{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ALANA SNARE","gend":1,"add":"1842 MACKS MOUNTAIN RD","city":"INDIAN VALLEY                 ","state":"VA","zip":"24105-3117","dob":"2004-05-14","age":"","mstatus":"","insh":4171381,"cliId":"","pno":5407894290,"cno":"","email":"","ename":"","eno":"","pphy":"SNIDER, ZAIRHA G","ppno":5406395188,"pcpadd":"202 8th St,","pcpcity":"Radford                       ","pcpstate":"VA","pcpzip":241412426,"pcpcounty":"","pcpid":"","pcpname":"NEW RIVER VALLEY PEDIATRICS","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"1842 MACKS MOUNTAIN RD","add3":"","madd1":"1842 MACKS MOUNTAIN RD","madd2":"","madd3":"","mcity":"INDIAN VALLEY                 ","mstate":"VA","mzip":"24105-3117","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J06.9","J02.9","R09.81","Z01.419","Z11.3","Z11.8","N20.0","K76.0","N39.0","R10.9","R30.0","Z88.1","Z79.899","Z87.42","Z86.69","K21.9","Z86.2","Z87.442","F17.210","R10.31","R31.9","N23","Z87.440","R35.0","N89.8","R11.0","N30.01","N76.0","Z00.121","Z01.10","Z01.00","Z23","Z68.53","R10.11"],"date":["2020-01-11","2020-01-11","2020-01-11","2021-07-23","2021-07-23","2021-07-23","2020-09-19","2020-09-19","2020-09-19","2020-10-21","2020-10-19","2020-10-19","2020-09-19","2020-10-19","2020-10-19","2020-10-19","2020-10-19","2020-10-19","2020-10-19","2020-10-19","2020-10-19","2020-10-21","2020-10-21","2021-08-04","2021-04-06","2021-04-06","2021-04-24","2021-04-29","2021-08-04","2021-08-04","2021-08-04","2021-08-25","2021-08-04","2021-08-05"],"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":[["","68180016006","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","31722094205","HYDROCO\/APAP","TAB 7.5-325","10","Select","Select",""],["","67405060203","FLUCONAZOLE","TAB 100MG","2","Select","Select",""],["","00555901658","SPRINTEC","TAB 28 DAY","28","Select","Select",""],["","75826011510","PHENAZOPYRID","TAB 200MG","9","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","20","Select","Select",""],["","00527600274","LIDOCAINE","SOL 2% VISC","100","Select","Select",""],["","57237003105","AMOXICILLIN","CAP 500MG","21","Select","Select",""],["","67877012440","SILVER","CRE 0.01","400","Select","Select",""],["","29300022705","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","57237023305","SMZ-TMP","TAB 800-160","10","Select","Select",""],["","00254202980","PREVIFEM","TAB ","28","Select","Select",""],["","66685100100","AMOX\/K","TAB 875-125","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":""}]}]}