{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"WILLIAM GRIFFIN","gend":0,"add":"202 S LLOYD ST","city":"SUFFOLK","state":"VA","zip":"23434-9998","dob":"1965-03-02","age":"","mstatus":"","insh":"2380869*01","cliId":"","pno":7573530501,"cno":7573530501,"email":"","ename":"","eno":"","pphy":"KAPOOR, SONIA MD","ppno":7575480076,"pcpadd":"SUITE 100 725 VOLVO PKWY,","pcpcity":"CHESAPEAKE","pcpstate":"VA","pcpzip":"23320-9998","pcpcounty":"","pcpid":"","pcpname":"Family Physicians of Chesapeake","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7575484652,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M75.121","M19.011","G89.18","D48.5","L81.4","Z71.9","M25.511","E78.5","I10.","M54.12","C82.81","R91.1","Z01.810","I45.10","I49.1","R00.1","N52.8","N40.1","V58.89","Z47.89","R04.0","Z12.5","R35.0","L30.9","M19.041","M19.042","NO DATA","M67.813","M75.51","S43.431A","Z47.1","M75.41","L60.0","M79.675"],"date":["2021-05-07","2021-05-07","2021-05-07","2022-07-25","2022-07-25","2022-08-08","2023-03-06","2023-06-20","2023-06-20","2023-05-18","2023-06-21","2023-06-21","2021-04-20","2021-04-20","2021-04-20","2021-04-20","2023-06-23","2023-06-23","2021-10-07","2021-10-07","2023-05-21","2023-02-09","2023-02-09","2022-01-24","2022-06-22","2022-07-08","2022-08-08","2021-05-07","2021-05-07","2021-05-07","2022-11-09","2021-05-07","2022-04-07","2022-04-07"],"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":[["","59267100002","PFIZER VACC INJ COVID-","19","0","Select","Select",""],["","68645051654","AMLODIPINE TAB","10MG","90","Select","Select",""],["","45802006435","TRIAMCINOLON CRE","0.1%","60","Select","Select",""],["","00067815203","VOLTAREN GEL","1%","200","Select","Select",""],["","16729032215","OLMESA MEDOX TAB","40MG","90","Select","Select",""],["","11877001140","BINAXNOW COV KIT HOME TES","","2","Select","Select",""],["","00093505998","ATORVASTATIN TAB","20MG","90","Select","Select",""],["","59746017310","PREDNISONE TAB","10MG","20","Select","Select",""],["","65862085730","AMLODIPINE-OLMESARTAN","10 MG-40MG","90","Select","Select",""],["","13668056830","TADALAFIL","20 MG","30","Select","Select",""],["","16729032215","OLMESARTAN MEDOXOMIL","40 MG","90","Select","Select",""],["","00093505898","ATORVASTATIN CALCIUM","40 MG","90","Select","Select",""],["","68382005105","MELOXICAM","15 MG","30","Select","Select",""],["","68645051054","HYDROCHLOROTHIAZIDE","25 MG","30","Select","Select",""],["","68645051654","AMLODIPINE BESYLATE","10 MG","90","Select","Select",""],["","57237011490","ALFUZOSIN HCL ER","10 MG","90","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":""}]}]}