{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"B CAASIEDUALC ","gend":0,"add":"     EUNEVA DOOWYLLOH 704                         ","city":"SUFFOLK                  ","state":"VA","zip":"23434-9998","dob":"1950-11-23","age":"","mstatus":"","insh":"00110398","cliId":"","pno":"5675742042","cno":7576574024,"email":"","ename":"","eno":"","pphy":"MUGAISI, HESED N","ppno":7577381375,"pcpadd":"148 BURNETTS WAY STE 107,STE 108","pcpcity":"Suffolk","pcpstate":"VA","pcpzip":234346149,"pcpcounty":"","pcpid":"","pcpname":"BON SECOURS SUFFOLK PRIMARY CARE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"TIDEWATER","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"407 HOLLYWOOD AVENUE                              ","madd2":"                                                  ","madd3":"","mcity":"SUFFOLK                  ","mstate":"VA","mzip":"23434-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["D64.9","H35.3221","E11.65","I50.32","I10","M25.561","E66.01","E78.5","M25.562","Z68.42","G89.29","M17.0","Z12.11","E11.9","K02.9","Z68.41","B35.3","B35.1","L03.031","B95.61","L60.0","I11.0","N47.1","H35.033","H43.813","Z12.5","Z23","R21","R60.0","I50.30","I77.810","I51.7","Z51.89","I50.9","M19.90","I50.33","Z79.84","Z79.82","Z79.899","Z00.00","Z71.89","Z13.31","Z01.818","H25.13","Z01.812","Z20.822"," ","R39.9"],"date":["2022-12-06","2022-11-29","2022-02-03","2022-08-12","2022-06-09","2019-11-20","2022-07-05","2022-08-12","2019-11-20","2020-02-03","2019-11-20","2022-02-03","2022-01-26","2022-10-18","2020-08-05","2022-08-12","2022-10-06","2022-10-06","2022-10-06","2022-10-06","2022-10-06","2022-08-12","2022-07-20","2022-10-18","2022-10-18","2021-09-23","2021-09-23","2021-09-23","2022-08-12","2021-12-20","2021-12-20","2021-12-20","2022-07-20","2022-07-05","2022-07-05","2022-07-05","2022-07-05","2022-07-05","2022-07-05","2022-02-03","2022-02-03","2022-02-03","2022-06-09","2020-10-13","2022-07-01","2022-07-01","2022-12-06","2022-10-13"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"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":[["","57237010099","METOPROL","TAB 25MG","180","Select","Select",""],["","68645051654","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","68382013201","TAMSULOSIN","CAP 0.4MG","30","Select","Select",""],["","43547040211","FUROSEMIDE","TAB 40MG","90","Select","Select",""],["","65162019011","NAPROXEN","TAB 500MG","180","Select","Select",""],["","68645054659","METFORMIN","TAB 1000MG","180","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","500","Select","Select",""],["","68645048154","ATORVASTATIN","TAB 20MG","90","Select","Select",""],["","43598071901","CHLORTHALID","TAB 25MG","90","Select","Select",""],["","51672129802","KETOCONAZOLE","CRE 0.02","120","Select","Select",""],["","406051201","OXYCOD\/APAP","TAB 5-325MG","20","Select","Select",""],["","23155072401","LABETALOL","TAB 200MG","60","Select","Select",""],["","832532411","POT  CL MICRO","TAB 10MEQ ER","90","Select","Select",""],["","16714049602","CLOTRIM\/BETA","CRE 1-0.05%","45","Select","Select",""],["","68382032010","POT  CHLORIDE","TAB 10MEQ ER","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":["",""]}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"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":""}]}]}