{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CORBIN   J PORTHOUSE","gend":0,"add":"875 ROCKY FORD ROAD","city":"POWHATAN                      ","state":"VA","zip":"23139-7202","dob":"2003-12-08","age":"","mstatus":"","insh":4150648,"cliId":"","pno":8048199348,"cno":"","email":"","ename":"","eno":"","pphy":"SAUNDERS, MARTHA KEY","ppno":8047942299,"pcpadd":"1407 Huguenot Rd,","pcpcity":"Midlothian                    ","pcpstate":"VA","pcpzip":231132618,"pcpcounty":"","pcpid":"","pcpname":"AFTERHOURS PEDIATRICS MIDLOTHIAN","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"CENTRAL","aligned":"","ano":"","add2":"875 ROCKY FORD ROAD","add3":"","madd1":"875 ROCKY FORD ROAD","madd2":"","madd3":"","mcity":"POWHATAN                      ","mstate":"VA","mzip":"23139-7202","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H65.192","H92.02","R50.9","J02.9","J06.9","Z23","Z00.121","F84.0","Z71.3","Z71.82","Z13.89","Z68.52","M16.0","M25.552","M25.551","G89.29","M47.816","M41.9","M54.5","R31.9","N45.1","T16.2XXA","X58.XXXA","Y92.89","F17.210","Z12.31","R09.89","Z00.129","H61.23","Z13.31"],"date":["2020-03-15","2021-06-17","2020-03-15","2020-10-06","2020-10-06","2021-11-02","2020-11-19","2020-11-19","2020-11-19","2020-11-19","2020-11-19","2020-11-19","2021-03-09","2021-03-09","2021-03-09","2021-03-09","2021-03-09","2021-03-09","2021-03-09","2021-05-05","2021-06-04","2021-06-17","2021-06-17","2021-06-17","2021-06-17","2021-06-17","2021-07-12","2021-11-02","2021-11-02","2021-11-02"],"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":[["","63304061650","DOXYCYC","CAP 100MG","20","Select","Select",""],["","65162027250","SMZ\/TMP","TAB 800-160","14","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0.3","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":""}]}]}