{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"EMAN KHALAF","gend":1,"add":"10111 OAKTON TERRACE RD APT 210","city":"OAKTON","state":"VA","zip":"22124-9998","dob":"1963-09-20","age":"","mstatus":"","insh":"20068556*01","cliId":"","pno":5714997107,"cno":5714997107,"email":"","ename":"","eno":"","pphy":"MULTANI, MANPREET MD","ppno":7039387800,"pcpadd":"130 PARK STREET SE SUITE 200","pcpcity":"VIENNA","pcpstate":"VA","pcpzip":"22180-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"NORTHERN & WINCHESTER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7039384541,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J84.9","M34.9","J84.10","I73.00","K21.9","R53.82","J84.112","R03.1","R42.","NO DATA","I10.","R63.0","D64.9","R06.02","I11.9","I35.0","I77.810","Z79.899","J18.9","R09.02","R74.8","L94.0","I12.9","N18.9","M34.81","Z20.822","J96.01","J00.","B97.89","J06.9","K59.00","R77.8","R59.0","Z87.891","N28.89","I05.8","R00.0","R05.9","J98.4","H35.033","H04.123","H43.393","U07.1","Z87.09","Z99.81","R19.7","R63.4","Z79.69","Z79.624"],"date":["2023-03-17","2023-03-28","2022-12-16","2023-03-28","2023-03-28","2022-04-14","2023-02-01","2021-03-27","2021-03-27","2023-03-28","2022-04-05","2022-04-05","2022-04-05","2023-03-17","2021-03-24","2021-03-24","2021-03-24","2021-11-15","2022-02-24","2023-03-17","2022-02-24","2022-02-24","2022-02-24","2023-03-17","2022-04-22","2022-02-24","2022-02-24","2022-02-24","2022-02-24","2022-02-24","2022-02-24","2022-02-24","2022-02-24","2022-02-24","2022-02-24","2022-02-25","2022-02-25","2022-04-15","2022-04-15","2022-02-17","2022-02-17","2022-02-17","2022-05-03","2022-05-02","2023-03-17","2023-03-17","2023-03-17","2023-03-17","2023-03-17"],"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":[["","67877022505","MYCOPHENOLAT","TAB 500MG","60","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","68180098103","LISINOPRIL","20 MG","90","Select","Select",""],["","00281032630","NITRO-BID","OIN 0.02","30","Select","Select",""],["","70461032103","FLUCLVX QUAD","INJ 2021-22","0","Select","Select",""],["","70954005920","PREDNISONE","TAB 10MG","24","Select","Select",""],["","57664051083","MIRTAZAPINE","TAB 7.5MG","90","Select","Select",""],["","69097014260","ALBUTEROL","AER HFA","7","Select","Select",""],["","00597014360","OFEV","100 MG","60","Select","Select",""],["","58160089052","FLUARIX QUAD","INJ 2022-23","0","Select","Select",""],["","69452020720","CALCITRIOL","0.25 MCG","30","Select","Select",""],["","59267030401","PFIZER BIVAL","INJ BA4\/BA5","0","Select","Select",""],["","67877022501","MYCOPHENOLATE MOFETIL","500 MG","60","Select","Select",""],["","69097014260","ALBUTEROL SULFATE HFA","90 MCG","6.7","Select","Select",""],["","68180072103","AMLODIPINE BESYLATE","10 MG","90","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":""}]}]}