{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"AROUSSIAG KALOUSTIAN","gend":1,"add":"14956 VIREO CT","city":"WOODBRIDGE","state":"VA","zip":"22193-9998","dob":"1946-01-13","age":"","mstatus":"","insh":"20042170*01","cliId":"","pno":7039823132,"cno":7039823132,"email":"","ename":"","eno":"","pphy":"VARMA, SOHAN R MD","ppno":7034369969,"pcpadd":"4229 LAFAYETTE CENTER DR STE 1125B-,","pcpcity":"CHANTILLY","pcpstate":"VA","pcpzip":"20151-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"NORTHERN & WINCHESTER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7035745585,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K80.50","Z20.822","Z76.0","I10.","E78.5","E21.0","E55.9","E83.52","M17.9","E66.9","H11.32","H26.493","Z00.00","Z13.820","M25.511","I16.0","Z76.89","N39.0","H25.11","K80.51","R10.13","R74.02","K83.1","R10.11","N89.9","M25.512","H26.9","H25.12","M25.562","Z53.31","Z71.2","M54.5","K80.21","H25.13","H43.811","K80.44","M19.90","R74.01","G62.9","Z88.6","Z79.899","Z88.0","R10.9","M25.561","M17.0","R68.89","R05.9","R07.89","R07.9","H04.123","H26.491","NO DATA","E53.8","E78.00","M06.9","R00.0","R94.31","Z01.818","H53.9","H43.813"],"date":["2021-08-10","2022-05-17","2022-06-28","2023-02-23","2022-09-01","2022-09-01","2022-06-28","2022-06-28","2022-11-08","2022-06-28","2022-11-30","2022-11-30","2023-01-31","2023-01-31","2023-01-31","2023-02-22","2023-02-22","2021-02-11","2021-05-25","2021-08-10","2021-08-10","2021-08-10","2021-08-10","2021-08-10","2021-01-28","2021-04-15","2021-07-08","2021-07-27","2021-09-23","2021-08-10","2021-09-09","2021-09-09","2021-09-09","2021-05-03","2021-05-03","2021-08-08","2021-08-08","2021-08-08","2021-08-08","2021-08-08","2021-08-08","2021-08-08","2021-08-08","2021-09-23","2021-09-23","2022-11-08","2022-11-08","2023-02-22","2023-02-22","2022-07-14","2022-02-21","2022-10-25","2023-03-21","2021-05-25","2021-05-25","2023-02-22","2023-02-22","2021-05-13","2021-05-13","2022-07-14"],"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":[["","70377002811","ATORVASTATIN","TAB 20MG","90","Select","Select",""],["","59267102504","PFIZER VACC","INJ ADLT RTU","0","Select","Select",""],["","80777027399","MODERNA VAC","INJ COVID-19","0","Select","Select",""],["","62332002891","LOSARTAN POT","TAB 50MG","60","Select","Select",""],["","11845012639","GLUCO\/CHONDR","CAP COMPLEX","30","Select","Select",""],["","80681016801","VITAMIN D3","TAB 25MCG","180","Select","Select",""],["","59779046708","ASPIRIN LOW","CHW 81MG","30","Select","Select",""],["","68180071909","AMLODIPINE","TAB 2.5MG","180","Select","Select",""],["","33342017910","OLMESA MEDOX","TAB 20MG","30","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","60505025203","TIZANIDINE","TAB 4MG","20","Select","Select",""],["","69097052444","DICLOFENAC SODIUM","1 %","100","Select","Select",""],["","33342017910","OLMESARTAN MEDOXOMIL","20 MG","90","Select","Select",""],["","70377002813","ATORVASTATIN CALCIUM","20 MG","90","Select","Select",""],["","68180071909","AMLODIPINE BESYLATE","2.5 MG","60","Select","Select",""],["","49281012265","FLUZONE HIGH-DOSE QUAD","2022-23 240MCG\/0.7","0.7","Select","Select",""],["","70377002811","ATORVASTATIN TAB","20MG","90","Select","Select",""],["","59267102504","PFIZER VACC INJ ADLT RTU","","0","Select","Select",""],["","80777027399","MODERNA VAC INJ COVID-","19","0","Select","Select",""],["","68180071909","AMLODIPINE TAB","2.5MG","180","Select","Select",""],["","62332002891","LOSARTAN POT TAB","50MG","180","Select","Select",""],["","80681016801","VITAMIN D","3 TAB 25MCG","60","Select","Select",""],["","59779046708","ASPIRIN LOW CHW","81MG","90","Select","Select",""],["","11845012639","GLUCO\/CHONDR CAP COMPLEX","","90","Select","Select",""],["","33342017910","OLMESA MEDOX TAB","20MG","90","Select","Select",""],["","60505025203","TIZANIDINE TAB","4MG","20","Select","Select",""],["","59746000103","METHYLPRED TAB","4MG","21","Select","Select",""],["","47781030301","NITROFURANTOIN MONO-MACRO","100 MG","10","Select","Select",""],["","69097081312","GABAPENTIN","100 MG","15","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":""}]}]}