{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CHRISTOPHER L PORTER","gend":0,"add":"3523 MELROSE AVE APT B","city":"TRIANGLE","state":"VA","zip":"22172-9998","dob":"1981-03-19","age":"","mstatus":"","insh":"20066851*01","cliId":"","pno":5714774319,"cno":5714774319,"email":"","ename":"","eno":"","pphy":"MOHIUDDIN, RASHID AHMED MD","ppno":7036807950,"pcpadd":"17739 MAIN STREET SUITE 130,","pcpcity":"DUMFRIES","pcpstate":"VA","pcpzip":"22026-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"NORTHERN & WINCHESTER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7036807953,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["A41.1","N17.0","U07.1","I10.","J45.909","E66.9","Z68.36","L02.219","L02.411","L03.113","L03.319","J98.2","J10.1","R65.20","F17.210","Z79.899","Z87.892","A41.9","N17.9","J45.41","I12.9","N18.9","Z68.37","Z79.891","Z09.","T81.89XA","F31.9","L92.8","J45.20","Z23.","J45.901","Z88.0","Z76.0","L02.413"],"date":["2022-11-08","2022-11-08","2022-12-02","2023-05-12","2022-11-08","2022-12-02","2022-11-08","2022-11-08","2022-12-19","2022-12-02","2022-11-08","2022-11-08","2022-11-08","2022-11-08","2023-05-12","2022-11-08","2022-11-08","2022-11-15","2022-11-15","2022-12-02","2022-12-02","2022-12-02","2022-12-02","2022-12-02","2022-12-19","2022-12-15","2022-12-12","2022-12-12","2022-12-13","2022-12-13","2023-05-12","2023-05-12","2023-05-12","2022-11-08"],"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":[["","77333098310","ZINC SULFATE","CAP 220MG","8","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","50428050854","CVS PURELAX","PAK ","10","Select","Select",""],["","65862049301","QUETIAPINE","TAB 200MG","30","Select","Select",""],["","68180072003","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","00173071620","ADVAIR HFA","115-21MCG","12","Select","Select",""],["","69097014260","ALBUTEROL SULFATE HFA","90 MCG","6.7","Select","Select",""],["","00093317431","ALBUTEROL AER HFA","","8","Select","Select",""],["","00378827052","ALBUTEROL NEB","0.083%","75","Select","Select",""],["","50428050854","CVS PURELAX PAK","","10","Select","Select",""],["","29300015001","QUETIAPINE TAB","200MG","30","Select","Select",""],["","77333098310","ZINC SULFATE CAP","220MG","8","Select","Select",""],["","68180072003","AMLODIPINE TAB","5MG","30","Select","Select",""],["","00173071620","ADVAIR HFA AER","115\/21","12","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":""}]}]}