{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" NAHTANYARB E","gend":0,"add":"NTRUOC74EVIRD YE","city":"AXTON","state":"VA","zip":"24054-3696","dob":"2003-08-08","age":"","mstatus":"","insh":"9796231","cliId":"","pno":"3767246444","cno":"","email":"","ename":"","eno":"","pphy":"SEAMON, DAVID W","ppno":2766329714,"pcpadd":"15 CLEVELAND AVE STE 14,","pcpcity":"Martinsville","pcpstate":"VA","pcpzip":"24112-2937","pcpcounty":"","pcpid":"","pcpname":"CHILDRENS MEDICAL CENTER LTD","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"47COURTNEY DRIVE","add3":"","madd1":"47COURTNEY DRIVE","madd2":"APT A2","madd3":"","mcity":"AXTON","mstate":"VA","mzip":"24054-3696","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["B27.90","R21","T63.791A","J01.90","Z20.822","F10.129","G93.41","S09.90XA","E87.6","R40.4","F29","S02.91XA","R09.02","L25.9","Z72.0","S06.0X0A","R42","V89.2XXA","S13.9XXA","S23.3XXA","S33.5XXA"],"date":["2021-01-21","2022-09-27","2021-07-12","2021-07-12","2021-09-14","2022-02-05","2022-02-05","2022-02-05","2022-02-05","2022-02-05","2022-02-05","2022-02-05","2022-02-05","2022-09-27","2022-09-27","2023-05-13","2023-05-13","2023-05-13","2023-05-13","2023-05-13","2023-05-13"],"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":[]},{"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":[["","50383077504","LIDOCAINE","SOL 2% VISC","50","Select","Select",""],["","45802025735","MOMETASONE","CRE 0.001","45","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","65862050320","AMOX\/K CLAV","TAB 875-125","20","Select","Select",""],["","50111064701","FLUOXETINE","CAP 10MG","30","Select","Select",""],["","00093117410","PENICILLN VK","TAB 500MG","30","Select","Select",""],["","49483060450","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","00378064110","PREDNISONE","TAB 10MG","21","Select","Select",""],["","00093310905","AMOXICILLIN","CAP 500MG","40","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","20","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":""}]}]}