{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MELVALA   L SMITH","gend":1,"add":"1369 HAWK AVENUE","city":"VIRGINIA BEACH                ","state":"VA","zip":"23453-2911","dob":"1982-03-24","age":"","mstatus":"","insh":4696079,"cliId":"","pno":7575158302,"cno":7573527013,"email":"","ename":"","eno":"","pphy":"ELHASSAN, AMIRA","ppno":7573051797,"pcpadd":"4421 VIRGINIA BEACH BLVD,STE 114","pcpcity":"VIRGINIA BEACH                ","pcpstate":"VA","pcpzip":234623114,"pcpcounty":"","pcpid":"","pcpname":"BON SECOURS TOWN CENTER MEDICAL ASSOCIATES","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"TIDEWATER","aligned":"","ano":"","add2":"1369 HAWK AVENUE","add3":"","madd1":"1369 HAWK AVENUE","madd2":"","madd3":"","mcity":"VIRGINIA BEACH                ","mstate":"VA","mzip":"23453-2911","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["L03.031","M79.674","I96","Z71.6","F17.290","I70.213","I70.235","F17.210","I73.9","F17.200","E78.00","Z23","I49.49","Z13.220","Z48.812","I70.261","Z87.891","I77.1","Z95.828","E78.2","I10","L02.31","L05.01","Z79.82","M79.669","M79.661","T82.868A","I73.89","M79.604","Z01.812","L20.82","Z01.818","E83.39","R73.9","E66.9","E78.5","Z68.37","D57.3","Z79.899","Z82.49","Z68.38","Z79.01","L97.519","K59.00","I74.3","Z01.810","I49.3","E83.31","E83.89","J44.9","I70.701","R53.83"],"date":["2020-09-23","2020-09-23","2021-09-08","2022-01-17","2020-10-29","2020-11-05","2020-12-04","2021-09-10","2022-03-11","2022-03-11","2021-09-12","2021-10-19","2020-11-24","2020-11-24","2021-10-11","2021-03-01","2021-03-01","2021-03-01","2022-02-28","2021-03-16","2021-09-12","2021-04-29","2021-04-29","2021-04-29","2022-03-11","2021-06-25","2021-06-29","2022-03-11","2021-06-25","2021-09-01","2021-08-17","2022-03-03","2021-09-12","2021-09-12","2021-09-09","2021-09-08","2021-09-08","2021-11-05","2021-09-08","2021-09-08","2021-09-08","2021-09-08","2021-09-08","2021-09-08","2021-09-08","2021-09-08","2021-09-08","2021-09-09","2021-09-11","2021-11-05","2021-11-15","2022-01-18"],"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":[["","00406051201","OXYCOD\/APAP","TAB 5-325MG","40","Select","Select",""],["","68645059090","CLOPIDOGREL","TAB 75MG","90","Select","Select",""],["","70436001104","BUPROPN","TAB 300MG XL","90","Select","Select",""],["","50458057710","XARELTO","TAB 2.5MG","60","Select","Select",""],["","50111056001","TRAZODONE","TAB 50MG","30","Select","Select",""],["","45802006435","TRIAMCINOLON","CRE 0.001","45","Select","Select",""],["","00003089421","ELIQUIS","TAB 5MG","42","Select","Select",""],["","00093505898","ATORVASTATIN","TAB 40MG","90","Select","Select",""],["","50742061510","METOPROL","TAB 25MG ER","90","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","14","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","12","Select","Select",""],["","43598048772","NICOTINE","LOZ 4MG MINT","90","Select","Select",""],["","67877022310","GABAPENTIN","CAP 300MG","90","Select","Select",""],["","11822323900","RA","LOZ 4MG MINT","72","Select","Select",""],["","65162019011","NAPROXEN","TAB 500MG","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":""}]}]}