{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CHRISTIAN COOK","gend":0,"add":"903 MEADOWVIEW DRIVE","city":"PULASKI                       ","state":"VA","zip":"24301-3245","dob":"1999-12-21","age":"","mstatus":"","insh":4108502,"cliId":"","pno":2763898480,"cno":"","email":"","ename":"","eno":"","pphy":"BROCHERO, ALFONSO D","ppno":5407693964,"pcpadd":"2900 LAMB CIRCLE,","pcpcity":"CHRISTIANSBURG                ","pcpstate":"VA","pcpzip":240736344,"pcpcounty":"","pcpid":"","pcpname":"PULASKI HEALTH AND REHAB CENTER","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"903 MEADOWVIEW DRIVE","add3":"","madd1":"903 MEADOWVIEW DRIVE","madd2":"APT 13","madd3":"","mcity":"PULASKI                       ","mstate":"VA","mzip":"24301-3245","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N18.4","I10","E21.1","R80.1","Z01.818","I12.9","I12.0","N18.6","K21.9","F17.210","Z79.899","Z01.810","I49.9","R94.31","N18.9","Z99.2","M79.602","M79.89","T82.858A","Z95.828","N18.5","Z76.82"],"date":["2021-06-15","2021-06-15","2021-04-07","2021-02-18","2021-06-15","2021-02-27","2021-02-19","2021-04-26","2021-02-27","2021-02-27","2021-02-27","2021-02-16","2021-02-16","2021-02-16","2021-10-27","2021-02-19","2021-02-27","2021-02-27","2021-04-14","2021-04-14","2021-06-15","2021-06-15"],"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":[["","65862014505","CARVEDILOL","TAB 25MG","60","Select","Select",""],["","29300039810","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","31722070210","LOSARTAN","TAB 100MG","30","Select","Select",""],["","00310111001","LOKELMA","PAK 10GM","16","Select","Select",""],["","29033002602","CALC","CAP 667MG","180","Select","Select",""],["","49884025601","MINOXIDIL","TAB 2.5MG","60","Select","Select",""],["","69452020713","CALCITRIOL","CAP 0.25MCG","30","Select","Select",""],["","16714061105","SERTRALINE","TAB 25MG","30","Select","Select",""],["","50383066730","LIDO\/PRILOCN","CRE 2.5-2.5%","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":""}]}]}