{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TAMARA   L SHELTON","gend":1,"add":"101   LAUREL  COURT                                         ","city":"STUART                        ","state":"VA","zip":"24171-1547","dob":"1996-08-16","age":"","mstatus":"","insh":4108164,"cliId":"","pno":2766924346,"cno":"","email":"","ename":"","eno":"","pphy":"COLE, RICHARD C                                             ","ppno":2766944466,"pcpadd":"18877 JEB STUART HWY                                        ,                                                            ","pcpcity":"STUART                        ","pcpstate":"VA","pcpzip":241711019,"pcpcounty":"","pcpid":"","pcpname":"PATRICK COUNTY FAMILY PRACTICE","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"101   LAUREL  COURT                                         ","add3":"","madd1":"101   LAUREL  COURT                                         ","madd2":"                                                            ","madd3":"","mcity":"STUART                        ","mstate":"VA","mzip":"24171-1547","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F90.0","R53.83","F41.1","F33.42","N92.0","M89.9","G60.3","K59.09","F51.01","E55.9","G90.9","M54.5","R04.0","R42","R51.9","J30.9","Z20.822","G90.09","M54.9","S61.422A","S62.002A","M25.532","S62.002D","N20.0","R30.0","E66.01","K80.20","N20.2","K80.10","Z13.89","K21.9","F41.9","F32.9","Z87.891","Z01.419","N91.2","Z32.02","R87.612","Z87.42","I82.401","M79.89","M79.604"],"date":["2022-06-24","2021-05-20","2022-06-24","2022-06-24","2020-09-09","2020-09-09","2020-09-09","2020-09-09","2020-10-08","2021-05-20","2020-10-08","2020-10-14","2021-03-24","2021-03-10","2021-05-03","2021-05-03","2021-05-03","2021-05-20","2021-10-11","2021-12-15","2022-01-29","2022-01-29","2022-02-02","2022-03-24","2022-03-24","2022-11-14","2022-04-04","2022-04-04","2022-04-27","2022-07-07","2022-04-27","2022-04-27","2022-04-27","2022-04-27","2022-07-07","2022-07-07","2022-08-09","2022-08-09","2022-08-09","2022-11-14","2022-11-14","2022-11-14"],"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":[["","43547040410","PHENTERMINE","TAB 37.5MG","30","Select","Select",""],["","00591544305","PREDNISONE","TAB 20MG","10","Select","Select",""],["","00406012305","HYDROCO\/APAP","TAB 5-325MG","20","Select","Select",""],["","68382013201","TAMSULOSIN","CAP 0.4MG","30","Select","Select",""],["","16571020150","DICLOFENAC","TAB 75MG DR","60","Select","Select",""],["","00456112030","VIIBRYD","TAB 20MG","30","Select","Select",""],["","00591352530","LIDOCAINE","PAD 0.05","90","Select","Select",""],["","51672401801","ETODOLAC","TAB 400MG","90","Select","Select",""],["","00904759080","FEROSUL","TAB 325MG","30","Select","Select",""],["","69452015120","VITAMIN","CAP 50000UNT","12","Select","Select",""],["","65862037301","ESCITALOPRAM","TAB 5MG","30","Select","Select",""],["","52817033200","CYCLOBENZAPR","TAB 10MG","30","Select","Select",""],["","59417010310","VYVANSE","CAP 30MG","30","Select","Select",""],["","49100040009","CULTURELLE","CAP ","30","Select","Select",""],["","70710122600","AMITRIPTYLIN","TAB 25MG","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":""}]}]}