{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BRYAN   C HERNANDEZ","gend":0,"add":"83 STONE LANE","city":"STUART                        ","state":"VA","zip":"24171-3467","dob":"2003-11-14","age":"","mstatus":"","insh":4121546,"cliId":"","pno":2768068441,"cno":"","email":"","ename":"","eno":"","pphy":"SEAMON, DAVID W","ppno":2766329714,"pcpadd":"15 Cleveland Ave,Ste 14","pcpcity":"Martinsville                  ","pcpstate":"VA","pcpzip":241122937,"pcpcounty":"","pcpid":"","pcpname":"CHILDRENS MEDICAL CENTER LTD","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"83 STONE LANE","add3":"","madd1":"83 STONE LANE","madd2":"LOT 9","madd3":"","mcity":"STUART                        ","mstate":"VA","mzip":"24171-3467","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J01.90","H92.01","H60.391","J06.9","U07.1","Z20.828","R73.03","Z23","Z00.129","K76.0","R74.01","R10.31","R63.5","B34.9","R51.9","J02.9","R09.81","Z20.822","R55","Z87.898"],"date":["2020-01-29","2020-01-29","2020-06-20","2021-03-15","2021-03-15","2021-03-15","2021-07-22","2021-07-22","2021-07-22","2021-11-10","2021-09-07","2021-08-24","2021-09-07","2021-10-20","2021-10-20","2021-10-20","2021-10-20","2021-10-20","2021-11-10","2021-11-10"],"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":[["","70710122501","AMITRIPTYLIN","TAB 10MG","30","Select","Select",""],["","68462010530","ONDANSETRON","TAB 4MG","10","Select","Select",""],["","31722054301","INDOMETHACIN","CAP 50MG","15","Select","Select",""],["","40985025222","VITAMIN","CAP 400UNIT","100","Select","Select",""],["","24208063562","NEO\/POLY\/HC","SUS 1% OTIC","10","Select","Select",""],["","68180071160","CEFDINIR","CAP 300MG","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":""}]}]}