{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"FREDDY MURIEL","gend":0,"add":"1785 S HAYES ST REGENCY CARE OF ARLINGTON","city":"ARLINGTON","state":"VA","zip":"22202-9998","dob":"1959-02-26","age":"","mstatus":"","insh":"20047588*01","cliId":"","pno":"703\/894-8956","cno":"703\/894-8956","email":"","ename":"","eno":"","pphy":"MATHUR, NAVDEEP MD","ppno":"571\/379-8827","pcpadd":"SUITE 101 8428 DORSEY CIRCLE","pcpcity":"MANASSAS","pcpstate":"VA","pcpzip":20110,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"888\/224-4936","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E55.9","U07.1","M62.81","M79.2","D64.9","R11.2","F10.19","M24.541","G93.41","M24.542","G62.1","Z91.81","M25.561","Z23.","G47.00","E87.6","F03.90","E78.5","F32.9","F33.9","I10.","R14.3","E11.9","R26.9","Z78.9","F10.10","Z86.69","Z20.828"],"date":["2022-10-01","2021-01-16","2022-09-16","2022-10-01","2022-10-01","2020-09-30","2021-12-01","2022-10-01","2022-09-16","2022-10-01","2022-10-01","2021-12-01","2022-10-01","2022-10-01","2022-10-01","2021-12-01","2022-08-18","2022-08-18","2022-08-18","2022-10-01","2022-09-16","2020-05-01","2022-09-16","2020-10-18","2020-10-18","2020-10-18","2020-10-18","2021-01-06"],"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":[["","16729016801","ESCITALOPRAM","TAB 5MG","30","Select","Select",""],["","68180047802","SIMVASTATIN","TAB 10MG","30","Select","Select",""],["","59267100002","PFIZER","INJ COVID-19","0","Select","Select",""],["","30768015745","MELATONIN","TAB 5MG","30","Select","Select",""],["","74312013329","FISH","CAP 1200MG","120","Select","Select",""],["","00761055520","VITAMIN","TAB 100MG","30","Select","Select",""],["","77333098310","ZINC","CAP 220MG","30","Select","Select",""],["","43386091710","POT  CHLORIDE","TAB 20MEQ ER","12","Select","Select",""],["","62037099905","POT  CL MICRO","TAB 20MEQ ER","12","Select","Select",""],["","52800048846","LUBRIDERM","LOT SCENTED","473","Select","Select",""],["","68462041827","LIDOCAINE","OIN 0.05","50","Select","Select",""],["","52817031910","BACLOFEN","TAB 5MG","60","Select","Select",""],["","65162010111","GABAPENTIN","CAP 100MG","60","Select","Select",""],["","67877025180","TRIAMCINOLON","CRE 0.001","80","Select","Select",""],["","00536103601","VITA-BEE\/C","TAB ","30","Select","Select",""],["","10939089844","SM","TAB WITH C","30","Select","Select",""],["","67457094901","HEPARIN","INJ 5000\/ML","28","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":""}]}]}