{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TIMOTHY ZIMMERMAN","gend":0,"add":"6104 CLUSTER SPRINGS ROAD","city":"ALTON","state":"VA","zip":"24520-9998","dob":"1970-06-14","age":"","mstatus":"","insh":"20055790*01","cliId":"","pno":4347532940,"cno":4347532940,"email":"","ename":"","eno":"","pphy":"ISKANDAR, SAID B MD","ppno":4345728977,"pcpadd":"2232 WILBORN AVENUE","pcpcity":"SOUTH BOSTON","pcpstate":"VA","pcpzip":"24592-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4345722510,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z01.812","Z20.822","R06.00","G47.33","J44.9","NO DATA","I10.","I36.1","F17.200","R80.9","N18.2","N17.9","I13.10","E66.9","R94.5","F10.20","R77.8","K70.30","K64.9","R74.01","B18.2","Z86.010","R06.09","E78.2","F17.210","N20.0","K70.0","Z11.59","R60.0","I27.81","I50.32","K29.70","K74.60","Z12.11","D12.3","D69.6","G47.10","I27.20","N18.9","R80.1","R60.9","E66.01","E87.1","E87.70","I50.33","E87.8","I95.1","K92.1","Z01.810","J43.8","Z09.","Z68.42","E86.0","R76.8","I25.10","Z88.0","Z88.5","G47.30","Z87.891","Z96.642","Z82.49","Z82.0","Z79.899","I34.0","I07.1","F41.9","J06.9","R05.1","R06.2","Z68.41","R79.89","F10.10","I50.41","Z23.","E87.2","K21.9","E78.00","I11.0","Z68.39","E55.9","D53.9","K29.00","R93.2","Z68.38","F17.290","Z79.51"],"date":["2022-02-04","2022-02-04","2021-05-21","2023-02-19","2023-02-19","2023-02-19","2022-12-08","2021-05-21","2021-10-19","2021-11-18","2022-09-06","2021-11-18","2021-08-09","2022-03-02","2022-03-02","2023-01-06","2023-02-27","2023-02-27","2022-05-17","2023-02-27","2023-02-27","2023-02-27","2022-12-08","2022-05-16","2023-02-03","2022-09-06","2022-09-06","2021-03-01","2022-05-16","2021-11-01","2022-12-08","2022-02-09","2023-02-27","2021-03-10","2021-03-10","2023-01-06","2021-03-11","2021-06-19","2021-11-16","2021-08-09","2021-08-09","2023-02-03","2021-11-01","2021-09-23","2021-09-21","2021-11-01","2021-11-01","2021-11-01","2022-02-04","2021-09-23","2021-09-23","2021-11-05","2021-11-05","2022-02-04","2022-02-09","2022-02-09","2022-02-09","2022-02-09","2022-02-09","2022-02-09","2022-02-09","2022-02-09","2022-02-09","2022-04-11","2022-04-11","2022-08-25","2023-02-03","2023-02-03","2023-02-03","2023-02-03","2021-01-29","2021-01-29","2021-09-18","2021-10-18","2021-11-01","2021-11-01","2021-11-01","2021-11-01","2021-11-01","2021-11-01","2021-11-01","2022-02-09","2022-08-17","2022-10-25","2021-04-15","2021-09-17"],"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":[["","68645055154","LISINOPRIL","TAB 5MG","90","Select","Select",""],["","65649040001","PLENVU","SOL ","3","Select","Select",""],["","16729029310","EPLERENONE","25 MG","90","Select","Select",""],["","58160082311","SHINGRIX","INJ 50\/0.5ML","1","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","00069047103","CHANTIX","PAK 0.5& 1MG","53","Select","Select",""],["","00173068220","VENTOLIN HFA","90 MCG","18","Select","Select",""],["","00173085910","BREO ELLIPTA","INH 100-25","60","Select","Select",""],["","00186037020","SYMBICORT","160-4.5MCG","10.2","Select","Select",""],["","00310737020","BUDES\/FORMOT","AER 160-4.5","10","Select","Select",""],["","68645051554","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","43547040111","FUROSEMIDE","TAB 20MG","30","Select","Select",""],["","45802004935","TRIAMCINOLON","OIN 0.005","15","Select","Select",""],["","00904549280","THERA-M","TAB ","30","Select","Select",""],["","29300041001","ATENOLOL","25 MG","90","Select","Select",""],["","50111091601","TORSEMIDE","10 MG","90","Select","Select",""],["","69315012710","FOLIC ACID","TAB 1000MCG","30","Select","Select",""],["","80681009800","VITAMIN B-1","TAB 100MG","30","Select","Select",""],["","11845069305","VITAMIN B-12","TAB 1000MCG","30","Select","Select",""],["","69315031228","PROCTO-MED","CRE HC 2.5%","28","Select","Select",""],["","00074262528","MAVYRET","TAB 100-40MG","84","Select","Select",""],["","58160081552","TWINRIX","INJ ","1","Select","Select",""],["","70010016305","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","68645052254","SERTRALINE","TAB 50MG","30","Select","Select",""],["","49035045875","ALLERGY REL","TAB 10MG","90","Select","Select",""],["","57664037708","TRAMADOL HCL","TAB 50MG","15","Select","Select",""],["","58160082152","ENGERIX-B","INJ 20MCG\/ML","1","Select","Select",""],["","49281072210","FLUBLOK QUAD","INJ 2022-23","0","Select","Select",""],["","80777028299","MODERNA BIVA","INJ BA4\/BA5","0","Select","Select",""],["","59746017310","PREDNISONE","10 MG","21","Select","Select",""],["","70010016305","CETIRIZINE HCL","10 MG","30","Select","Select",""],["","66993001968","ALBUTEROL SULFATE HFA","90 MCG","18","Select","Select",""],["","45802006435","TRIAMCINOLONE ACETONIDE","0.1 %","45","Select","Select",""],["","42806071401","BENZONATATE","100 MG","30","Select","Select",""],["","50111078710","AZITHROMYCIN","250 MG","6","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":""}]}]}