{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JOHN   T HARRELL","gend":0,"add":"1203 DECATUR ST APT 3","city":"CHESAPEAKE","state":"VA","zip":"23324-9998","dob":"1961-09-23","age":"","mstatus":"","insh":"20042853*01","cliId":"","pno":"757\/270-7153","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":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","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":["I71.03","Z98.890","I72.3","Z86.79","I71.01","I10.","F17.210","I70.1","Z79.899","Z79.02","Z79.82","Z23.","Z01.810","Z01.812","R94.31","Z20.828","I71.6","I71.2","Z48.89","Z95.2","R69.","T82.330A","F17.200","I71.02","Z29.9","I25.10","I73.9","I71.1","Q27.1","S35.229S","I71.4","R50.9","H25.13","H52.01","H52.223","H52.4"],"date":["2021-10-26","2021-10-26","2021-10-26","2021-10-26","2020-12-28","2021-02-04","2020-12-28","2020-12-28","2020-12-28","2020-12-28","2020-12-28","2020-12-28","2020-12-28","2020-12-28","2020-12-28","2020-12-28","2020-12-29","2020-09-02","2020-08-25","2020-08-25","2021-01-07","2020-08-24","2021-02-04","2020-12-28","2020-08-24","2021-02-04","2021-02-04","2021-02-04","2021-02-04","2021-02-04","2021-09-08","2020-08-20","2019-07-24","2019-07-24","2019-07-24","2019-07-24"],"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":[["","43547035410","LISINOPRIL","TAB 20MG","30","Select","Select",""],["","67877019905","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","27808015601","ROSUVASTATIN","TAB 10MG","30","Select","Select",""],["","64380073406","HYDRALAZINE","TAB 25MG","180","Select","Select",""],["","","LABETALOL","TAB 200MG","","Select","Select",""],["","","BRILINTA","TAB 90MG","","Select","Select",""],["","80777027399","MODERNA","INJ COVID-19","0","Select","Select",""],["","","HYDROCO\/APAP","TAB 5-325MG","","Select","Select",""],["","00069046856","CHANTIX","TAB 0.5MG","56","Select","Select",""],["","","OXYCOD\/APAP","TAB 5-325MG","","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":""}]}]}