{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JULIO CUEVAS","gend":0,"add":"1139 GEORGETOWN RD APT 203","city":"NORFOLK","state":"VA","zip":"23502-9998","dob":"1985-08-10","age":"","mstatus":"","insh":"2257002*01","cliId":"","pno":4847199342,"cno":4847199342,"email":"","ename":"","eno":"","pphy":"BARNETT, STEVEN K MD","ppno":7576400929,"pcpadd":"1001 MONTICELLO AVE STE 100,","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":"23510-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8662920928,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["B20.","E05.90","N40.1","K52.9","I10.","J06.9","Z20.822","I20.8","R01.1","R05.4","F17.210","R21.","K13.0"],"date":["2022-10-22","2022-10-22","2022-04-23","2022-04-23","2022-10-22","2021-04-28","2021-04-28","2021-10-07","2021-10-07","2021-10-07","2021-10-07","2022-07-30","2022-07-30"],"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":[["","61958250101","BIKTARVY","50-200-25","30","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","00603548421","PROPRANOLOL","TAB 40MG","30","Select","Select",""],["","43598057530","TADALAFIL","TAB 5MG","30","Select","Select",""],["","57237011490","ALFUZOSIN","TAB 10MG ER","30","Select","Select",""],["","67877019890","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","70564080260","MYTESI","TAB 125MG","60","Select","Select",""],["","51672127502","CLOTRIMAZOLE","CRE 0.01","30","Select","Select",""],["","57237000511","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","69238110005","DOXYCYCL HYC","CAP 100MG","14","Select","Select",""],["","00574200802","NYSTOP","POW 100000","60","Select","Select",""],["","59746017306","PREDNISONE","TAB 10MG","30","Select","Select",""],["","16571020110","DICLOFENAC","TAB 75MG DR","60","Select","Select",""],["","00069034530","PAXLOVID","TAB 300-100","30","Select","Select",""],["","57237002801","AMOXICILLIN","TAB 500MG","20","Select","Select",""],["","72888001405","CYCLOBENZAPR","TAB 10MG","20","Select","Select",""],["","00603548421","PROPRANOLOL HCL","40 MG","30","Select","Select",""],["","67877019890","AMLODIPINE BESYLATE","5 MG","30","Select","Select",""],["","61958250101","BIKTARVY TAB","","30","Select","Select",""],["","00603548421","PROPRANOLOL TAB","40MG","30","Select","Select",""],["","00093101042","MUPIROCIN OIN","2%","22","Select","Select",""],["","70564080260","MYTESI TAB","125MG","60","Select","Select",""],["","43598057530","TADALAFIL TAB","5MG","30","Select","Select",""],["","67877019890","AMLODIPINE TAB","5MG","30","Select","Select",""],["","57237011490","ALFUZOSIN TAB","10MG ER","30","Select","Select",""],["","51672127502","CLOTRIMAZOLE CRE","1%","30","Select","Select",""],["","57237000511","FLUCONAZOLE TAB","150MG","2","Select","Select",""],["","00574200802","NYSTOP POW","100000","60","Select","Select",""],["","72888001405","CYCLOBENZAPR TAB","10MG","20","Select","Select",""],["","00069034530","PAXLOVID TAB","300-100","30","Select","Select",""],["","16571020110","DICLOFENAC TAB","75MG DR","60","Select","Select",""],["","57237002801","AMOXICILLIN TAB","500MG","20","Select","Select",""],["","69238110005","DOXYCYCL HYC CAP","100MG","14","Select","Select",""],["","59746017306","PREDNISONE TAB","10MG","30","Select","Select",""],["","51672128402","TRIAMCINOLONE ACETONIDE","0.1 %","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":""}]}]}