{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ENIHPLEDMAHDROF ","gend":1,"add":"             TS HSAUQ 449                         ","city":"HAMPTON                  ","state":"VA","zip":"23669-9998","dob":"1963-09-28","age":"","mstatus":"","insh":"10114606","cliId":"","pno":"8875771981","cno":3169926036,"email":"","ename":"","eno":"","pphy":"DELAHOUSSAYE, ALADEE R","ppno":7577880400,"pcpadd":"400 MEDICAL DR,","pcpcity":"Hampton","pcpstate":"VA","pcpzip":236661767,"pcpcounty":"","pcpid":"","pcpname":"HAMPTON NEWPORT NEWS COMMUNITY SERVICE BOARD","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"TIDEWATER","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"190 Michigan Dr                                   ","madd2":"                                                  ","madd3":"","mcity":"Hampton                  ","mstate":"VA","mzip":"23669-3825","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R69","F31.9","M54.89","M54.41","M54.5","M79.644","Z88.5","Z88.8","F17.210","M54.9","J01.00","Z20.828","Z01.84","J45.998","Z23","A59.01","N30.00","J45.30","Z72.0","R25.2","R73.9","R03.0"," ","F33.2","R45.851","F12.10","J45.909","F14.20","M54.50","G47.00","F41.9","Z20.822","Z79.51","Z88.6","Z02.2","M48.061","M43.10","R45.89","Z59.00","J45.21","R06.02","M25.552","G89.29","F19.10","Z79.52","Z79.899","R07.9","Z75.1"],"date":["2022-02-28","2022-11-04","2021-02-05","2021-07-06","2021-07-06","2021-07-06","2022-11-27","2022-11-27","2022-11-27","2021-07-06","2021-02-17","2021-02-17","2020-12-30","2020-12-30","2022-11-11","2021-01-11","2021-01-11","2022-07-20","2022-07-20","2022-07-20","2022-07-20","2022-07-20","2022-12-09","2022-12-09","2022-11-12","2022-12-09","2022-11-12","2022-12-09","2022-11-12","2022-11-11","2022-11-11","2022-11-27","2022-11-27","2022-11-27","2022-11-28","2022-11-28","2022-11-28","2022-11-28","2022-11-28","2022-11-27","2022-11-27","2022-11-27","2022-11-27","2022-11-27","2022-11-27","2022-11-27","2022-11-27","2022-12-01"],"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":[["","70010075401","METHOCARBAM","TAB 500MG","20","Select","Select",""],["","27241009706","DULOXETINE","CAP 20MG","30","Select","Select",""],["","60505265401","TRAZODONE","TAB 100MG","60","Select","Select",""],["","67877025001","QUETIAPINE","TAB 100MG","30","Select","Select",""],["","00093317431","ALBUTEROL","FAT E","8.5","Select","Select",""],["","173069500","ADVAIR","AER 100\/50","60","Select","Select",""],["","00603533932","PREDNISONE","TAB 20MG","21","Select","Select",""],["","65162062711","TRAMADOL","TAB 50MG","15","Select","Select",""],["","29300022705","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","52565006360","DIFLORASONE","OIN 0.0005","360","Select","Select",""],["","69238110005","DOXYCYCL","CAP 100MG","20","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":""}]}]}