{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DESTINY LEWIS","gend":1,"add":"11254 ASHBY DRIVE","city":"FREDERICKSBURG                ","state":"VA","zip":"22407-8639","dob":"2004-04-22","age":"","mstatus":"","insh":4163742,"cliId":"","pno":5402050155,"cno":2672220010,"email":"","ename":"","eno":"","pphy":"SIMES, REBECCA S","ppno":5407862100,"pcpadd":"4701 Spotsylvania Pkwy Ste 205,","pcpcity":"Fredericksburg                ","pcpstate":"VA","pcpzip":224079435,"pcpcounty":"","pcpid":"","pcpname":"PRATT MEDICAL CENTER LTD","plan":"VPHP","program":"MEDICAID","lob":"MLTSS","region":"CENTRAL","aligned":"","ano":"","add2":"11254 ASHBY DRIVE","add3":"","madd1":"11254 ASHBY DRIVE","madd2":"","madd3":"","mcity":"FREDERICKSBURG                ","mstate":"VA","mzip":"22407-8639","pcpfaxno":5407860677,"pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R51","R60.9","S06.0X1A","R41.82","W20.8XXA","Y92.009","R40.2362","R40.2142","R40.2252","W01.0XXA","Y92.89","Y93.89","R44.3","F48.9","F32.9","F41.9","F20.9","F32.3","F33.3","R10.10","Z20.828","R10.9","R19.7","R11.10","Z20.822","Z00.129","Z23","F90.2","H93.293","N83.209","R10.31","R10.84","R50.9","R09.02","R10.2"],"date":["2020-01-23","2020-01-22","2020-01-22","2020-01-22","2020-01-22","2020-01-22","2020-01-22","2020-01-22","2020-01-22","2020-01-22","2020-01-22","2020-01-22","2020-01-28","2020-01-28","2020-01-28","2020-01-28","2020-09-14","2021-09-05","2021-11-22","2021-01-08","2021-01-08","2021-03-25","2021-01-08","2021-01-08","2021-01-08","2021-01-27","2021-06-04","2021-11-22","2021-02-24","2021-03-25","2021-03-25","2021-03-25","2021-03-25","2021-05-14","2021-09-14"],"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":[["","43547034106","RISPERIDONE","TAB 1MG","30","Select","Select",""],["","42806015905","HYDROXYZ","TAB 10MG","60","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":""}]}]}