLD GLUC","50","Select","Select",""],["","60505317007","OMEGA-3-ACID","CAP 1GM","360","Select","Select",""],["","91237000128","ALCOHOL","PAD ","200","Select","Select",""],["","59762444002","METHYLPRED","TAB 4MG","21","Select","Select",""],["","70010077001","METHOCARBAM","TAB 750MG","30","Select","Select",""],["","16729018317","HYDROCHLOROT","TAB 25MG","90","Select","Select",""],["","00088221905","LANTUS","INJ 100\/ML","15","Select","Select",""],["","68180051701","LISINOPRIL","TAB 40MG","30","Select","Select",""],["","00002879959","HUMALOG","INJ 100\/ML","15","Select","Select",""],["","65862052301","GABAPENTIN","TAB 600MG","60","Select","Select",""],["","53885027150","ONETOUCH","TES VERIO","100","Select","Select",""],["","00169633910","NOVOLOG","INJ FLEXPEN","15","Select","Select",""],["","31604002585","VITAMIN","CAP 2000UNIT","90","Select","Select",""],["","16729000615","SIMVASTATIN","TAB 40MG","30","Select","Select",""],["","70461031803","FLUCLVX","INJ 2018-19","0","Select","Select",""],["","68196893101","PEN  NEEDLES","MIS 31GX3\/16","100","Select","Select",""],["","45802041954","AMMONIUM","LOT 0.12","150","Select","Select",""],["","00168084401","DICLOFENAC","GEL 0.03","100","Select","Select",""],["","00168020437","LIDOCAINE","OIN 0.05","35","Select","Select",""],["","00781711783","CALCIPOTRIEN","CRE 0.00005","120","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":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"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":""}]}]}