{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"S NONNAHSNAMHCSUB ","gend":1,"add":"R KCEN SHGUOROBRACS 97311                        D","city":"BELLE HAVEN              ","state":"VA","zip":"23306-9998","dob":"1954-06-19","age":"","mstatus":"","insh":"10118948","cliId":"","pno":"8670723398","cno":7073371828,"email":"","ename":"","eno":"","pphy":"HEDSPETH, TAMMY A","ppno":7574426600,"pcpadd":"10085 WILLIAM S BERNART CIR,","pcpcity":"Nassawadox","pcpstate":"VA","pcpzip":234131040,"pcpcounty":"","pcpid":"","pcpname":"RIVERSIDE PHYSICIAN SERVICES INC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"TIDEWATER","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"11379 SCARBOROUGHS NECK RD                        ","madd2":"                                                  ","madd3":"","mcity":"BELLE HAVEN              ","mstate":"VA","mzip":"23306-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J06.9","E78.00","I10","I48.91","I25.10","R06.02","J44.9","Z87.891","Z99.81","R07.9","J44.1","R07.81","R00.1","R55","Z20.822","E78.5","I48.0","J43.9","Z79.01","Z79.899","Z88.0","Z88.5","Z95.5","Z88.1","M85.88","Z78.0","R07.89","M79.602","M54.50","M25.552","M25.551","K59.00","K72.90","J96.90","J18.9","I49.3","F41.1","Z79.51","Z79.52","R00.2","I25.119","F41.9","R00.0","K59.01","R04.0","M85.851","G43.B0","R51.9","Z23","F17.210","M89.49","I47.1","I08.0","I45.81","R63.8","R63.1","R35.89","M54.9","Z82.49","R10.30","H25.13","I25.2","M19.90","Z74.3","N64.4","N63.10","J98.11","I49.1","R44.3"," ","N63.11","F34.1","Z00.00","R94.31","I49.9"],"date":["2022-01-06","2022-08-04","2022-11-28","2022-11-28","2022-11-28","2022-11-28","2022-08-31","2022-11-28","2022-04-26","2022-08-22","2022-11-28","2022-02-12","2022-02-12","2022-02-12","2022-11-28","2022-11-28","2022-08-22","2022-02-12","2022-08-21","2022-08-21","2022-04-23","2022-08-21","2022-11-28","2022-08-21","2022-04-21","2022-04-21","2022-08-21","2021-10-16","2022-08-19","2021-10-16","2021-10-16","2022-04-23","2022-04-23","2022-04-23","2022-04-23","2022-08-23","2022-04-23","2022-06-30","2022-08-19","2022-05-13","2022-02-12","2022-08-22","2022-05-13","2022-04-26","2022-04-26","2022-04-26","2022-06-17","2022-06-23","2022-10-06","2022-06-04","2021-10-11","2022-05-26","2022-03-02","2022-08-23","2022-07-02","2022-07-02","2022-07-02","2022-08-19","2022-08-19","2022-08-19","2022-09-28","2022-08-21","2022-11-04","2022-08-21","2022-09-21","2022-09-21","2022-11-04","2022-06-06","2022-11-21","2022-11-28","2022-11-21","2022-11-21","2022-01-17","2022-02-15","2022-02-15"],"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":[["","59746017310","PREDNISONE","TAB 10MG","30","Select","Select",""],["","00228291809","DILTIAZEM","CAP 360MG ER","30","Select","Select",""],["","72511075001","REPATHA","INJ 140MG\/ML","2","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8.5","Select","Select",""],["","13107008405","LORAZEPAM","TAB 1MG","90","Select","Select",""],["","43547028111","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","00597010061","SPIRIVA","SPR 2.5MCG","12","Select","Select",""],["","00173088210","BREO","INH 200-25","60","Select","Select",""],["","00591292754","LEVALBUTEROL","AER 45\/ACT","15","Select","Select",""],["","00003089421","ELIQUIS","TAB 5MG","180","Select","Select",""],["","49281012265","FLUZONE","INJ 2022-23","0.7","Select","Select",""],["","00487980125","IPRATROPIUM","SOL 0.02%INH","187.5","Select","Select",""],["","68462015713","ONDANSETRON","TAB 4MG ODT","10","Select","Select",""],["","00310737020","BUDES\/FORMOT","AER 160-4.5","10.2","Select","Select",""],["","16714085202","METOPROL","TAB 25MG ER","90","Select","Select",""],["","29300041519","CYCLOBENZAPR","TAB 10MG","30","Select","Select",""],["","00093505798","ATORVASTATIN","TAB 80MG","30","Select","Select",""],["","55111018015","TIZANIDINE","TAB 4MG","30","Select","Select",""],["","50111078710","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","68180044501","QUETIAPINE","TAB 25MG","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":["",""],"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":""}]}]}