{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MARECUS  A MAUPIN","gend":0,"add":"316 NEWBRIDGE RD APT 145","city":"RICHMOND","state":"VA","zip":"23223-9998","dob":"1982-06-26","age":"","mstatus":"","insh":"20082574*01","cliId":"","pno":8042036901,"cno":8042036901,"email":"","ename":"","eno":"","pphy":"MUELLER, GEORGE DO","ppno":8045590405,"pcpadd":"7505 RIGHT FLANK ROAD SUITE 700","pcpcity":"MECHANICSVILLE","pcpstate":"VA","pcpzip":"23116-9998","pcpcounty":"","pcpid":"","pcpname":"Virginia Cardiovascular Specialists","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8045590409,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E87.5","G47.33","N18.6","Z99.2","J10.89","I82.402","I12.0","Z87.891","I51.7","R94.31","I82.622","R07.81","M54.2","R00.0","R07.9","I82.412","M79.642","M10.30","J01.90","B96.89","Z20.822","A41.9","J10.1","I82.C12","D63.1","M10.9","T82.898A","Z49.01","F17.210","Z76.82","N25.0","Z88.8","Z86.718","Z90.89","Z98.890","Z79.899","R06.02","T82.868A","Q61.2","E83.39","I16.9","Z95.828","I08.0","I10.","Z72.0","Z90.5","Z01.818","T82.848A","T82.510A","Z04.9","Z01.810","T82.856A","I82.C11","T82.590A","T82.9XXA","X58.XXXA","Q61.3","Z53.29","Z87.440","N50.1","N50.819"],"date":["2023-02-15","2023-02-15","2023-03-21","2023-03-01","2023-03-01","2023-02-10","2023-02-08","2023-02-08","2023-02-10","2023-02-10","2023-01-15","2023-01-15","2023-01-15","2023-01-25","2023-01-15","2023-03-02","2022-04-07","2023-03-21","2022-09-25","2022-09-25","2023-02-08","2022-11-01","2022-11-01","2023-02-15","2023-02-15","2023-02-08","2023-03-21","2023-03-21","2023-03-21","2022-10-31","2023-02-08","2022-10-31","2022-10-31","2022-10-31","2022-10-31","2022-10-31","2022-10-31","2023-02-15","2023-02-15","2023-02-15","2023-02-15","2023-02-15","2023-02-15","2023-02-15","2023-02-15","2023-02-15","2022-07-14","2022-12-15","2023-02-08","2023-03-02","2022-07-27","2022-08-24","2022-12-15","2023-01-25","2023-01-25","2023-01-25","2023-02-08","2023-02-08","2023-02-08","2023-02-18","2023-02-18"],"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":[["","00378668977","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","65862078430","ESOMEPRA MAG","CAP 40MG DR","30","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","65862083130","CINACALCET","TAB 30MG","30","Select","Select",""],["","65862050220","AMOX\/K CLAV","TAB 500-125","10","Select","Select",""],["","70954005830","PREDNISONE","PAK 5MG","21","Select","Select",""],["","47781046813","OSELTAMIVIR","CAP 30MG","2","Select","Select",""],["","65862083130","CINACALCET HCL","30 MG","30","Select","Select",""],["","00093172110","WARFARIN SODIUM","5 MG","30","Select","Select",""],["","00003089421","ELIQUIS","5 MG","74","Select","Select",""],["","49884012305","LABETALOL HCL","200 MG","60","Select","Select",""],["","29300039810","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":""}]}]}