{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DARRELL   N HOLMES","gend":0,"add":"1616 HEAD OF RIVER ROAD","city":"CHESAPEAKE","state":"VA","zip":"23322-9998","dob":"1960-03-10","age":"","mstatus":"","insh":"20029352*01","cliId":"","pno":"757\/421-9465","cno":"","email":"","ename":"","eno":"","pphy":"ISLAM, ANWARUL MD","ppno":"757\/547-4448","pcpadd":"637 KINGSBOROUGH SQ STE B","pcpcity":"CHESAPEAKE","pcpstate":"VA","pcpzip":23320,"pcpcounty":"","pcpid":"","pcpname":"ANWARUL ISLAM MD PC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/547-7557","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["D57.819","E87.5","D57.1","G89.4","C61.","Z76.5","Z71.6","E61.1","Z79.891","R06.02","R50.9","M16.11","M87.051","R00.0","D50.9","I10.","R80.9","Z23.","L85.3","F14.10","D57.00","N17.9","E86.0","NO DATA","M62.830","N18.4","M79.609","D64.9","Z71.89","M16.0","R06.00","N18.9","K04.7","E78.2","E78.1","M19.90","R31.9","R94.31","J30.9","H10.9","M79.604","M54.9","Z85.46","F14.90","M25.551","R51.9","F17.210","M62.838","N18.3","R07.9","N17.0","B34.9","I12.9","I44.4","H91.90","Z86.718","Z79.899","M87.851","M70.61","N52.37","R45.1","F41.9","D72.829","Z82.49","E87.6","R52.","M79.89","J06.9","Z87.01","Z83.3","M87.052","M16.7"],"date":["2019-02-24","2021-11-21","2021-11-23","2021-11-23","2021-10-14","2020-04-13","2020-04-13","2019-07-15","2021-11-23","2021-09-26","2020-05-28","2021-12-21","2021-11-12","2021-01-21","2021-10-14","2021-11-16","2021-03-18","2021-10-14","2021-07-12","2021-08-24","2021-11-22","2021-11-22","2021-11-18","2021-11-18","2020-09-22","2021-09-25","2020-09-26","2021-09-30","2021-03-15","2021-08-13","2021-09-25","2021-11-22","2020-05-05","2020-05-05","2020-05-05","2021-11-16","2020-12-17","2021-11-18","2019-07-16","2019-07-16","2021-06-01","2020-09-26","2021-11-18","2021-06-01","2021-06-01","2021-11-18","2021-11-18","2019-12-13","2019-10-17","2020-05-28","2020-05-28","2020-05-28","2021-11-18","2021-11-18","2021-11-18","2021-11-18","2021-11-18","2021-12-21","2021-12-21","2019-06-27","2019-10-10","2019-10-10","2021-11-18","2020-05-28","2019-02-22","2019-02-22","2019-02-22","2020-05-28","2020-05-28","2020-05-28","2021-10-01","2021-10-01"],"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":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"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":[["","","HYDROXYUREA"," HYDROXYUREA ","60","Select","Select",""],["","","FOLIC"," FOLIC ","90","Select","Select",""],["","","OXYCOD\/APAP"," OXYCOD\/APAP ","130","Select","Select",""],["","","VITAMIN"," VITAMIN ","4","Select","Select",""],["","","CLOTRIM\/BETA"," CLOTRIM\/BETA ","45","Select","Select",""],["","","IBUPROFEN"," IBUPROFEN ","20","Select","Select",""],["","","LORATADINE"," LORATADINE ","30","Select","Select",""],["","","CIPROFLOXACN"," CIPROFLOXACN ","20","Select","Select",""],["","","AMOXICILLIN"," AMOXICILLIN ","30","Select","Select",""],["","","TADALAFIL","TAB 20MG","","Select","Select",""],["","","AMMONIUM","LOT 0.12","","Select","Select",""],["","","FLUCLVX","INJ 2020-21","","Select","Select",""],["","","SHINGRIX","INJ 50\/0.5ML","","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":""}]}]}