{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"FLORA BARCENAS ERAZO","gend":1,"add":"14008 ERMENE CT","city":"WOODBRIDGE","state":"VA","zip":"22193-9998","dob":"1941-10-24","age":"","mstatus":"","insh":"20076149*01","cliId":"","pno":7038991753,"cno":7038991753,"email":"","ename":"","eno":"","pphy":"BORNACELLY PEREZ, MICHEL MD","ppno":7034946111,"pcpadd":"12480 DILLINGHAM SQUARE,","pcpcity":"WOODBRIDGE","pcpstate":"VA","pcpzip":"22192-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"NORTHERN & WINCHESTER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7034970476,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E89.0","Z85.850","C90.02","Z51.12","Z01.810","C90.00","I08.3","I77.810","Z51.11","K86.9","I10.","M81.0","Z23.","R21.","R35.0","K86.89","I51.7","M89.8X8","J98.11","I70.0","M41.85","M51.35","M51.36","Z90.49","Z90.710","Z87.81","K86.2","C73.","C34.2","E03.9","R11.2","R53.83","J18.9","R05.3","J45.40","I42.9","I07.1","NO DATA","I35.1","I35.8","J45.21","J16.8","Z20.822","R63.0","Z51.5","R55.","I50.30","C34.90","M25.511","M54.2"],"date":["2023-08-29","2022-10-25","2023-09-21","2023-09-21","2022-05-10","2022-11-29","2022-05-10","2022-11-03","2022-04-06","2022-04-14","2023-08-29","2023-01-09","2023-02-22","2022-10-11","2022-10-11","2022-04-12","2022-04-12","2022-04-12","2022-04-12","2022-04-12","2022-04-12","2022-04-12","2022-04-12","2022-04-12","2022-04-12","2022-04-12","2022-05-17","2022-05-17","2023-09-06","2022-05-17","2022-07-28","2022-07-28","2022-11-29","2022-11-29","2023-08-29","2022-05-10","2022-11-03","2022-11-03","2023-08-30","2022-11-03","2023-01-09","2022-10-30","2022-10-30","2022-07-28","2022-07-28","2023-08-30","2023-08-30","2023-09-06","2023-09-06","2023-09-06"],"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":[["","50742061610","METOPROL SUC","TAB 50MG ER","90","Select","Select",""],["","00378180710","LEVOTHYROXIN","TAB 88MCG","90","Select","Select",""],["","68382079101","ACYCLOVIR","400 MG","168","Select","Select",""],["","00054418425","DEXAMETHASON","TAB 4MG","100","Select","Select",""],["","33342007810","VALSART\/HCTZ","TAB 320-25MG","30","Select","Select",""],["","65862032904","ALENDRONATE","TAB 70MG","4","Select","Select",""],["","68180072003","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","59572050321","POMALYST","3 MG","21","Select","Select",""],["","59746011506","PROCHLORPER","TAB 10MG","32","Select","Select",""],["","68462010530","ONDANSETRON","TAB 4MG","40","Select","Select",""],["","49483048112","ASPIRIN LOW","TAB 81MG EC","30","Select","Select",""],["","50428029464","CVS SENNA PL","TAB 8.6-50MG","120","Select","Select",""],["","00093310905","AMOXICILLIN","CAP 500MG","21","Select","Select",""],["","67877025130","TRIAMCINOLON","CRE 0.001","30","Select","Select",""],["","49884090738","MEGESTROL AC","SUS 40MG\/ML","300","Select","Select",""],["","00121087316","LACTULOSE","SOL 10GM\/15","473","Select","Select",""],["","49483060450","IBUPROFEN","TAB 800MG","20","Select","Select",""],["","64380071207","BENZONATATE","CAP 100MG","20","Select","Select",""],["","00093321930","KETOCONAZOLE","2 %","30","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","70436015542","PROMETHAZINE","SOL DM","240","Select","Select",""],["","67877054360","CEFDINIR","CAP 300MG","20","Select","Select",""],["","24658031205","DOXYCYCL HYC","TAB 100MG","14","Select","Select",""],["","00536124701","SENEXON-S","8.6MG-50MG","120","Select","Select",""],["","67877019810","AMLODIPINE BESYLATE","5 MG","30","Select","Select",""],["","66993001968","ALBUTEROL SULFATE HFA","90 MCG","18","Select","Select",""],["","50742061610","METOPROLOL SUCCINATE","50 MG","90","Select","Select",""],["","43547031509","VALSARTAN-HYDROCHLOROTHIAZIDE","320MG-25MG","90","Select","Select",""],["","00378064110","PREDNISONE","10 MG","14","Select","Select",""],["","65862032904","ALENDRONATE SODIUM","70 MG","12","Select","Select",""],["","00378180710","LEVOTHYROXINE SODIUM","88 MCG","90","Select","Select",""],["","00054418425","DEXAMETHASON TAB","4MG","28","Select","Select",""],["","65862032904","ALENDRONATE TAB","70MG","4","Select","Select",""],["","33342007810","VALSART\/HCTZ TAB","320-25MG","90","Select","Select",""],["","00378180710","LEVOTHYROXIN TAB","88MCG","90","Select","Select",""],["","50742061610","METOPROL SUC TAB","50MG ER","90","Select","Select",""],["","68382079101","ACYCLOVIR TAB","400MG","180","Select","Select",""],["","68180072003","AMLODIPINE TAB","5MG","90","Select","Select",""],["","49483048112","ASPIRIN LOW TAB","81MG EC","30","Select","Select",""],["","59572050321","POMALYST CAP","3MG","21","Select","Select",""],["","68462010530","ONDANSETRON TAB","4MG","40","Select","Select",""],["","59746011506","PROCHLORPER TAB","10MG","32","Select","Select",""],["","50428029464","CVS SENNA PL TAB","8.6-50MG","120","Select","Select",""],["","49884090738","MEGESTROL AC SUS","40MG\/ML","300","Select","Select",""],["","00121087316","LACTULOSE SOL","10GM\/15","473","Select","Select",""],["","67877054360","CEFDINIR CAP","300MG","20","Select","Select",""],["","00093310905","AMOXICILLIN CAP","500MG","21","Select","Select",""],["","00093317431","ALBUTEROL AER HFA","","8","Select","Select",""],["","49483060450","IBUPROFEN TAB","800MG","20","Select","Select",""],["","67877025130","TRIAMCINOLON CRE","0.1%","30","Select","Select",""],["","64380071207","BENZONATATE CAP","100MG","20","Select","Select",""],["","00093321930","KETOCONAZOLE CRE","2%","30","Select","Select",""],["","24658031205","DOXYCYCL HYC TAB","100MG","14","Select","Select",""],["","00536124701","SENEXON-S TAB","8.6-50MG","120","Select","Select",""],["","70436015542","PROMETHAZINE SOL DM","","240","Select","Select",""],["","70954040310","DEXAMETHASONE","4 MG","20","Select","Select",""],["","00173060002","FLOVENT DISKUS","50 MCG","60","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":""}]}]}