{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" EIRAMHCOK E","gend":1,"add":"ROB 1072DAOR RED","city":"CHESAPEAKE","state":"VA","zip":23324,"dob":"1978-11-11","age":"","mstatus":"","insh":"10114257","cliId":"","pno":"9975775638","cno":8048545811,"email":"","ename":"","eno":"","pphy":"BEVERLY, VERNIS L","ppno":7579983657,"pcpadd":"1701 CHURCH ST ,STE B","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23504,"pcpcounty":"","pcpid":"","pcpname":"ADULT AND PEDIATRIC MEDICAL AS","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"TIDEWATER","aligned":"Y","ano":"","add2":"","add3":"","madd1":"2701 BORDER ROAD","madd2":"","madd3":"","mcity":"CHESAPEAKE","mstate":"VA","mzip":"23324-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["ASIAN\/PACIFIC"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.2","B35.1","E11.51","I79.8","M79.676","R60.0","R26.2","F25.0","S20.211A","R07.81","V89.2XXA","J45.909","F31.81","F17.210","E11.9","E78.2","I10","Z79.899","F43.8","E55.9","F41.9","F32.A","F10.20","R39.81","N81.84","F25.1","R52","F33.1","F20.9","F41.1","N39.0","R30.0","I50.31","B96.20","I11.0","Z79.84","N31.9","K21.9","F25.9","N28.1","Z87.440","U07.1","R07.89","R43.9","Z20.822","E73.9","Z86.11","Z88.8","Z91.048","F31.4","M54.5","M26.609","M79.10","E78.5","N32.81","R45.851","I73.9","M79.671","M20.11","M79.672","Z72.0","M77.41","M20.12","G89.29","R53.83","M21.961","R41.82","F29","M62.81","D64.9","Z96.9","M20.41","F43.25","N17.9","N30.01","E08.29","F31.9","N23","Z98.890","F79","Z79.82","Z79.891","Z01.810","Z01.812","R94.31","N30.00","R50.9","R10.814","R10.9","Z87.09","R07.9","R39.15","F41.8","R42","H53.8","Y92.410","Z91.011","E11.42","M21.6X1","M21.6X2","R51.9","R03.0","R06.00","M79.609","Z00.00","R10.2","I50.9","M20.42","M21.962","Z98.1","D50.9","G47.00","F32.9","Z91.5","M79.89","R11.0","R11.2","Z01.818","N28.89","M21.611","N12","R10.32","R10.31","G44.209","D53.9","E86.0","F17.200","R10.30","M54.9","M79.669","R35.0","M19.90","S29.9XXA","F17.290","H60.92","R10.0"],"date":["2022-04-08","2022-10-13","2022-10-13","2022-10-13","2022-07-08","2022-10-27","2022-07-08","2022-07-22","2022-06-06","2022-06-06","2022-06-13","2022-07-15","2022-07-15","2022-07-15","2022-10-27","2022-07-15","2022-10-04","2022-07-15","2022-06-06","2022-10-27","2022-08-05","2022-08-05","2022-03-21","2022-10-28","2022-10-28","2022-09-13","2021-12-15","2022-10-30","2022-10-04","2022-09-29","2022-05-18","2022-05-12","2021-08-01","2022-05-12","2021-11-29","2022-07-15","2021-08-01","2022-10-27","2022-07-15","2021-08-04","2022-06-13","2022-01-21","2022-06-20","2022-01-21","2022-07-15","2022-06-20","2022-01-21","2022-06-20","2022-06-20","2021-08-08","2021-09-14","2021-09-14","2021-09-14","2022-07-07","2022-08-25","2022-07-15","2021-05-21","2022-10-19","2021-10-28","2022-10-19","2022-01-21","2021-05-27","2021-10-28","2021-05-16","2021-03-25","2021-10-28","2022-05-13","2022-05-13","2021-08-01","2022-04-28","2021-05-27","2021-09-22","2022-07-15","2022-07-15","2022-05-12","2022-10-04","2022-10-04","2022-05-12","2022-05-12","2021-06-18","2021-06-18","2021-06-18","2021-05-21","2021-05-24","