{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DAINA  M GRAHAM","gend":1,"add":"3024 VALLEY AVE APT 8","city":"WINCHESTER","state":"VA","zip":"22601-9998","dob":"1977-07-09","age":"","mstatus":"","insh":"20051439*01","cliId":"","pno":5409742268,"cno":5409742268,"email":"","ename":"","eno":"","pphy":"AGGARWAL, RAJIV K MD","ppno":5712233833,"pcpadd":"1860 TOWN CENTER DR SUITE 340,","pcpcity":"RESTON","pcpstate":"VA","pcpzip":"20190-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"NORTHERN & WINCHESTER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":5712233834,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F41.9","F11.20","I10.","F32.9","G43.909","R73.9","R41.82","E86.0","N17.9","F39.","E11.9","R53.83","R10.9","R11.2","R93.3","K31.89","NO DATA","K86.89","Z23.","E11.65","Z72.0","U07.1","J44.1","Z00.01","K85.90","K80.50","Z90.410","E66.3","K86.1","E87.2","E03.9","G93.41","F11.29","E10.65","K59.00","D12.2","D12.3","K63.5","Z79.4","Z87.442","D72.829","R00.0","K52.9","K56.7","J45.909","M79.7","K58.9","Z20.822","F17.210","R13.10","F31.9","N28.9","G89.29","M06.9","Z28.311","D12.4","B34.2","E13.65","E87.0","E87.1","K21.9","E11.649","F11.10","Z91.14","K25.9","E10.10","R06.02","R05.9","Z71.89","R56.9","R10.84","Z53.8","F17.200","N20.0","B18.2"],"date":["2023-07-10","2023-07-29","2023-07-10","2023-04-21","2023-01-30","2021-11-09","2021-10-27","2021-10-27","2022-05-10","2021-11-24","2022-06-03","2021-11-22","2022-03-04","2022-03-03","2022-05-12","2022-03-03","2022-03-03","2022-04-22","2022-10-12","2023-01-03","2022-12-06","2023-04-21","2023-02-24","2023-03-24","2022-05-24","2022-05-24","2022-05-24","2022-05-24","2022-03-28","2021-10-28","2021-10-28","2021-10-28","2022-03-28","2022-05-09","2022-05-12","2022-05-12","2022-05-12","2022-05-12","2022-05-12","2022-05-12","2021-10-25","2021-10-25","2022-03-21","2022-03-03","2022-05-10","2022-03-03","2022-03-03","2022-03-03","2022-03-03","2022-03-03","2022-03-03","2022-03-21","2022-03-03","2022-05-10","2022-04-22","2022-05-12","2021-09-13","2021-10-25","2021-10-25","2021-10-25","2022-05-10","2021-10-25","2021-10-25","2021-10-25","2022-03-03","2021-11-01","2023-05-18","2022-07-22","2022-09-15","2023-01-30","2022-03-03","2022-05-10","2022-05-10","2022-05-10","2023-07-10"],"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":[["","00378180310","LEVOTHYROXIN","TAB 50MCG","90","Select","Select",""],["","00228202950","ALPRAZOLAM","0.5 MG","120","Select","Select",""],["","59651000305","OMEPRAZOLE","40 MG","90","Select","Select",""],["","13668001005","CITALOPRAM","TAB 20MG","90","Select","Select",""],["","00169750111","NOVOLOG","100\/ML","30","Select","Select",""],["","00088221905","LANTUS SOLOS","INJ 100\/ML","30","Select","Select",""],["","68382025116","ATORVASTATIN","TAB 40MG","90","Select","Select",""],["","65162052110","PROMETHAZINE","TAB 25MG","15","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","67877021660","CEFUROXIME","500 MG","20","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","00002318280","TRULICITY","4.5 MG\/0.5","2","Select","Select",""],["","08290320109","BD PEN NEEDL","MIS 31GX8MM","100","Select","Select",""],["","59267100002","PFIZER VACC","INJ COVID-19","0","Select","Select",""],["","57599000101","FREESTYLE","KIT SENSOR","2","Select","Select",""],["","51672413001","LAMOTRIGINE","TAB 