{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TRACEY M SWETT","gend":1,"add":"106 HUPPS HILL CT","city":"STRASBURG","state":"VA","zip":"22657-9998","dob":"1984-01-25","age":"","mstatus":"","insh":"2311264*01","cliId":"","pno":7035951882,"cno":7035951882,"email":"","ename":"","eno":"","pphy":"MIR, PAYAM MD","ppno":7033724429,"pcpadd":"11213 LEE HWY STE H,","pcpcity":"FAIRFAX","pcpstate":"VA","pcpzip":"22030-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"NORTHERN & WINCHESTER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7036890077,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F31.10","F31.31","NO DATA","Z30.41","Z20.828","J20.9","M25.512","Z32.02","Z79.3","R11.0","R51.9","N92.1","F33.2","U07.1","Z03.818","Z30.9","O26.891","Z3A.09","R55.","R10.2","O46.8X1","O34.81","N83.12","R82.71","O99.331","F17.200","Z88.5","O09.521"],"date":["2022-04-11","2021-06-01","2021-11-16","2022-05-20","2022-01-13","2022-01-13","2021-08-10","2022-05-20","2021-08-10","2021-12-23","2021-12-23","2022-12-06","2023-01-20","2022-01-19","2021-01-18","2021-05-11","2022-07-22","2022-07-22","2022-07-22","2022-07-22","2022-07-22","2022-07-22","2022-07-22","2022-07-22","2022-07-22","2022-07-22","2022-07-22","2022-07-22"],"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":[["","00054418625","DEXAMETHASON","TAB 6MG","5","Select","Select",""],["","65862048901","QUETIAPINE","TAB 25MG","30","Select","Select",""],["","16729020201","BUSPIRONE","TAB 10MG","60","Select","Select",""],["","42806016005","HYDROXYZ HCL","TAB 25MG","90","Select","Select",""],["","57237004705","DIVALPROEX","TAB 250MG DR","90","Select","Select",""],["","65162019050","NAPROXEN","TAB 500MG","60","Select","Select",""],["","68462030929","NORGEST\/ETHI","TAB 0.25\/35","84","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","20","Select","Select",""],["","59762500801","MISOPROSTOL","TAB 200MCG","8","Select","Select",""],["","10702000350","PROMETHAZINE","TAB 25MG","10","Select","Select",""],["","65862077685","MILI","TAB 0.25\/35","84","Select","Select",""],["","68180016011","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","64380080807","IBUPROFEN","600 MG","24","Select","Select",""],["","00406012305","HYDROCODONE-ACETAMINOPHEN","5 MG-325MG","4","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":""}]}]}