{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"AMUL   K SINGH","gend":0,"add":"42469 ABNEY WOOD DR","city":"CHANTILLY","state":"VA","zip":"20152-9998","dob":"1984-01-28","age":"","mstatus":"","insh":"2245457*01","cliId":"","pno":"703\/362-7551","cno":"703\/362-7551","email":"","ename":"","eno":"","pphy":"ALSAMMAN, MHD MOUNAF MD","ppno":"703\/722-2510","pcpadd":"24801 PINEBROOK RD STE 202","pcpcity":"CHANTILLY","pcpstate":"VA","pcpzip":20152,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"703\/722-2511","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["T84.89XA","M94.261","S83.281A","S83.241A","Z98.890","S52.552A","M25.532","M54.42","M54.2","M54.41","S62.025A","M54.12","L02.222","L02.223","L70.0","V54.12","V58.89","M54.16","B35.4","Z20.822","M25.561","R26.2","Z01.818","M25.511","M51.36","M54.5","M54.89","Z74.3","M51.26","NO DATA","M60.9","V89.2XXA","S00.10XA","H40.023","L50.1","D72.1","E80.4","N52.8","N47.2","R10.32","R74.8","K21.9","M62.838","H65.02","R51.9","V89.2XXD","M79.18","M54.32","U07.1","Z87.438","N50.89","Z20.828","H53.8","Z13.1","R07.89","S52.515A","S63.592A","B36.9","T88.6XXA","T39.395A","L73.9","R10.84","S62.102A","S49.92XA","V18.4XXA","R05.9","J02.9","G89.29","H92.02","B34.9","J30.89","H10.10","J30.9","J40.","J06.9","R09.82","S13.9XXA","M54.30","Z04.9","Z03.818","R07.9","M23.51","M25.361","S83.511A","G89.18","Z88.8","Z79.899","Z00.00","R06.2"],"date":["2020-09-28","2020-09-28","2020-09-28","2020-09-28","2021-12-27","2021-12-27","2022-02-22","2022-01-25","2021-12-30","2021-12-30","2021-11-29","2022-02-16","2022-03-03","2022-03-03","2022-03-03","2022-02-24","2022-02-22","2022-03-03","2022-03-03","2022-09-14","2021-03-31","2021-08-19","2021-08-27","2021-12-27","2022-03-03","2021-07-08","2021-08-31","2021-08-31","2022-02-18","2022-02-18","2022-02-18","2021-11-09","2021-10-18","2021-10-18","2020-08-21","2020-08-21","2020-08-21","2020-09-23","2020-10-08","2021-03-15","2021-03-15","2021-03-15","2021-10-07","2021-08-20","2021-10-07","2021-10-07","2021-07-13","2022-01-04","2022-08-02","2020-09-23","2020-10-08","2021-05-13","2021-10-07","2021-10-07","2022-02-18","2021-12-27","2021-12-27","2022-02-18","2020-07-08","2022-02-18","2020-07-08","2022-02-18","2021-11-15","2021-11-15","2021-11-15","2022-08-02","2022-08-02","2021-05-10","2021-08-31","2022-06-09","2022-06-09","2022-06-09","2022-06-09","2022-06-28","2022-06-28","2022-06-28","2021-08-31","2021-08-31","2021-09-02","2021-12-06","2022-06-05","2020-08-20","2020-08-20","2020-10-27","2020-10-27","2022-02-18","2022-02-18","2022-07-11","2022-07-11"],"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":[["","69097014260","ALBUTEROL","AER HFA","7","Select","Select",""],["","64380071207","BENZONATATE","CAP 100MG","30","Select","Select",""],["","00069108530","PAXLOVID","TAB 300-100","30","Select","Select",""],["","00115169449","EPINEPHRINE","INJ 0.3MG","2","Select","Select",""],["","00093321930","KETOCONAZOLE","CRE 0.02","30","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","30","Select","Select",""],["","51991074790","DULOXETINE","CAP 30MG","30","Select","Select",""],["","59651000305","OMEPRAZOLE","CAP 40MG","90","Select","Select",""],["","70710113803","FLUCONAZOLE","TAB 100MG","7","Select","Select",""],["","00378064205","PREDNISONE","TAB 20MG","5","Select","Select",""],["","68180016011","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","00121077516","GG\/CODEINE","SOL 100-10\/5","118","Select","Select",""],["","65862057490","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","70069000701","OLOPATADINE","DRO 0.001","5","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","16571041110","CIPROFLOXACN","TAB 250MG","14","Select","Select",""],["","59779065034","TUSSIN","LIQ 100\/5ML","236","Select","Select",""],["","10702000710","CYCLOBENZAPR","TAB 10MG","10","Select","Select",""],["","00574222545","TRETINOIN","CRE 0.00025","45","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","40","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","00603459315","METHYLPRED","TAB 4MG","21","Select","Select",""],["","43598029390","PREGABALIN","CAP 75MG","90","Select","Select",""],["","69097081312","GABAPENTIN","CAP 100MG","90","Select","Select",""],["","29300016915","TIZANIDINE","TAB 4MG","90","Select","Select",""],["","00172392570","DIAZEPAM","TAB 2MG","6","Select","Select",""],["","65862050320","AMOX\/K","TAB 875-125","20","Select","Select",""],["","00603188016","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","12","Select","Select",""],["","69842097417","DICLOFENAC","GEL 0.01","50","Select","Select",""],["","24208063110","NEO\/POLY\/HC","SOL 1% OTIC","10","Select","Select",""],["","45802031801","BENZOYL","LIQ 10% WASH","284","Select","Select",""],["","21922000201","CLINDAMYCIN","SOL 0.01","60","Select","Select",""],["","45802048678","DOCUSATE","CAP 100MG","20","Select","Select",""],["","33332032001","AFLURIA","INJ 2020-21","0","Select","Select",""],["","59779060006","CVS","TAB 81MG EC","30","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","20","Select","Select",""],["","50111033401","METRONIDAZOL","TAB 500MG","14","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":""}]}]}