2021-05-21","2021-11-29","2021-02-02","2021-02-02","2021-02-02","2022-05-09","2022-06-20","2021-04-26","2021-04-26","2022-06-28","2021-04-30","2022-06-13","2022-06-13","2022-10-19","2022-10-19","2022-10-19","2021-08-06","2021-08-06","2021-08-06","2021-08-01","2022-05-12","2021-11-29","2021-11-29","2021-10-28","2021-10-28","2021-10-28","2021-09-04","2021-04-20","2021-05-27","2021-04-26","2021-08-01","2022-05-09","2022-05-09","2021-05-07","2021-06-24","2021-05-27","2021-02-02","2021-02-02","2021-02-02","2021-02-02","2021-02-02","2021-05-16","2021-02-26","2021-02-02","2021-05-16","2021-02-18","2021-05-16","2021-02-02","2022-06-06","2022-06-20","2021-09-04","2021-02-02"],"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":[["","62175011843","OMEPRAZOLE","CAP 20MG","31","Select","Select",""],["","57237021905","PIOGLITAZONE","TAB 15MG","31","Select","Select",""],["","00093100301","BUSPIRONE","TAB 15MG","93","Select","Select",""],["","00832003850","OXYBUTYNIN","TAB 5MG","62","Select","Select",""],["","43547028211","ESCITALOPRAM","TAB 20MG","31","Select","Select",""],["","69097045805","FENOFIBRATE","TAB 145MG","31","Select","Select",""],["","59148001971","ABILIFY","INJ 400MG","1","Select","Select",""],["","00006027754","JANUVIA","TAB 100MG","31","Select","Select",""],["","67877021905","CEPHALEXIN","CAP 500MG","14","Select","Select",""],["","00185067405","HYDROXYZ","CAP 25MG","62","Select","Select",""],["","69097082412","CITALOPRAM","TAB 40MG","31","Select","Select",""],["","65162027110","SMZ-TMP","TAB 400-80MG","31","Select","Select",""],["","50111043403","TRAZODONE","TAB 100MG","31","Select","Select",""],["","65862055990","PANTOPRAZOLE","TAB 20MG","30","Select","Select",""],["","80777027399","MODERNA","INJ COVID-19","0.5","Select","Select",""],["","65162044210","MECLIZINE","TAB 25MG","60","Select","Select",""],["","56151146304","TRUE","TES GLUCOSE","50","Select","Select",""],["","65162090209","ARIPIPRAZOLE","TAB 30MG","31","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","11","Select","Select",""],["","65162027250","SMZ\/TMP","TAB 800-160","14","Select","Select",""],["","68180030260","CEFUROXIME","TAB 250MG","8","Select","Select",""],["","42195055014","CIPROFLOXACN","SOL 0.002","14","Select","Select",""],["","50228014610","HYDROCHLOROT","CAP 12.5MG","31","Select","Select",""],["","08496280801","EASY","MIS LANC\/28G","100","Select","Select",""],["","68462018905","NAPROXEN","TAB 375MG","30","Select","Select",""],["","68462015713","ONDANSETRON","TAB 4MG ODT","20","Select","Select",""],["","58160088752","FLUARIX","INJ 2021-22","0.5","Select","Select",""],["","67877032005","IBUPROFEN","TAB 600MG","30","Select","Select",""],["","68462040601","INDOMETHACIN","CAP 25MG","90","Select","Select",""],["","33332032203","AFLURIA","INJ 2022-23","0.5","Select","Select",""],["","47781019601","OXYCOD\/APAP","TAB 5-325MG","30","Select","Select",""],["","43386033001","TRIMETHOPRIM","TAB 100MG","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":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"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":""}]}]}