{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JASON E LAND","gend":0,"add":"8044 AMF DR","city":"MECHANICSVILLE","state":"VA","zip":"23111-9998","dob":"1983-03-21","age":"","mstatus":"","insh":"1732362*01","cliId":"","pno":8049392353,"cno":8049392353,"email":"","ename":"","eno":"","pphy":"AKBAR, SALMAN MD","ppno":8043305452,"pcpadd":"909 HIOAKS RD STE F\/G,","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":"23225-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8043379950,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G47.33","I10.","Z91.14","R42.","I51.7","E55.9","F41.9","B00.2","A49.3","A64.","NO DATA","K59.00","E66.09","R22.1","M15.0","E11.8","J30.9","J30.1","L20.89","H10.45","L29.9","E66.9","K59.09","E78.5","R73.02","H65.03","Z79.891","F11.20","R60.9","N39.0"],"date":["2023-08-09","2023-03-17","2022-07-04","2022-07-04","2022-07-04","2022-11-11","2022-11-11","2022-02-03","2022-02-03","2022-03-10","2023-03-17","2023-03-17","2022-01-24","2022-01-24","2023-02-08","2022-08-22","2021-08-12","2021-08-12","2021-08-12","2021-08-12","2021-08-12","2022-11-28","2022-11-28","2022-11-28","2022-11-28","2022-12-30","2023-03-03","2023-03-03","2022-11-17","2022-11-17"],"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":[["","49884012201","LABETALOL","TAB 100MG","60","Select","Select",""],["","42806054701","VITAMIN D","2 1250 MCG","4","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","29300012810","HYDROCHLOROT","TAB 25MG","30","Select","Select",""],["","31722072690","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","65862050220","AMOX\/K CLAV","TAB 500-125","20","Select","Select",""],["","69230030001","ALLERGY RELF","TAB 180MG","30","Select","Select",""],["","00115180401","HYDROXYZ PAM","CAP 50MG","60","Select","Select",""],["","60432060416","PROMETHAZINE","SYP DM","180","Select","Select",""],["","45802086866","POLYETH GLYC","POW 3350 NF","30","Select","Select",""],["","68180031909","BUPROPN HCL","TAB 150MG XL","30","Select","Select",""],["","60505009500","DOXAZOSIN MESYLATE","4 MG","30","Select","Select",""],["","60432060416","PROMETHAZINE-DM","6.25-15\/5","60","Select","Select",""],["","43598057530","TADALAFIL","5 MG","30","Select","Select",""],["","00228282011","HYDROCHLOROTHIAZIDE","12.5 MG","30","Select","Select",""],["","65862050220","AMOXICILLIN-CLAVULANATE POTASS","500-125 MG","20","Select","Select",""],["","52817033200","CYCLOBENZAPRINE HCL","10 MG","60","Select","Select",""],["","68180072103","AMLODIPINE TAB","10MG","90","Select","Select",""],["","29300012810","HYDROCHLOROT TAB","25MG","30","Select","Select",""],["","49884012201","LABETALOL TAB","100MG","180","Select","Select",""],["","69452015120","VITAMIN D CAP","50000UNT","4","Select","Select",""],["","31722072690","MONTELUKAST TAB","10MG","30","Select","Select",""],["","60432060416","PROMETHAZINE SYP DM","","180","Select","Select",""],["","65862050220","AMOX\/K CLAV TAB","500-125","20","Select","Select",""],["","69230030001","ALLERGY RELF TAB","180MG","30","Select","Select",""],["","00115180401","HYDROXYZ PAM CAP","50MG","60","Select","Select",""],["","45802086866","POLYETH GLYC POW","3350 NF","30","Select","Select",""],["","68180031909","BUPROPN HCL TAB","150MG XL","30","Select","Select",""],["","29300039810","AMLODIPINE BESYLATE","10 MG","30","Select","Select",""],["","49884012301","LABETALOL HCL","200 MG","120","Select","Select",""],["","27808023302","DOXYCYCLINE HYCLATE","100 MG","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":""}]}]}