{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SIMEEN AHMADI","gend":1,"add":"27 MILHAVEN SQ","city":"HENRICO","state":"VA","zip":"23238-9998","dob":"1959-01-01","age":"","mstatus":"","insh":"20055155*01","cliId":"","pno":"804\/980-4371","cno":"","email":"","ename":"","eno":"","pphy":"SANDERFORD, SOERIA NP","ppno":"804\/741-6200","pcpadd":"9600 PATTERSON AVE","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":23229,"pcpcounty":"","pcpid":"","pcpname":"PATTERSON AVENUE FAMILY PRACTICE","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/741-6213","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R07.9","E78.00","I10.","M62.830","R35.0","D50.8","Z68.24","G47.00","R94.30","R94.39","NO DATA","E78.2","N28.9","R25.2","K29.90","R42.","Z68.26","Z23.","I20.8","Z68.25","I25.118","I50.9","M25.561","M25.562","E55.9","K21.9","G62.9","Z68.22","Z01.810","D72.829","H92.01","R07.89","R01.1","R52.","I36.1"],"date":["2021-01-22","2020-10-06","2021-12-10","2021-03-19","2021-03-19","2021-12-10","2021-12-10","2021-06-11","2020-11-19","2021-03-16","2021-03-16","2021-12-10","2021-12-10","2021-12-10","2021-12-10","2020-10-06","2020-10-06","2021-01-22","2021-03-16","2021-03-16","2020-10-16","2020-10-16","2020-08-07","2020-08-07","2021-06-11","2021-06-11","2021-06-11","2021-06-11","2020-10-16","2021-08-13","2021-08-13","2019-12-05","2019-04-18","2019-12-13","2019-04-18"],"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":[["","31722070190","LOSARTAN","TAB 50MG","90","Select","Select",""],["","50111043401","TRAZODONE","TAB 100MG","30","Select","Select",""],["","","METOPROL","TAB 25MG ER","","Select","Select",""],["","70377002811","ATORVASTATIN","TAB 20MG","90","Select","Select",""],["","","ISOSORB","TAB 30MG ER","","Select","Select",""],["","80777027399","MODERNA","INJ COVID-19","0","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","","SLOW","TAB 45MG","","Select","Select",""],["","","NITROGLYCERN","SUB 0.4MG","","Select","Select",""],["","55111015810","OMEPRAZOLE","CAP 20MG","30","Select","Select",""],["","69097015907","MELOXICAM","TAB 15MG","30","Select","Select",""],["","23155000810","HYDROCHLOROT","TAB 25MG","30","Select","Select",""],["","","CVS","TAB 81MG EC","","Select","Select",""],["","","IRON","TAB 45MG","","Select","Select",""],["","60505384801","CELECOXIB","CAP 100MG","60","Select","Select",""],["","67877032005","IBUPROFEN","TAB 600MG","20","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":""}]}]}