{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JOHN   M BAYNE","gend":0,"add":"2259 BAGLEYS MILL ROAD","city":"SOUTH HILL                    ","state":"VA","zip":"23970-7109","dob":"2004-06-29","age":"","mstatus":"","insh":4171482,"cliId":"","pno":4347557879,"cno":"","email":"","ename":"","eno":"","pphy":"HOLLAND, JOHN A","ppno":4346962165,"pcpadd":"1508 K V Rd,","pcpcity":"Victoria                      ","pcpstate":"VA","pcpzip":239742624,"pcpcounty":"","pcpid":"","pcpname":"LUNENBURG MEDICAL CENTER","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"CENTRAL","aligned":"","ano":"","add2":"2259 BAGLEYS MILL ROAD","add3":"","madd1":"2259 BAGLEYS MILL ROAD","madd2":"","madd3":"","mcity":"SOUTH HILL                    ","mstate":"VA","mzip":"23970-7109","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H92.01","Z01.10","J06.9","K21.9","F98.9","F84.0","Z68.54","R05","Z20.828","J45.20","Z11.59","J02.9","R03.0","H65.00","I10","Z00.129","Z23","J30.1","I51.7","R00.1","I36.1","I34.0","I37.1","S76.111A","J30.9","B34.9","I11.9","R42","R68.89","R73.09","H53.9","E66.3","S30.861A","K21.00","K59.00","R10.84","F33.9","R53.81","F80.9","R41.840","R06.83","F32.A","G47.30","R11.10","R10.9","G44.209"],"date":["2020-01-20","2020-01-20","2020-02-03","2021-09-28","2020-07-06","2021-10-04","2020-07-06","2021-08-11","2020-08-10","2021-08-31","2020-09-26","2021-02-08","2020-09-26","2020-09-26","2021-12-14","2020-10-14","2020-10-14","2020-10-14","2021-11-17","2020-11-11","2020-11-11","2020-11-11","2020-11-11","2021-02-05","2021-08-11","2021-02-08","2021-05-19","2021-05-22","2021-05-22","2021-07-21","2021-07-21","2021-07-28","2021-07-28","2021-08-31","2021-11-17","2021-08-31","2021-09-28","2021-09-28","2021-10-04","2021-10-04","2021-10-04","2021-10-04","2021-10-04","2021-12-01","2021-12-01","2021-12-14"],"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":[["","00093317431","ALBUTEROL","FAT E","8.5","Select","Select",""],["","59746017509","PREDNISONE","TAB 20MG","5","Select","Select",""],["","00472024260","PERMETHRIN","CRE 0.05","60","Select","Select",""],["","29300022019","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","68645045690","ENALAPRIL","TAB 10MG","30","Select","Select",""],["","65162067684","AZELASTINE","SPR 0.001","30","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","16571040250","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","00781286810","OMEPRAZOLE","CAP 20MG","30","Select","Select",""],["","00173071920","FLOVENT","AER 110MCG","12","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","45802006435","TRIAMCINOLON","CRE 0.001","15","Select","Select",""],["","63304061650","DOXYCYC","CAP 100MG","20","Select","Select",""],["","16714008210","HYDROXYZ","TAB 25MG","20","Select","Select",""],["","00143928501","AMOXICILLIN","TAB 875MG","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":""}]}]}