{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CHRISTINA AUSBY","gend":1,"add":"751 44TH ST ","city":"NEWPORT NEWS","state":"VA","zip":"23602-9998","dob":"1988-12-25","age":"","mstatus":"","insh":11004163,"cliId":"5H42X29GF87","pno":7574185041,"cno":7579985494,"email":"","ename":"","eno":"","pphy":"HOSKOTE, NAGRAJ","ppno":7572344285,"pcpadd":"12652 Jefferson Avenue","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":236024392,"pcpcounty":"","pcpid":"P9059014","pcpname":"RIVERSIDE INTERNAL MEDICINE OF DENBIGH","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"TIDEWATER","aligned":"Y","ano":"","add2":"","add3":"","madd1":"751 44TH ST ","madd2":"","madd3":"","mcity":"NEWPORT NEWS","mstate":"VA","mzip":"23602-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["R21","S02.2XXA","M79.632","M79.642","R51","W10.9XXA","Y93.01","S69.92XA","F10.129","Z87.891","J45.909","S61.012A","S09.93XA","Z74.3","N76.0","B96.89","Q18.3","Q63.1","F17.290","F17.210","R11.2","R10.31","R10.9","R10.32","R11.10","W01.0XXA","Z00.00","Z09","R93.89","I49.9","Z82.79","S93.401A","X58.XXXA","M25.571","R06.09","M25.532","W10.8XXA","Y92.009","N92.1","N85.00","N85.2","S00.35XA","Z23","T17.1XXA","Z18.9","Q96.9","Z72.0","Z01.811","N84.0","Z88.0","Z79.899","T78.40XA","F17.200","G31.84","N94.89","R39.15","R30.0","A59.9","R10.30","F79","B07.0","M79.672","R10.84","R19.7","R10.33","R19.4"],"date":["2020-01-02","2020-04-06","2020-03-07","2020-03-07","2020-03-07","2020-03-07","2020-03-07","2020-05-05","2020-03-07","2020-06-12","2020-06-12","2020-03-07","2020-03-07","2020-03-11","2020-03-11","2020-03-11","2020-04-17","2021-10-06","2020-03-11","2020-03-11","2020-03-11","2021-10-06","2020-03-11","2020-03-11","2020-03-11","2020-04-06","2020-04-07","2020-04-07","2020-05-28","2020-04-17","2020-04-17","2019-04-29","2020-05-25","2019-04-29","2020-05-04","2020-05-05","2020-05-05","2020-05-05","2020-06-12","2020-05-07","2020-05-07","2020-06-12","2021-05-14","2020-06-12","2020-05-25","2020-06-12","2020-05-28","2020-05-28","2020-06-12","2021-07-28","2021-07-28","2020-06-12","2019-06-24","2019-06-13","2020-06-15","2019-07-15","2019-07-15","2019-07-19","2019-07-19","2019-07-19","2020-12-02","2020-10-21","2021-07-28","2021-09-09","2021-10-06","2021-10-12"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}},{"a":[]}]},{"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":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}}]},{"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":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","54327099","FLUTICASONE","SPR 50MCG","","Select","Select",""],["","45802013970","METRONIDAZOL","GEL 0.75%VAG","","Select","Select",""],["","53746027205","SMZ\/TMP DS","TAB 800-160","","Select","Select",""],["","59310057922","PROAIR HFA","AER ","","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","","Select","Select",""],["","68645014059","FAMOTIDINE","TAB 20MG","","Select","Select",""],["","68645056259","IBUPROFEN","TAB 600MG","","Select","Select",""],["","781577631","AZITHROMYCIN","TAB 250MG","","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","","Select","Select",""],["","16714008210","HYDROXYZ HCL","TAB 25MG","","Select","Select",""],["","59746017509","PREDNISONE","TAB 20MG","","Select","Select",""],["","781577631","AZITHROMYCIN ","TAB 250MG","4","Select","Select",""],["","54327099","FLUTICASONE ","SPR 50MCG","16","Select","Select",""],["","45802013970","METRONIDAZOL ","GEL 0.75%VAG","70","Select","Select",""],["","53746027205","SMZ\/TMP ","TAB 800-160","12","Select","Select",""],["","53746010901","HYDROCO\/APAP ","TAB 5-325MG","15","Select","Select",""],["","59310057922","PROAIR ","AER ","17","Select","Select",""],["","59746017509","PREDNISONE ","TAB 20MG","4","Select","Select",""],["","68645014059","FAMOTIDINE ","TAB 20MG","28","Select","Select",""],["","16714008210","HYDROXYZ ","TAB 25MG","30","Select","Select",""],["","68180012202","CEPHALEXIN ","CAP 500MG","30","Select","Select",""],["","68645056259","IBUPROFEN ","600MG","30","Select","Select",""],["","59310057922","PROAIR","","17","Select","Select",""],["","53746027205","SMZ\/TMP","800-160","12","Select","Select",""],["","00143122701","DICYCLOMINE","20MG","30","Select","Select",""],["","16714008210","HYDROXYZ","25MG","30","Select","Select",""],["","00143122701","DICYCLOMINE ","TAB 20MG","30","Select","Select",""]]}},{"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":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[[["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""]]]},{"t":"Mini-Cog","q":[{"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":""}]}]}