{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"GUILLERMO   E VASQUEZ-POSTIGO","gend":0,"add":"412 E LAUREL AVE","city":"STERLING","state":"VA","zip":"20164-9998","dob":"2003-03-21","age":"","mstatus":"","insh":"2114257*01","cliId":"","pno":"703\/421-3775","cno":"","email":"","ename":"","eno":"","pphy":"BOWIE, KATHLEEN JUDGE FNP","ppno":"703\/689-2180","pcpadd":"11484 WASHINGTON PLAZA W STE 300","pcpcity":"RESTON","pcpstate":"VA","pcpzip":20190,"pcpcounty":"","pcpid":"","pcpname":"LOUDOUN COMMUNITY HEALTH CENTER INC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"NORTHERN & WINCHESTER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"703\/481-3853","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F32.9","L91.0","H40.052","H35.453","H35.09","R07.89","R07.9","B07.8","R23.8","L53.8","I45.19","Q24.9","R77.8","R94.31","J45.909","Q23.1","Z20.822","Q21.0","H35.413","H04.123","I51.4","J45.990","I40.9","Z02.5","S63.502A","S80.12XA","S80.11XA","M79.662","Z00.00","G47.00","E55.9","Z11.4","Z68.26","R03.0","R79.89","I30.9","S16.1XXA","M54.2","H40.053","H53.453","H40.012","S90.31XA","H35.013","T79.6XXA"],"date":["2022-06-28","2021-02-22","2021-12-07","2022-06-07","2022-06-07","2022-01-10","2022-01-10","2021-03-18","2021-03-18","2021-03-18","2022-01-05","2022-01-06","2022-01-06","2022-01-06","2022-01-05","2022-03-04","2022-01-05","2022-03-04","2022-06-07","2022-06-07","2022-05-02","2022-01-24","2022-02-10","2021-04-07","2021-11-01","2021-11-01","2021-11-01","2021-11-01","2022-05-02","2022-06-28","2022-05-02","2022-05-02","2022-05-02","2022-05-02","2022-01-06","2022-03-04","2020-01-28","2020-01-28","2022-06-07","2020-12-18","2022-06-07","2022-06-22","2020-06-19","2021-05-07"],"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":[["","43547028111","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","70010000201","COLCHICINE","TAB 0.6MG","30","Select","Select",""],["","68645056259","IBUPROFEN","TAB 600MG","30","Select","Select",""],["","00173068220","VENTOLIN","AER ","18","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8","Select","Select",""],["","50742061510","METOPROL","TAB 25MG ER","30","Select","Select",""],["","50111056001","TRAZODONE","TAB 50MG","30","Select","Select",""],["","60505024701","MIRTAZAPINE","TAB 15MG","30","Select","Select",""],["","05388062809","MELATONIN","TAB 5MG","60","Select","Select",""],["","68645052154","SERTRALINE","TAB 25MG","60","Select","Select",""],["","16714008210","HYDROXYZ","TAB 25MG","60","Select","Select",""],["","51660052605","ALLERGY","TAB 10MG","30","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","57237002801","AMOXICILLIN","TAB 500MG","15","Select","Select",""],["","00406012301","HYDROCO\/APAP","TAB 5-325MG","6","Select","Select",""],["","16714040101","CEFUROXIME","TAB 500MG","20","Select","Select",""],["","50111078751","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","59746017506","PREDNISONE","TAB 20MG","9","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":""}]}]}