{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TYRONE WATERS","gend":0,"add":"528 SMITHFIELD AVE","city":"WINCHESTER","state":"VA","zip":"22601-9998","dob":"1967-02-04","age":"","mstatus":"","insh":"20053935*01","cliId":"","pno":5404860351,"cno":5404860351,"email":"","ename":"","eno":"","pphy":"ALBEDRANI, KHALID MD","ppno":5407222369,"pcpadd":"1330 AMHERST STREET, SUITE C","pcpcity":"WINCHESTER","pcpstate":"VA","pcpzip":"22601-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"NORTHERN & WINCHESTER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":5407226601,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M75.121","S43.431A","M19.011","M75.41","F43.10","F33.1","F43.22","G89.18","M25.511","V58.89","Z47.89","F25.0","V62.85","F19.10","F10.129","Z20.822","V62.84","F32.1","M51.37","M47.817","Z20.828","Z03.818","F12.20","B18.2","R06.83","F41.9","NO DATA","Z79.899","F17.210","M46.1","R63.4","Z76.89","F41.1","F33.9","M75.111"],"date":["2023-01-27","2022-10-13","2023-01-27","2023-01-27","2023-03-21","2022-06-08","2022-03-21","2022-10-13","2022-10-31","2023-01-27","2022-10-31","2023-01-20","2021-01-23","2021-01-23","2021-01-23","2021-01-23","2021-01-23","2021-01-26","2022-02-03","2022-02-03","2021-01-13","2021-01-20","2021-06-02","2022-10-13","2022-10-13","2022-10-13","2022-10-13","2022-10-13","2022-10-13","2021-01-26","2022-09-09","2022-09-09","2022-09-09","2022-09-09","2022-10-13"],"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":[["","00172392670","DIAZEPAM","TAB 5MG","2","Select","Select",""],["","65862049101","QUETIAPINE","TAB 100MG","90","Select","Select",""],["","00555032302","HYDROXYZ PAM","CAP 25MG","90","Select","Select",""],["","65162075710","DIVALPROEX","TAB 500MG ER","60","Select","Select",""],["","65162055310","METAXALONE","TAB 800MG","90","Select","Select",""],["","65862019405","FLUOXETINE","CAP 40MG","30","Select","Select",""],["","00536589588","NICOTINE TD","DIS 14MG\/24H","21","Select","Select",""],["","00093005805","TRAMADOL HCL","TAB 50MG","21","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","32","Select","Select",""],["","00093406901","PRAZOSIN HCL","5 MG","30","Select","Select",""],["","16729020301","BUSPIRONE","TAB 15MG","60","Select","Select",""],["","51991074890","DULOXETINE","CAP 60MG","30","Select","Select",""],["","69097096507","NABUMETONE","TAB 500MG","42","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","30","Select","Select",""],["","68462010530","ONDANSETRON","TAB 4MG","20","Select","Select",""],["","69097015907","MELOXICAM","TAB 15MG","30","Select","Select",""],["","51672129803","KETOCONAZOLE","CRE 0.02","45","Select","Select",""],["","13107003134","MIRTAZAPINE","15 MG","30","Select","Select",""],["","00603533815","PREDNISONE","PAK 10MG","21","Select","Select",""],["","33342007007","OLANZAPINE","10 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":""}]}]}