{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"E ENORYTMOXOLB ","gend":0,"add":"          DR NOTSOB 85013                         ","city":"PUNGOTEAGUE              ","state":"VA","zip":"23422-9998","dob":"1953-01-31","age":"","mstatus":"","insh":"10111360","cliId":"","pno":"4475714132","cno":"","email":"","ename":"","eno":"","pphy":"JONES, DAVID FITZGERALD","ppno":7573165888,"pcpadd":"20486 MARKET ST,","pcpcity":"ONANCOCK","pcpstate":"VA","pcpzip":23417,"pcpcounty":"","pcpid":"","pcpname":"RIVERSIDE PHYSICIAN SERVICES INC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"TIDEWATER","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"PO BOX 383                                        ","madd2":"                                                  ","madd3":"","mcity":"PUNGOTEAGUE              ","mstate":"VA","mzip":"23422-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G46.4","N18.1","J84.89","J18.9","R91.8","R93.89","I12.9","E11.22","Z71.9","D50.0","B35.1","L85.1","E11.42","R23.4","E11.9","I10","E03.9","R56.9","I69.959","E78.1","D50.9","Z23","G40.209","I69.354","M17.12","M25.369","M17.9","M25.562","Z86.73","Z87.891","R68.89","N18.30","E55.9","R80.9","G40.909","I69.954","Z91.81","I21.4","K74.60","D56.3","Z87.898","J84.9","J92.9","R06.00","J84.116","M77.41","M77.42","M79.89","L57.0","Z12.5","I24.9","R06.02","E11.40","F32.9","G45.9","R51.9","I69.398","H53.47","N18.9","D63.1","E78.5","K21.9","Z79.899","Z79.82","Z79.84","I63.9","I67.1","H53.462","H53.9","R29.898","R29.818","G93.89","R00.1","R42","G81.14","I51.7","J44.9","W19.XXXA","Z04.3","R53.1","N18.6","Z74.3","R07.9","A00.0","R97.20","Z71.3","R94.31","N18.4","N18.32","J30.2","R69"," ","I25.10"],"date":["2021-07-28","2021-11-22","2020-07-22","2020-07-22","2022-01-17","2020-07-22","2022-10-03","2022-10-03","2021-07-26","2022-10-26","2022-11-17","2022-11-17","2022-05-02","2021-02-18","2022-10-31","2022-11-02","2022-10-31","2022-10-31","2022-10-31","2022-10-31","2022-10-31","2022-10-31","2020-10-20","2022-08-13","2022-04-11","2021-11-26","2021-11-26","2022-04-11","2022-11-02","2022-06-24","2021-11-26","2022-05-24","2022-09-27","2022-10-03","2022-11-15","2022-11-15","2022-11-15","2020-01-14","2022-08-13","2020-06-10","2020-01-14","2022-01-17","2022-01-17","2022-03-02","2021-01-20","2022-08-09","2022-08-09","2022-08-09","2022-08-09","2022-02-15","2022-02-15","2022-06-24","2022-11-17","2020-06-22","2021-07-08","2021-07-07","2021-07-07","2021-07-07","2021-07-07","2021-07-07","2021-07-07","2022-06-20","2022-08-13","2022-08-13","2022-08-13","2022-12-02","2021-07-07","2021-07-07","2021-07-07","2021-07-07","2021-07-07","2021-07-07","2022-06-27","2021-07-07","2021-07-07","2021-07-08","2022-10-27","2022-04-11","2022-04-11","2022-04-11","2022-05-31","2022-06-24","2022-06-27","2022-07-14","2022-10-31","2022-10-31","2022-06-27","2022-09-27","2022-10-03","2022-10-31","2022-11-01","2022-12-02","2022-11-02"],"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":[["","66993001968","ALBUTEROL","AER HFA","18.00","Select","Select",""],["","68180011507","LEVETIRACETA","TAB 1000MG","90","Select","Select",""],["","68180098101","LISINOPRIL","TAB 20MG","90","Select","Select",""],["","00597010061","SPIRIVA","SPR 2.5MCG","4","Select","Select",""],["","65862014405","CARVEDILOL","TAB 12.5MG","180","Select","Select",""],["","00378395205","ATORVASTATIN","TAB 40MG","90","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","67877056105","METFORMIN","TAB 500MG","180","Select","Select",""],["","13668000901","CITALOPRAM","TAB 10MG","90","Select","Select",""],["","68382013201","TAMSULOSIN","CAP 0.4MG","90","Select","Select",""],["","50111032701","HYDRALAZINE","TAB 25MG","60","Select","Select",""],["","00378004710","METOPROL","TAB 100MG","180","Select","Select",""],["","00173085910","BREO","INH 100-25","60","Select","Select",""],["","69238183007","LEVOTHYROXIN","TAB 25MCG","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":["",""]}},{"a":{"indx":["1",""],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""],"sub":{"indx":[["","",""],[""],[""],[""],[""]],"comment":[["","",""],[""],[""],[""],[""]],"sub":[]}}},{"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":""}]}]}