{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"EVIN MALDONADO","gend":0,"add":"308 WADSWORTH DR","city":"RICHMOND","state":"VA","zip":"23236-9998","dob":"1993-10-18","age":"","mstatus":"","insh":"2322999*01","cliId":"","pno":8043988924,"cno":8043988924,"email":"","ename":"","eno":"","pphy":"FAROOQI, SHAZIA MD","ppno":5405203507,"pcpadd":"112 S PROVIDENCE ROAD SUITE 103","pcpcity":"NORTH CHESTERFIELD","pcpstate":"VA","pcpzip":"23236-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8006769961,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G51.4","F17.210","T43.615A","R25.3","B96.3","D64.9","E86.0","B20.","E87.1","R50.9","Z51.89","R53.1","Z48.817","M00.852","A41.89","M25.452","E80.6","E88.09","R73.9","F41.9","M79.621","G47.9","Z21.","R61.","E55.9","Z79.899","M79.605","M25.552","R78.81","M00.859","A49.2","Z68.26","D52.9","Z45.2","Z79.2","Z91.81","M62.81","A41.3","N17.9","E22.2","E44.1","M00.9","E11.22","E11.65","E86.1","G47.00","NO DATA","Z20.822","R26.2","A41.9","R65.10","R29.898","R52.","R22.42","Z95.9"],"date":["2022-08-22","2022-12-08","2022-08-22","2022-08-22","2023-01-05","2022-12-09","2022-12-08","2023-02-07","2023-01-05","2022-12-03","2022-12-09","2022-12-09","2022-12-08","2023-01-05","2022-12-09","2023-01-01","2022-12-09","2023-01-05","2022-12-08","2023-01-05","2022-12-12","2022-12-08","2022-12-08","2022-12-08","2023-02-07","2021-10-13","2022-11-19","2022-11-23","2022-12-12","2022-12-05","2022-12-12","2022-12-05","2023-01-05","2023-01-05","2023-01-05","2023-01-05","2023-01-05","2022-11-17","2022-11-17","2022-11-17","2022-11-17","2022-12-12","2022-11-17","2022-11-17","2022-11-17","2022-11-17","2022-11-17","2022-11-17","2022-11-17","2022-11-19","2022-11-19","2022-11-19","2022-11-16","2022-11-19","2022-12-12"],"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",""],["","64380073706","VITAMIN D","2 1250 MCG","4","Select","Select",""],["","59676058005","JANSSEN VACC","INJ COVID-19","0","Select","Select",""],["","49483060450","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","76385012450","METHOCARBAM","TAB 750MG","16","Select","Select",""],["","11534016503","FOLIC ACID","TAB 1MG","30","Select","Select",""],["","08290306414","HEPARIN LOCK","INJ 10UNT\/ML","25","Select","Select",""],["","60505614904","CEFTRIAXONE","INJ 2GM","7","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":""}]}]}