{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LESLIE M BALDWIN","gend":1,"add":"C\/O LESLIE BALDWIN 100 8TH ST","city":"COLONIAL BEACH","state":"VA","zip":"22443-9998","dob":"1960-11-01","age":"","mstatus":"","insh":"1683712*01","cliId":"","pno":8042140822,"cno":8042140822,"email":"","ename":"","eno":"","pphy":"FARKHANI, HASAN MD","ppno":8042247890,"pcpadd":"525B EUCLID AVENUE,","pcpcity":"COLONIAL BEACH","pcpstate":"VA","pcpzip":"22443-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G47.33","E66.09","R06.2","E87.5","NO DATA","I10.","E11.21","N25.81","R80.8","E87.2","N18.4","R80.1","R07.9","E78.5","I25.5","I12.9","I50.32","J44.9","F17.201","E11.29","E78.2","Z00.00","N18.9","R80.9","R07.2","I25.10","I13.10","E11.22","N17.9","R94.31","Z23.","D63.1","E87.8","I25.82","Z79.02","Z95.5","Z79.899","Z91.119","E11.9","D64.9","R42.","R07.89","I70.219","N25.9","R79.89"],"date":["2021-04-27","2021-01-28","2021-01-28","2023-02-16","2023-09-15","2023-09-15","2021-12-20","2023-09-15","2023-09-15","2022-09-20","2023-09-15","2022-09-20","2021-07-31","2021-12-20","2021-12-20","2023-09-15","2021-12-20","2022-12-31","2021-12-20","2022-06-03","2022-06-03","2022-06-03","2023-09-15","2021-09-03","2021-08-02","2022-12-31","2021-08-02","2022-12-31","2022-12-31","2022-12-29","2022-12-31","2022-12-31","2022-12-31","2022-12-31","2022-12-31","2022-12-31","2022-12-31","2022-12-31","2023-02-16","2021-07-30","2021-07-30","2021-07-30","2021-11-29","2022-12-30","2022-12-30"],"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":[["","00378395305","ATORVASTATIN","TAB 80MG","30","Select","Select",""],["","00597015561","STIOLTO","AER 2.5-2.5","12","Select","Select",""],["","64980052810","SODIUM BICAR","TAB 650MG","60","Select","Select",""],["","68462016405","CARVEDILOL","TAB 12.5MG","180","Select","Select",""],["","00186077660","BRILINTA","TAB 60MG","180","Select","Select",""],["","42806054701","VITAMIN D","2 1250 MCG","12","Select","Select",""],["","55111046701","METOPROL SUC","TAB 50MG ER","30","Select","Select",""],["","29300039810","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","11877001140","BINAXNOW COV","KIT HOME TES","8","Select","Select",""],["","73502058610","SOAANZ","40 MG","30","Select","Select",""],["","23155066201","CALCITRIOL","0.25 MCG","15","Select","Select",""],["","00310111030","LOKELMA","10 G","30","Select","Select",""],["","29300039810","AMLODIPINE BESYLATE","10 MG","30","Select","Select",""],["","00223172101","SODIUM BICARBONATE","650 MG","180","Select","Select",""],["","00378395305","ATORVASTATIN CALCIUM","80 MG","90","Select","Select",""],["","55111046701","METOPROLOL SUCCINATE","50 MG","30","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":""}]}]}