{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DOUGLAS PAIGE","gend":0,"add":"511 S FAYETTE ST","city":"ALEXANDRIA","state":"VA","zip":"22314-9998","dob":"1963-01-05","age":"","mstatus":"","insh":"2152890*01","cliId":"","pno":7035494396,"cno":7035494396,"email":"","ename":"","eno":"","pphy":"HADJIVASSILIOU, GIORGOS MD","ppno":7035355568,"pcpadd":"8221 WILLOW OAKS CORPORATE DR STE 4,","pcpcity":"FAIRFAX","pcpstate":"VA","pcpzip":"22031-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"NORTHERN & WINCHESTER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7032991794,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z23.","I10.","B20.","E78.00","S99.192A","S92.302A","W10.9XXA","S92.355A","R00.0","R26.9"],"date":["2021-10-19","2021-01-29","2021-01-29","2021-01-29","2022-04-19","2022-04-19","2022-04-19","2022-04-08","2022-04-08","2021-02-28"],"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":[["","60505257909","ATORVASTATIN","TAB 20MG","30","Select","Select",""],["","49702023113","TRIUMEQ","TAB ","30","Select","Select",""],["","69097012705","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","49348098053","SM ASPIRIN","TAB 81MG EC","30","Select","Select",""],["","10135068962","ASPIRIN","TAB 81MG EC","30","Select","Select",""],["","49702024613","DOVATO","50MG-300MG","30","Select","Select",""],["","00536123441","ASPIRIN LOW","TAB 81MG EC","30","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","10","Select","Select",""],["","70677013202","SM ASPIRIN TAB","81MG EC","30","Select","Select",""],["","67877019805","AMLODIPINE TAB","5MG","30","Select","Select",""],["","60505257909","ATORVASTATIN TAB","20MG","30","Select","Select",""],["","49702024613","DOVATO TAB","50-300MG","30","Select","Select",""],["","00536123441","ASPIRIN LOW TAB","81MG EC","30","Select","Select",""],["","53746010901","HYDROCO\/APAP TAB","5-325MG","10","Select","Select",""],["","72205002390","ATORVASTATIN CALCIUM","20 MG","30","Select","Select",""],["","67877019805","AMLODIPINE BESYLATE","5 MG","30","Select","Select",""],["","00536123441","ASPIRIN EC","81 MG","30","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":""}]}]}