25MG","30","Select","Select",""],["","13668042990","PANTOPRAZOLE","TAB 40MG","90","Select","Select",""],["","00597015330","JARDIANCE","TAB 25MG","30","Select","Select",""],["","00228212750","CLONIDINE","TAB 0.1MG","270","Select","Select",""],["","52268001201","SUPREP BOWEL","SOL PREP KIT","354","Select","Select",""],["","43386009019","GAVILYTE-G","SOL ","4000","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","00173088710","TRELEGY","AER ELLIPTA","60","Select","Select",""],["","00069108530","PAXLOVID","TAB 300-100","30","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","30","Select","Select",""],["","49502025175","SEMGLEE (YFGN) PEN","100\/ML (3)","30","Select","Select",""],["","73070010315","INSULIN ASPART FLEXPEN","100\/ML (3)","15","Select","Select",""],["","13668001005","CITALOPRAM HBR","20 MG","90","Select","Select",""],["","00088221905","LANTUS SOLOSTAR","100\/ML (3)","15","Select","Select",""],["","13668042990","PANTOPRAZOLE SODIUM","40 MG","90","Select","Select",""],["","00378180310","LEVOTHYROXINE SODIUM","50 MCG","90","Select","Select",""],["","00173088710","TRELEGY ELLIPTA","100-62.5","60","Select","Select",""],["","68382025110","ATORVASTATIN CALCIUM","40 MG","90","Select","Select",""],["","00093317431","ALBUTEROL SULFATE HFA","90 MCG","8.5","Select","Select",""],["","00228212750","CLONIDINE HCL","0.1 MG","270","Select","Select",""],["","00310737020","BUDESONIDE-FORMOTEROL FUMARATE","160-4.5MCG","10.2","Select","Select",""],["","00186037020","SYMBICORT","160-4.5MCG","10.2","Select","Select",""],["","64380094906","PREDNISONE","50 MG","5","Select","Select",""],["","00002318280","TRULICITY INJ","4.5\/0.5","2","Select","Select",""],["","00088221905","LANTUS SOLOS INJ","100\/ML","30","Select","Select",""],["","00228202950","ALPRAZOLAM TAB","0.5MG","120","Select","Select",""],["","13668001005","CITALOPRAM TAB","20MG","90","Select","Select",""],["","59310057922","PROAIR HFA AER","","8","Select","Select",""],["","00093317431","ALBUTEROL AER HFA","","8","Select","Select",""],["","59651000305","OMEPRAZOLE CAP","40MG","90","Select","Select",""],["","65162052110","PROMETHAZINE TAB","25MG","15","Select","Select",""],["","00378180310","LEVOTHYROXIN TAB","50MCG","90","Select","Select",""],["","00169750111","NOVOLOG INJ","100\/ML","30","Select","Select",""],["","13668042990","PANTOPRAZOLE TAB","40MG","90","Select","Select",""],["","00228212750","CLONIDINE TAB","0.1MG","270","Select","Select",""],["","52268001201","SUPREP BOWEL SOL PREP KIT","","354","Select","Select",""],["","00597015330","JARDIANCE TAB","25MG","30","Select","Select",""],["","47781030301","NITROFURANTN CAP","100MG","14","Select","Select",""],["","43386009019","GAVILYTE-G SOL","","4000","Select","Select",""],["","68382025116","ATORVASTATIN TAB","40MG","90","Select","Select",""],["","00173088710","TRELEGY AER","100MCG","60","Select","Select",""],["","67877021660","CEFUROXIME TAB","500MG","20","Select","Select",""],["","00069108530","PAXLOVID TAB","300-100","30","Select","Select",""],["","00173088710","TRELEGY AER ELLIPTA","","60","Select","Select",""],["","68180012202","CEPHALEXIN CAP","500MG","30","Select","Select",""],["","00169633910","NOVOLOG FLEXPEN","100\/ML (3)","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":""}]}]}