{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CALVIN JUDGE","gend":0,"add":"2917 PARKSIDE DR  ","city":"CHESAPEAKE  ","state":"VA","zip":"23325-9998","dob":"1952-09-01","age":"","mstatus":"","insh":11008484,"cliId":"2YJ2YG6WE99","pno":7577290095,"cno":7573480984,"email":"","ename":"","eno":"","pphy":"PARAGAS, FLORENCE ","ppno":7574245778,"pcpadd":"1200 S Military Hwy,Ste 101","pcpcity":"Chesapeake  ","pcpstate":"VA","pcpzip":233202251,"pcpcounty":"","pcpid":"P9307460","pcpname":"PRIMARY CARE PHYSICIANS FOR HAMPTON ROADS","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"TIDEWATER","aligned":"Y","ano":"","add2":"APARTMENT C ","add3":"","madd1":"2917 PARKSIDE DR  ","madd2":"APARTMENT C ","madd3":"","mcity":"CHESAPEAKE  ","mstate":"VA","mzip":"23325-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["I10","R29.818","F10.10","R00.0","R68.89","G62.9","E16.2","F17.210","Z68.1","K74.60","E87.0","E87.1","R53.1","R62.7","R13.10","R63.8","R27.0","N17.9","F10.11","E87.6","Z72.0","E44.0","R26.89","G93.41","R64","K70.30","M41.9","E86.0","B19.20","F17.200","Z86.11","Z91.81","Z76.0","A41.9","R41.82","Y90.0","N17.0","D65","E43","J69.0","J96.02","J96.01","R65.21","I24.8","E87.2","N39.0","B96.20","E83.51","J90","R09.02","R79.89","T14.90XA","I26.99","J18.1","J43.2"],"date":["2020-07-01","2020-02-17","2021-06-11","2020-02-25","2020-12-28","2019-12-13","2019-11-11","2019-12-13","2021-05-18","2021-11-01","2021-05-20","2021-11-03","2021-05-18","2021-06-11","2021-05-19","2021-05-19","2021-05-19","2021-11-04","2021-05-20","2021-05-20","2021-05-19","2021-05-19","2021-05-20","2021-11-03","2021-05-18","2021-05-18","2021-05-18","2021-05-18","2021-05-18","2021-05-18","2021-05-18","2021-05-18","2021-06-11","2021-11-04","2021-11-03","2021-11-03","2021-11-03","2021-11-03","2021-11-03","2021-11-03","2021-11-03","2021-11-03","2021-11-04","2021-11-03","2021-11-04","2021-11-03","2021-11-03","2021-11-04","2021-11-04","2021-11-03","2021-11-03","2021-11-03","2021-11-03","2021-11-03","2021-11-03"],"priorHcc":["","","","","","","","","",null,"",null,"","","","","",null,"","","","","",null,"","","","","","","","","",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null]}},{"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":[["","57664050658","METOPROL TAR","TAB 25MG","","Select","Select",""],["","69097081312","GABAPENTIN","CAP 100MG","","Select","Select",""],["","69097081312","GABAPENTIN ","CAP 100MG","30","Select","Select",""],["","57664050658","METOPROL ","TAB 25MG","60","Select","Select",""],["","70436015301","POT  CHLORIDE","20MEQ ER","30","Select","Select",""],["","832532511","POT  CL MICRO","20MEQ ER","30","Select","Select",""],["","57664050658","METOPROL","25MG","60","Select","Select",""],["","70436015301","POT CHLORIDE","20MEQ ER","30","Select","Select",""],["","00832532511","POT CL MICRO","20MEQ ER","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":[[["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["Yes","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":""}]}]}