{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" S YAFSNEWO","gend":1,"add":"      .DR KCENDRIB .N 141                         ","city":"VIRGINIA BEACH           ","state":"VA","zip":"23451-9998","dob":"1987-04-16","age":"","mstatus":"","insh":"00111211","cliId":"","pno":"7775794799","cno":7574286448,"email":"","ename":"","eno":"","pphy":"KENNEY, BRENNA ALYSSA","ppno":7579552828,"pcpadd":"885 KEMPSVILLE RD STE 320,","pcpcity":"Norfolk","pcpstate":"VA","pcpzip":235023800,"pcpcounty":"","pcpid":"","pcpname":"BON SECOURS MEDICAL GROUP HAMPTON ROADS PRIMARY CARE LLC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"TIDEWATER","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"141 N. BIRDNECK RD.                               ","madd2":"                                                  ","madd3":"","mcity":"VIRGINIA BEACH           ","mstate":"VA","mzip":"23451-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R48.2","R47.01","R48.9","F80.9","R41.83","R39.81","F79","R00.0","R10.9","K59.00","Z76.89","I10","Z23","Z68.41","Z68.42","R10.11","K81.9","Z87.19","K21.9","K80.20","K81.1","Z00.00","E66.01","Z13.89","E55.9","N92.6","F81.89","R03.0","M25.552","Z13.39","Z13.31","R19.00","F41.9","J01.00","J20.9","K82.8","Q51.810","Z01.419","R10.13","H10.31","H57.89","R10.84","K76.0","R05.9","R93.89","B37.2","Z12.39","Z11.3","F84.0","R32","E66.9","K59.09","H01.002","H01.005","F72","R60.0","J00","B35.4","F70","F80.2","R74.8","U07.1","E86.0","F80.89","Z79.899","Z20.822","L21.9","Z71.3","H61.23","R27.8","K80.10","Z68.43","R41.89","Z90.49","R31.1"," ","N39.0","G89.29"],"date":["2022-11-30","2022-11-30","2022-11-30","2021-12-01","2021-12-01","2021-10-06","2021-10-06","2021-01-06","2022-11-29","2021-06-10","2019-10-15","2019-10-15","2022-04-26","2022-11-29","2022-10-25","2019-11-04","2019-11-04","2019-11-04","2022-10-25","2022-06-13","2022-07-06","2022-04-26","2022-10-25","2022-08-29","2022-08-29","2022-08-29","2022-10-25","2022-04-26","2021-12-03","2021-12-03","2021-12-03","2021-12-13","2019-12-10","2018-12-11","2018-12-11","2021-12-13","2021-12-13","2022-01-25","2018-01-15","2020-01-17","2020-01-17","2022-05-31","2022-11-29","2022-01-25","2022-01-25","2022-01-25","2022-01-25","2022-01-25","2020-01-28","2020-01-28","2022-11-29","2020-01-28","2018-02-05","2018-02-05","2020-02-10","2018-03-05","2019-03-15","2021-03-23","2018-04-09","2018-04-09","2021-06-28","2021-05-10","2019-05-20","2019-05-20","2022-06-30","2022-11-29","2021-07-29","2022-04-26","2022-04-26","2022-11-30","2022-06-30","2022-06-30","2022-06-30","2022-11-29","2022-10-25","2022-11-30","2022-11-29","2022-11-29"],"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":[["","65162063709","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","00406012305","HYDROCO\/APAP","TAB 5-325MG","12","Select","Select",""],["","00781717612","NALOXONE","SPR 4MG","2","Select","Select",""],["","65862052205","NAPROXEN","TAB 500MG","10","Select","Select",""],["","00574402435","ERYTHROMYCIN","OIN 5MG\/GM","3.5","Select","Select",""],["","68462079965","NYSTAT\/TRIAM","OIN ","60","Select","Select",""],["","16729013600","CLONAZEPAM","TAB 0.5MG","1.00","Select","Select",""],["","67877021905","CEPHALEXIN","CAP 500MG","28","Select","Select",""],["","69315090510","LORAZEPAM","TAB 1MG","1","Select","Select",""],["","51672128901","NYSTATIN","CRE 100000","15.00","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","52565001915","AUG","OIN 0.0005","15","Select","Select",""],["","57237000511","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","00456120230","LINZESS","CAP 290MCG","30","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":["",""]}},{"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":""}]}]}