{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"HUNTER   A LONG","gend":0,"add":"2009   PULASKI GILES  TURNPIKE                              ","city":"PEARISBURG                    ","state":"VA","zip":"24134-2621","dob":"2004-06-04","age":"","mstatus":"","insh":4180477,"cliId":"","pno":5409981738,"cno":"","email":"","ename":"","eno":"","pphy":"SAMPLES, RANDALL GARY                                       ","ppno":5406749359,"pcpadd":"5562 Cougar Trail Rd                                        ,                                                            ","pcpcity":"Dublin                        ","pcpstate":"VA","pcpzip":240843849,"pcpcounty":"","pcpid":"","pcpname":"CHILDRENS CHOICE PC","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"2009   PULASKI GILES  TURNPIKE                              ","add3":"","madd1":"2009   PULASKI GILES  TURNPIKE                              ","madd2":"                                                            ","madd3":"","mcity":"PEARISBURG                    ","mstate":"VA","mzip":"24134-2621","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F90.2","Z79.899","Z00.129","Z23","J01.40","R04.0","L25.9","Z00.00","H00.019","T14.8XXA"],"date":["2021-08-11","2021-04-27","2021-08-11","2022-11-08","2021-09-07","2021-09-07","2022-05-16","2022-08-29","2022-09-12","2022-09-20"],"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":[["","24208031510","POLYMYXIN","SOL TRIMETHP","10","Select","Select",""],["","","ADDERALL","CAP 20MG","30","Select","Select",""],["","59746017509","PREDNISONE","TAB 20MG","20","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0.3","Select","Select",""],["","59762219803","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","29300022019","MONTELUKAST","TAB 10MG","30","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":""}]}]}