{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ERIC  L WADE","gend":0,"add":"901 ELMHURST LN","city":"PORTSMOUTH","state":"VA","zip":"23701-9998","dob":"1962-03-04","age":"","mstatus":"","insh":"20049804*01","cliId":"","pno":7573593064,"cno":7573593064,"email":"","ename":"","eno":"","pphy":"RAMOLIA, MANSUKHLAL R MD","ppno":7574836401,"pcpadd":"4035 TAYLOR RD #K,","pcpcity":"CHESAPEAKE","pcpstate":"VA","pcpzip":"23321-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7576863025,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J32.9","I10.","N28.9","C85.90","C83.38","Z01.810","E78.00","I25.10","Z94.81","Z85.79","Z68.25","I12.9","NO DATA","M25.511","R00.1","R06.2","S46.011A","G89.29","Z68.26","Z48.290","V58.89","S46.101A","L57.0","L81.4","D18.00","D23.9","Z12.83","Z71.9","L03.90","S42.444A","C83.30","I11.0","I50.9","F19.10","Z92.21","Z94.84","M19.071","M19.072","M21.611","M21.612","M20.41","M20.42","M79.671","M79.672","Z00.00","Z12.11","M75.121","M20.12","M20.5X2","M25.522","Z23.","G47.9","Z68.24","M19.90"],"date":["2021-08-10","2023-01-04","2022-05-04","2022-05-04","2023-07-13","2022-01-05","2023-01-04","2023-01-04","2022-01-05","2023-01-04","2022-01-05","2023-03-29","2023-03-29","2022-01-05","2022-05-04","2022-05-04","2021-06-25","2021-06-25","2021-06-25","2021-05-27","2022-01-03","2022-01-03","2022-04-19","2022-04-19","2022-04-19","2022-04-19","2022-04-19","2022-04-19","2022-09-21","2022-09-21","2021-11-29","2021-11-15","2021-11-15","2021-11-15","2021-11-29","2021-11-29","2021-06-15","2021-06-15","2021-06-15","2021-06-15","2021-06-15","2021-06-15","2021-06-15","2021-06-15","2021-09-01","2021-09-01","2021-06-09","2021-06-09","2021-06-09","2022-09-27","2021-10-27","2023-01-04","2023-01-04","2023-01-04"],"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":[["","70377002911","ATORVASTATIN","TAB 40MG","90","Select","Select",""],["","00173086910","ANORO ELLIPT","AER 62.5-25","60","Select","Select",""],["","00378668910","PANTOPRAZOLE","TAB 40MG","90","Select","Select",""],["","23155000810","HYDROCHLOROT","TAB 25MG","90","Select","Select",""],["","72888003605","CARVEDILOL","12.5 MG","180","Select","Select",""],["","68180016013","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","59267102504","PFIZER VACC","INJ ADLT RTU","0","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","68180072003","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","51672411806","FLUOROURACIL","CRE 0.05","40","Select","Select",""],["","65862042005","SMZ\/TMP DS","TAB 800-160","14","Select","Select",""],["","00093224001","CEPHALEXIN","TAB 500MG","20","Select","Select",""],["","65162019050","NAPROXEN","TAB 500MG","20","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","00173068220","VENTOLIN HFA","AER ","18","Select","Select",""],["","23155000810","HYDROCHLOROTHIAZIDE","25 MG","90","Select","Select",""],["","68180072103","AMLODIPINE BESYLATE","10 MG","30","Select","Select",""],["","70377002911","ATORVASTATIN CALCIUM","40 MG","90","Select","Select",""],["","00378668910","PANTOPRAZOLE SODIUM","40 MG","90","Select","Select",""],["","76385011350","CARVEDILOL TAB","25MG","180","Select","Select",""],["","23155000810","HYDROCHLOROT TAB","25MG","90","Select","Select",""],["","70377002911","ATORVASTATIN TAB","40MG","90","Select","Select",""],["","00173086910","ANORO ELLIPT AER","62.5-25","60","Select","Select",""],["","68180072003","AMLODIPINE TAB","5MG","30","Select","Select",""],["","51672411806","FLUOROURACIL CRE","5%","40","Select","Select",""],["","00378668910","PANTOPRAZOLE TAB","40MG","90","Select","Select",""],["","00093317431","ALBUTEROL AER HFA","","8","Select","Select",""],["","00093224001","CEPHALEXIN TAB","500MG","20","Select","Select",""],["","59267102504","PFIZER VACC INJ ADLT RTU","","0","Select","Select",""],["","65862042005","SMZ\/TMP DS TAB","800-160","14","Select","Select",""],["","65162019050","NAPROXEN TAB","500MG","20","Select","Select",""],["","68180012202","CEPHALEXIN CAP","500MG","20","Select","Select",""],["","00173068220","VENTOLIN HFA AER","","18","Select","Select",""],["","59310057922","PROAIR HFA AER","","8","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":""}]}]}