{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"PATRICIA   G PISHIONERI","gend":1,"add":"1469 LAKE JAMES DR","city":"VIRGINIA BEACH","state":"VA","zip":"23464-9998","dob":"1949-03-13","age":"","mstatus":"","insh":"900030635*01","cliId":"2PN3RK7TU04","pno":"757\/420-1858","cno":"757\/420-1858","email":"","ename":"","eno":"","pphy":"GAGLIONE, MARGARET M MD","ppno":"757\/644-6819","pcpadd":"1405 KEMPSVILLE ROAD","pcpcity":"CHESAPEAKE","pcpstate":"VA","pcpzip":23320,"pcpcounty":"","pcpid":178852,"pcpname":"COASTAL INTERNAL MEDICINE AND TIDEWATER BARIATRICS","plan":"OHP","program":"MEDICARE","lob":"MA-Non DSNP","region":"TIDEWATER","aligned":"","ano":"757\/289-7274","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/644-6816","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["D72.828","R59.1","K21.9","Z12.11","E66.3","M79.89","J84.10","J47.9","R59.0","Z00.00","F33.1","I70.0","E66.9","Z91.81","I25.10","I10.","F50.9","Z68.34","L82.1","D23.9","J98.4","D75.89","R53.83","R79.89","J01.01","R09.82","R09.81","R73.03","R41.89","R41.840","J32.1","J32.3","J32.2","J34.89","Q30.8","K13.79","R06.83","R13.10","R11.0","G47.33","R91.8","J84.9","F43.8","R20.2","M51.36","M48.061","M79.662","E78.5","R73.9","K26.3","B37.2","R93.89","K29.70","K44.9","K31.89","R11.2","R10.32","K57.30","R19.4"],"date":["2020-08-13","2020-08-13","2021-09-22","2020-09-16","2021-11-11","2020-10-20","2021-02-19","2021-02-19","2021-02-19","2020-06-19","2020-06-19","2020-06-19","2020-12-08","2020-06-19","2021-06-17","2021-06-17","2020-12-08","2020-12-08","2020-11-04","2020-11-04","2021-02-19","2021-05-19","2021-01-15","2020-02-06","2020-07-13","2021-01-15","2021-01-15","2020-07-02","2020-07-02","2020-07-02","2020-07-13","2020-07-13","2020-07-13","2020-07-13","2020-07-13","2021-02-10","2021-02-10","2021-06-17","2021-11-11","2021-07-06","2020-08-13","2021-04-16","2020-12-08","2021-01-07","2020-10-16","2020-10-16","2020-10-20","2020-01-23","2020-01-23","2020-02-07","2020-07-01","2021-01-07","2021-06-17","2021-06-17","2021-06-17","2021-09-22","2021-11-11","2021-11-11","2021-11-11"],"priorHcc":["","",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":[]},{"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":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","62175011843","OMEPRAZOLE ","20MG","60","Select","Select",""],["","00093078710","ATENOLOL ","25MG","90","Select","Select",""],["","70377000415","SIMVASTATIN ","40MG","90","Select","Select",""],["","68382009705","PAROXETINE ","10MG","90","Select","Select",""],["","68180098003","LISINOPRIL ","10MG","90","Select","Select",""],["","50111043302","TRAZODONE ","50MG","45","Select","Select",""],["","68462063901","NITROGLYCERN ","0.4MG","100","Select","Select",""],["","00172572960","FAMOTIDINE ","40MG","-90","Select","Select",""],["","65862078430","ESOMEPRA ","40MG DR","180","Select","Select",""],["","66685100100","AMOX\/K ","875-125","-20","Select","Select",""],["","45802088094","NYSTAT\/TRIAM ","","30","Select","Select",""],["","00591299801","URSODIOL ","250MG","60","Select","Select",""],["","51267089099","CONTRAVE ","8-90MG","70","Select","Select",""],["","49281012065","FLUZONE ","PF 20-21","1","Select","Select",""],["","16729031701","OXYBUTYNIN ","5MG ER","-30","Select","Select",""],["","68462010805","TOPIRAMATE ","25MG","90","Select","Select",""],["","62175011843","","20MG","60","Select","Select",""],["","59651000205","OMEPRAZOLE","20MG","60","Select","Select",""],["","70377000415","SIMVASTATIN","40MG","90","Select","Select",""],["","68180098003","LISINOPRIL","10MG","90","Select","Select",""],["","68382002210","ATENOLOL","25MG","90","Select","Select",""],["","45802088094","NYSTAT\/TRIAM","","30","Select","Select",""],["","62332000231","FAMOTIDINE","40MG","90","Select","Select",""],["","43598043601","NITROGLYCERN","0.4MG","100","Select","Select",""],["","65862078430","ESOMEPRA","40MG DR","180","Select","Select",""],["","66685100100","AMOX\/K","875-125","20","Select","Select",""],["","50111043302","TRAZODONE","50MG","45","Select","Select",""],["","68382009705","PAROXETINE","10MG","90","Select","Select",""],["","00591299801","URSODIOL","250MG","60","Select","Select",""],["","51267089099","CONTRAVE","8-90MG","120","Select","Select",""],["","16729031701","OXYBUTYNIN","5MG ER","-30","Select","Select",""],["","68462010805","TOPIRAMATE","25MG","90","Select","Select",""],["","49281012165","FLUZONE","2021-22","1","Select","Select",""],["","52268020101","SUTAB ","TAB ","24","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","",""],["Yes","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":""}]}]}