{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JOHN W MOORE","gend":0,"add":"237 MANASSAS DR","city":"MANASSAS","state":"VA","zip":"20111-9998","dob":"1972-09-17","age":"","mstatus":"","insh":"2304312*01","cliId":"","pno":7035867032,"cno":7035867032,"email":"","ename":"","eno":"","pphy":"ISLAM, ASMA MD","ppno":7036310331,"pcpadd":"21785 FILIGREE CT STE 100","pcpcity":"ASHBURN","pcpstate":"VA","pcpzip":"20147-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"NORTHERN & WINCHESTER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7036312573,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.9","I10.","R79.89","R97.20","F41.9","E78.5","E29.1","F32.9","G47.00","R13.10","F43.10","D68.51","I82.403","L29.9","N52.01","S80.11XA","NO DATA","R21.","L03.119","Z20.822","J01.00","R20.0","L50.9","R20.2","T67.5XXS","E78.2","R53.83","S10.91XA","T14.8XXA","Z79.01","Z79.899","Z88.8","Z87.891","Z86.718","M54.2","R73.03","N52.9","W19.XXXS","S89.91XA"],"date":["2022-08-10","2022-08-10","2022-08-10","2022-06-21","2022-08-10","2022-08-10","2022-06-21","2021-07-06","2022-08-10","2022-05-09","2022-08-10","2022-05-09","2022-05-09","2022-05-09","2022-06-21","2022-11-17","2022-03-01","2022-08-23","2022-08-23","2022-02-21","2022-02-21","2022-06-03","2022-08-10","2022-06-03","2022-08-10","2022-08-10","2022-08-10","2021-03-11","2021-03-11","2022-11-17","2021-03-11","2021-03-11","2021-03-11","2021-03-11","2021-03-11","2021-03-16","2021-03-16","2021-03-16","2022-11-17"],"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":[["","65862096801","ESZOPICLONE","TAB 2MG","30","Select","Select",""],["","00228202950","ALPRAZOLAM","TAB 0.5MG","30","Select","Select",""],["","70377002911","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","68462079817","TRIAMCINOLON","OIN 0.005","15","Select","Select",""],["","68382003616","VENLAFAXINE","CAP 150MG ER","90","Select","Select",""],["","50458057930","XARELTO","TAB 20MG","30","Select","Select",""],["","69238207807","PROPRANOLOL","TAB 20MG","180","Select","Select",""],["","00591565810","CYCLOBENZAPR","TAB 10MG","6","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","12","Select","Select",""],["","65862050320","AMOX\/K CLAV","TAB 875-125","20","Select","Select",""],["","42667551101","NATESTO","GEL 5.5MG","22","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","31722070430","VALACYCLOVIR","TAB 500MG","10","Select","Select",""],["","70010049110","METFORMIN","TAB 500MG ER","90","Select","Select",""],["","58657050016","CODEINE\/GG","SOL 10-100\/5","118","Select","Select",""],["","68180016013","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","00378668910","PANTOPRAZOLE","TAB 40MG","180","Select","Select",""],["","00378064205","PREDNISONE","TAB 20MG","14","Select","Select",""],["","62332002891","LOSARTAN POT","TAB 50MG","90","Select","Select",""],["","45802046564","KETOCONAZOLE","SHA 0.02","120","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":""}]}]}