{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LAURA ROSADO","gend":1,"add":"PO BOX 434","city":"CALLAO","state":"VA","zip":"22435-9998","dob":"2003-02-15","age":"","mstatus":"","insh":"8535779*01","cliId":"","pno":"804\/450-1041","cno":"","email":"","ename":"","eno":"","pphy":"AZZAM, YAHYA DO","ppno":"804\/529-6141","pcpadd":"17452 RICHMOND RD","pcpcity":"CALLAO","pcpstate":"VA","pcpzip":22435,"pcpcounty":"","pcpid":"","pcpname":"MCV ASSOCIATED PHYSICIANS","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/526-6916","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F43.10","M22.2X2","J01.40","R05.","R52.","Z30.42","Z20.822","R43.2","R43.0","L50.1","L29.9","M25.562","R29.898","A08.4","L02.91","K42.9","R11.0","Z01.419","Z11.3","Z30.9","R21.","W57.XXXD","L50.9","J06.9","R06.02","Z00.00","R10.9","R35.0","R22.0","J45.901","R53.83","F41.9","B97.89","B96.89","S39.011A","Z88.0","Z88.1","Z88.2","Z79.899","Z79.3","Z09.","J45.909","K21.9","F43.23","J45.20","Z32.02","R30.0","F90.2","J20.9","J01.90","L23.7","R50.9","J02.9","B34.9","Z68.52","R53.81","F43.9","Z13.31","Z72.51","F41.1","J01.00","R31.9","R69.","B86."],"date":["2021-08-13","2020-09-21","2021-02-02","2021-02-02","2021-02-02","2021-08-20","2021-12-01","2021-10-21","2021-10-21","2020-05-05","2020-05-05","2020-09-09","2020-09-09","2021-04-06","2021-07-16","2021-08-13","2021-08-10","2020-06-11","2020-06-11","2020-06-11","2020-05-28","2020-05-28","2020-04-27","2021-05-18","2020-12-10","2021-05-18","2021-08-13","2021-05-18","2021-05-18","2021-05-18","2021-05-18","2021-05-18","2020-01-10","2021-05-17","2021-08-13","2021-08-13","2021-08-13","2021-08-13","2021-08-13","2021-08-13","2019-01-03","2019-07-26","2019-07-26","2019-05-07","2019-11-27","2019-11-27","2019-11-27","2019-11-27","2019-02-26","2019-02-26","2019-07-26","2019-04-09","2019-06-27","2019-06-27","2019-08-07","2019-06-27","2019-06-27","2019-08-07","2019-06-27","2019-08-11","2019-01-11","2019-01-11","2019-02-19","2019-08-07"],"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":{"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":[["","00143980305","DOXYCYCL","CAP 100MG","14","Select","Select",""],["","59762453802","MEDROXYPR","INJ 150MG\/ML","1","Select","Select",""],["","52817033200","CYCLOBENZAPR","TAB 10MG","14","Select","Select",""],["","00116200116","CHLORHEX","SOL 0.0012","473","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","","BENZONATATE","CAP 100MG","","Select","Select",""],["","","AZITHROMYCIN","TAB 250MG","","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","59651036105","IBUPROFEN","TAB 600MG","30","Select","Select",""],["","00591544243","PREDNISONE","PAK 10MG","48","Select","Select",""],["","27808003502","HYDROCO\/APAP","TAB 5-325MG","10","Select","Select",""],["","00363017508","PAIN","TAB 500MG","30","Select","Select",""],["","50111044101","TRAZODONE","TAB 150MG","30","Select","Select",""],["","","OSELTAMIVIR","CAP 75MG","","Select","Select",""],["","","CIMETIDINE","TAB 400MG","","Select","Select",""],["","","ONDANSETRON","TAB 4MG ODT","","Select","Select",""],["","","CETIRIZINE","TAB 10MG","","Select","Select",""],["","","MELOXICAM","TAB 15MG","","Select","Select",""],["","11917018705","FLUTICASONE","SPR 50MCG","10","Select","Select",""],["","23155013525","DOXYCYC","TAB 100MG","20","Select","Select",""],["","69097084905","ESCITALOPRAM","TAB 20MG","30","Select","Select",""],["","00603158658","PROMETHAZINE","SYP DM","120","Select","Select",""],["","31722072250","LEVOFLOXACIN","TAB 500MG","7","Select","Select",""],["","49884033601","FLUOXETINE","TAB 20MG","30","Select","Select",""],["","00591024005","LORAZEPAM","TAB 0.5MG","6","Select","Select",""],["","00093506201","HYDROXYZ","TAB 50MG","20","Select","Select",""],["","45802026937","PERMETHRIN","CRE 0.05","60","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":""}]}]}