{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SHAHID CHOUDHURY","gend":0,"add":"12020 WHEAT RIDGE CTS","city":"GLEN ALLEN","state":"VA","zip":"23059-9998","dob":"1951-11-07","age":"","mstatus":"","insh":"20081168*01","cliId":"","pno":4698552412,"cno":4698552412,"email":"","ename":"","eno":"","pphy":"PARAS, KERRIE PA","ppno":8049685700,"pcpadd":"SUITE 100 5000 COX ROAD,","pcpcity":"GLEN ALLEN","pcpstate":"VA","pcpzip":"23060-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8049685739,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H04.123","E11.9","Z96.1","NO DATA","I10."],"date":["2022-02-08","2022-02-08","2022-02-08","2022-03-17","2022-03-17"],"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":[["","64980028001","GLIPIZIDE ER","TAB 5MG","60","Select","Select",""],["","50742061610","METOPROL SUC","TAB 50MG ER","30","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","70377002911","ATORVASTATIN","TAB 40MG","90","Select","Select",""],["","00536104710","SODIUM BICAR","TAB 650MG","60","Select","Select",""],["","33342017910","OLMESA MEDOX","TAB 20MG","90","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","90","Select","Select",""],["","11877001140","BINAXNOW COV","KIT HOME TES","2","Select","Select",""],["","80777027399","MODERNA VAC","INJ COVID-19","0","Select","Select",""],["","59267102504","PFIZER VACC","INJ ADLT RTU","0","Select","Select",""],["","68180072103","AMLODIPINE BESYLATE","10 MG","30","Select","Select",""],["","64980028001","GLIPIZIDE ER TAB","5MG","60","Select","Select",""],["","68382025116","ATORVASTATIN TAB","40MG","90","Select","Select",""],["","33342017807","OLMESA MEDOX TAB","5MG","30","Select","Select",""],["","50742061610","METOPROL SUC TAB","50MG ER","30","Select","Select",""],["","68180072103","AMLODIPINE TAB","10MG","30","Select","Select",""],["","65862085901","FAMOTIDINE TAB","20MG","90","Select","Select",""],["","00536104710","SODIUM BICAR TAB","650MG","60","Select","Select",""],["","11877001140","BINAXNOW COV KIT HOME TES","","2","Select","Select",""],["","59267102504","PFIZER VACC INJ ADLT RTU","","0","Select","Select",""],["","80777027399","MODERNA VAC INJ COVID-","19","0","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":""}]}]}