{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MOHAMMAD  S MOHAMMADI","gend":0,"add":"14658 FORSYTHIA TERRACE","city":"WOODBRIDGE","state":"VA","zip":"22193-9998","dob":"1954-09-12","age":"","mstatus":"","insh":"20068992*01","cliId":"","pno":5713517433,"cno":5713517433,"email":"","ename":"","eno":"","pphy":"MARTIN, RHONDA M MD","ppno":7034501125,"pcpadd":"SUITE 107 46440 BENEDICT DRIVE,","pcpcity":"STERLING","pcpstate":"VA","pcpzip":"20164-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"NORTHERN & WINCHESTER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7034501145,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F03.90","C61.","N40.1","N52.9","N39.3","I25.10","R07.9","I10.","E78.5","E11.8","H11.151","H17.811","H25.13","H40.013","H53.8","H52.4","H52.03","H52.223","M25.561","M76.51","R06.02","F32.9","F41.9","K21.9","Z13.6","Z23.","Z85.46","NO DATA"],"date":["2021-03-31","2022-09-01","2023-02-09","2022-09-01","2022-09-01","2022-09-01","2022-08-01","2023-02-09","2023-02-09","2021-11-22","2022-07-14","2022-07-14","2022-07-14","2022-07-14","2022-07-14","2022-07-14","2022-07-14","2022-07-14","2021-01-15","2021-01-15","2022-08-01","2023-02-09","2023-02-09","2023-02-09","2023-02-09","2023-02-09","2023-02-09","2023-02-09"],"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":[["","68645055754","LISINOP\/HCTZ TAB","20-12.5","30","Select","Select",""],["","00093505998","ATORVASTATIN TAB","20MG","90","Select","Select",""],["","49035056314","ASPIRIN LOW TAB","81MG EC","30","Select","Select",""],["","61314064511","NEO\/POLY\/HC SUS","1% OTIC","10","Select","Select",""],["","11877001140","BINAXNOW COV KIT HOME TES","","8","Select","Select",""],["","68382056410","METOPROL SUC TAB","25MG ER","30","Select","Select",""],["","68645055754","LISINOPRIL-HYDROCHLOROTHIAZIDE","20-12.5 MG","30","Select","Select",""],["","68382056410","METOPROLOL SUCCINATE","25 MG","30","Select","Select",""],["","49035056314","ASPIRIN EC","81 MG","30","Select","Select",""],["","00093505998","ATORVASTATIN CALCIUM","20 MG","90","Select","Select",""],["","68645059459","FAMOTIDINE","20 MG","60","Select","Select",""],["","11877001140","BINAXNOW COVID-","19 AG SELF TEST ","8","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":""}]}]}