{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ROBYN  L FUCHS","gend":1,"add":"11747 N SHORE DR","city":"RESTON","state":"VA","zip":"20190-9998","dob":"1983-02-21","age":"","mstatus":"","insh":"20057357*01","cliId":"","pno":2028345109,"cno":2028345109,"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":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G40.909","R56.9","NO DATA","S81.812A","Z86.73","M79.605","V89.2XXD","D57.1","F17.200","E86.0","G89.4","M54.42","D57.00","M54.9","M77.32","M25.572","M79.604","Z53.29","Z04.9","S46.911A","X50.9XXA","M79.662","N93.8","R11.2","S09.90XA","Z74.3","R10.32","G40.309","F41.9","N93.9","R11.0","R50.9","Z20.822","S61.011A","R22.31","F17.210","M79.601","R10.9","N83.299","G40.901","G89.29","R00.0","D63.8","Z87.891","Z88.8","M79.89","F43.10","L30.9","R94.31","M79.644","R10.2","N92.0","R55.","D64.9","R10.30","M25.552","N83.209","M54.32","R07.9","M32.9","R05.9","G47.01","F17.290","Z01.419","R30.9"],"date":["2023-04-03","2023-04-03","2022-11-12","2023-01-07","2023-03-01","2023-03-03","2023-03-03","2023-03-03","2023-03-03","2022-10-28","2022-10-28","2022-11-12","2023-04-03","2022-11-12","2023-03-03","2023-03-03","2023-03-01","2023-03-01","2022-10-28","2022-04-25","2022-04-25","2022-08-02","2022-08-22","2022-08-22","2023-01-07","2023-01-07","2022-12-31","2023-03-22","2023-03-14","2022-08-26","2022-12-31","2022-12-31","2023-01-03","2021-11-27","2021-11-27","2022-04-25","2022-06-21","2022-08-26","2022-10-04","2022-10-28","2022-10-28","2023-01-07","2022-10-28","2022-10-28","2022-10-28","2022-10-28","2021-01-26","2021-01-26","2021-02-02","2021-11-27","2022-08-26","2022-03-15","2022-03-15","2022-03-15","2022-06-27","2022-08-03","2022-07-12","2023-03-01","2023-04-25","2023-03-14","2021-12-13","2022-04-11","2022-08-26","2022-01-20","2022-01-20"],"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":[["","51991070505","ALPRAZOLAM","TAB 0.5MG","60","Select","Select",""],["","00172392670","DIAZEPAM","5 MG","30","Select","Select",""],["","68382003516","VENLAFAXINE","CAP 75MG ER","30","Select","Select",""],["","67877025130","TRIAMCINOLON","CRE 0.001","60","Select","Select",""],["","00131247835","VIMPAT","100 MG","60","Select","Select",""],["","51672413304","LAMOTRIGINE","TAB 200MG","60","Select","Select",""],["","00591079501","DICYCLOMINE","TAB 20MG","60","Select","Select",""],["","68180065208","DOXYCYC MONO","CAP 100MG","20","Select","Select",""],["","50111033401","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","59267100002","PFIZER VACC","INJ COVID-19","0","Select","Select",""],["","70461032103","FLUCLVX QUAD","INJ 2021-22","0","Select","Select",""],["","65162092406","LACOSAMIDE","100 MG","60","Select","Select",""],["","43547028810","BUPROPION","TAB 100MG SR","60","Select","Select",""],["","65862019105","CYCLOBENZAPR","TAB 10MG","15","Select","Select",""],["","42806016005","HYDROXYZ HCL","TAB 25MG","30","Select","Select",""],["","00054418425","DEXAMETHASON","TAB 4MG","3","Select","Select",""],["","63304069301","CLINDAMYCIN","CAP 300MG","21","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","9","Select","Select",""],["","10702025350","BUT\/APAP\/CAF","TAB ","5","Select","Select",""],["","59779086322","SLEEP-AID","TAB 25MG","16","Select","Select",""],["","16571020106","DICLOFENAC","TAB 75MG DR","60","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","20","Select","Select",""],["","65862024608","LEVETIRACETA","TAB 500MG","60","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","12","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","10","Select","Select",""],["","71930004212","HYDROCODONE-ACETAMINOPHEN","5 MG-300MG","12","Select","Select",""],["","00054023525","MORPHINE SULFATE","15 MG","5","Select","Select",""],["","71930005552","ACETAMINOPHEN-CODEINE","300MG-30MG","12","Select","Select",""],["","00093216568","NALOXONE HCL","4 MG","2","Select","Select",""],["","69584061250","METHOCARBAMOL","750 MG","15","Select","Select",""],["","00603188016","LIDOCAINE","5 %","10","Select","Select",""],["","68180012202","CEPHALEXIN","500 MG","30","Select","Select",""],["","10702001801","OXYCODONE HCL","5 MG","15","Select","Select",""],["","70710113803","FLUCONAZOLE","100 MG","10","Select","Select",""],["","16571041250","CIPROFLOXACIN HCL","500 MG","20","Select","Select",""],["","50111033401","METRONIDAZOLE","500 MG","30","Select","Select",""],["","64980014703","RISAQUAD","8B CELL","30","Select","Select",""],["","59651000305","OMEPRAZOLE","40 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":""}]}]}