{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"E   NHOJHSIRRAP ","gend":0,"add":"KCOR 9225GDNL TROP","city":"SUFFOLK","state":"VA","zip":"23435-9998","dob":"1944-02-10","age":"","mstatus":"","insh":"04000910*223","cliId":"","pno":"18\/7570007-6","cno":"","email":"","ename":"","eno":"","pphy":"WHITING, HOLLY KRISTIN NP","ppno":"757\/354-2885","pcpadd":"955 HARPERSVILLE ROAD","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":23601,"pcpcounty":"","pcpid":"","pcpname":"MID-ATLANTIC POST ACUTE AND LONG TERM CARE PLLC","plan":"OHP","program":"MEDICARE","lob":"MA-Non DSNP","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R26.9","R26.89","I10.","N18.4","I42.0","E87.5","I12.9","H25.12","N18.9","I51.9","E11.9","F01.50","R55.","E55.9","S05.11XA","I08.3","I27.20","I25.10","R26.81","R29.6","R53.81","M19.011","I63.9","I67.82","I67.9","M62.81","I49.9","S40.011A","G44.311","I25.82","I50.1","F01.51","R41.841","R79.9","R09.89","I51.7","W19.XXXA","I50.9","E78.5","S09.90XA","Z91.81"],"date":["2021-04-13","2022-07-27","2022-08-16","2021-07-27","2022-01-23","2021-07-27","2021-07-27","2020-09-02","2022-08-16","2021-11-09","2022-07-27","2022-08-16","2021-11-09","2021-11-09","2021-10-11","2021-10-21","2021-10-21","2022-08-16","2022-07-27","2022-07-27","2021-11-12","2021-10-11","2021-10-12","2021-10-12","2022-07-27","2022-07-11","2021-10-11","2021-10-12","2021-10-12","2021-11-01","2021-11-01","2022-07-27","2022-07-27","2022-07-20","2022-07-15","2022-07-15","2022-07-15","2022-08-16","2022-07-15","2022-06-28","2022-06-28"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"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":[["","27241007106","MEMANTINE","TAB HCL 10MG","60","Select","Select",""],["","00378395177","ATORVASTATIN","TAB 20MG","30","Select","Select",""],["","68180037703","LOSARTAN","TAB 50MG","30","Select","Select",""],["","68462016205","CARVEDILOL","TAB 3.125MG","38","Select","Select",""],["","50458057990","XARELTO","TAB 20MG","30","Select","Select",""],["","00904679480","ASPIRIN","CHW 81MG","30","Select","Select",""],["","42799060501","LOPERAMIDE","CAP 2MG","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":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"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":""}]}]}