{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"COURTNEY  M BROWN","gend":0,"add":"6921 MARLOWE RD APT 1020","city":"RICHMOND","state":"VA","zip":"23225-9998","dob":"1989-07-19","age":"","mstatus":"","insh":"2214057*01","cliId":"","pno":8047484293,"cno":8047484293,"email":"","ename":"","eno":"","pphy":"AKBAR, SALMAN MD","ppno":8043305452,"pcpadd":"909 HIOAKS RD STE F\/G","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":"23225-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8043379950,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J96.01","B20.","R00.0","R94.31","R06.02","J96.00","A53.9","Z23.","A41.9","Z20.822","B59.","E87.2","E88.09","I10.","Z78.9","Z87.891","Z91.19","N45.1","A60.00","B25.9","Z79.899","A64.","A60.02","Z21.","R30.0","R09.02","R91.8"],"date":["2022-07-07","2023-01-23","2022-07-06","2022-07-06","2022-07-05","2022-07-08","2022-10-24","2022-11-03","2022-07-04","2022-07-04","2022-07-04","2022-07-04","2022-07-04","2022-10-07","2022-07-04","2022-10-07","2022-07-04","2021-10-11","2021-10-11","2022-10-07","2022-10-07","2021-03-31","2021-10-11","2021-10-11","2021-10-11","2022-07-05","2022-07-05"],"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":[["","59676080030","SYMTUZA","800-150 MG","30","Select","Select",""],["","29300012810","HYDROCHLOROT","TAB 25MG","30","Select","Select",""],["","65862042005","SMZ\/TMP DS","TAB 800-160","30","Select","Select",""],["","65162062711","TRAMADOL HCL","TAB 50MG","15","Select","Select",""],["","00378427677","VALACYCLOVIR","TAB 1GM","5","Select","Select",""],["","53489012002","DOXYCYCL HYC","TAB 100MG","14","Select","Select",""],["","70954006020","PREDNISONE","TAB 20MG","28","Select","Select",""],["","00378001805","METOPROL TAR","TAB 25MG","60","Select","Select",""],["","65862020399","LOSARTAN POT","TAB 100MG","30","Select","Select",""],["","57237000430","FLUCONAZOLE","100 MG","30","Select","Select",""],["","69452015120","VITAMIN D","2 1250 MCG","4","Select","Select",""],["","27241021601","CHLORTHALID","TAB 25MG","30","Select","Select",""],["","65862042005","SULFAMETHOXAZOLE-TRIMETHOPRIM","800-160 MG","30","Select","Select",""],["","27241021601","CHLORTHALIDONE","25 MG","90","Select","Select",""],["","45802065087","LORATADINE","10 MG","90","Select","Select",""],["","65862020399","LOSARTAN POTASSIUM","100 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":""}]}]}