{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KADEN   B MULLINS","gend":1,"add":"1877   JERRYS BRANCH                                        ","city":"CLINTWOOD                     ","state":"VA","zip":"24228-7098","dob":"2004-07-15","age":"","mstatus":"","insh":4195160,"cliId":"","pno":2769268661,"cno":"","email":"","ename":"","eno":"","pphy":"CAMPBELL, JAMES                                             ","ppno":2766791286,"pcpadd":"1014 PARK AVE NW                                            ,                                                            ","pcpcity":"NORTON                        ","pcpstate":"VA","pcpzip":242731823,"pcpcounty":"","pcpid":"","pcpname":"WELLMONT MEDICAL ASSOCIATES INC","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"SOUTHWEST","aligned":"","ano":"","add2":"1877   JERRYS BRANCH                                        ","add3":"","madd1":"1877   JERRYS BRANCH                                        ","madd2":"                                                            ","madd3":"","mcity":"CLINTWOOD                     ","mstate":"VA","mzip":"24228-7098","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["L30.9","Z68.52","Z30.011","Z30.41","U07.1","J30.1","F43.10","F41.1","T74.22XA","F33.1","J01.00","Z20.89","F40.10","R11.2","Z20.828","Z11.3","Z32.02","D64.9","Z83.2","Z83.49"],"date":["2022-10-26","2020-02-11","2022-04-13","2022-04-13","2020-10-28","2020-10-28","2021-11-02","2021-06-02","2021-02-17","2021-02-17","2021-05-04","2021-05-04","2021-11-02","2021-08-11","2021-11-08","2022-04-13","2022-04-13","2022-10-26","2022-10-26","2022-10-26"],"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":[["","69367026701","WESTAB","TAB 27-1MG","30","Select","Select",""],["","50383026760","CLOBETASOL","CRE 0.0005","60","Select","Select",""],["","45802026937","PERMETHRIN","CRE 0.05","60","Select","Select",""],["","00093226401","AMOXICILLIN","TAB 875MG","20","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","15","Select","Select",""],["","00378728653","NORGEST\/ETHI","TAB 0.25\/35","84","Select","Select",""],["","68462013159","TRIAMCINOLON","CRE 0.001","30","Select","Select",""],["","00254202980","PREVIFEM","TAB ","84","Select","Select",""],["","62332024231","FLUOXETINE","TAB 10MG","30","Select","Select",""],["","43547028110","ESCITALOPRAM","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":""}]}]}