{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CHRISTINA   N SLATE","gend":1,"add":"125 MODEL T DRIVE","city":"BASSETT","state":"VA","zip":"24055-7012","dob":"1986-08-16","age":"","mstatus":"","insh":"4195630","cliId":"","pno":"2767321435","cno":"","email":"","ename":"","eno":"","pphy":"COLE, RICHARD C","ppno":"2766944466          ","pcpadd":"18877 JEB STUART HWY, ","pcpcity":"STUART","pcpstate":"VA","pcpzip":"241711019","pcpcounty":"","pcpid":"","pcpname":"PATRICK COUNTY FAMILY PRACTICE","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"LOT 19","add3":"","madd1":"1311 Spring Rd","madd2":"","madd3":"","mcity":"Patrick Springs","mstate":"VA","mzip":"24133-3824","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J10.1","D50.0","E53.9","R00.2","I45.10","I34.1","Q23.1","R07.89","N20.1","R10.31","E87.6","E83.42","A09","E07.9","Z79.899","N13.1","Q63.2","R31.9","K21.9","E03.9","J45.909","N39.0","R50.9","R11.10","Z48.816","Z46.6","E86.0","F12.10","R11.2","Z88.8","Z91.012","R10.9","I10","R10.11","R10.30","R53.1","R11.0","N83.201","D50.8","D60.9","D70.9","E55.9","Z01.419","N92.6","N92.0","N93.9","D64.9","R06.02","R55","Z85.41","Z87.891","D61.01","R01.1","R42","L93.2","R53.83","M54.2","R51.9","R07.2","R07.9","D60.0","R93.1","R09.89","E78.49","S46.912A","M79.89","J98.59","R59.0","M32.9","E32.8","D49.89","D50.9","J45.30","J30.9","Z86.2","R06.09","D15.0"],"date":["2020-01-13","2020-02-17","2021-01-25","2021-04-27","2021-05-07","2021-05-14","2021-04-27","2021-05-06","2020-03-06","2020-10-24","2021-01-25","2020-02-21","2020-02-21","2020-02-21","2021-05-07","2020-02-25","2020-02-25","2020-03-06","2020-02-24","2022-01-18","2021-05-06","2020-10-24","2020-02-27","2020-02-27","2020-03-06","2020-03-06","2020-10-22","2020-10-22","2020-10-24","2020-10-22","2021-09-28","2020-10-24","2020-10-24","2020-10-24","2021-04-23","2020-10-24","2020-10-24","2020-10-24","2021-10-19","2022-01-18","2021-01-25","2022-01-18","2021-04-14","2021-04-14","2021-05-03","2021-05-07","2021-04-23","2021-05-06","2021-04-23","2021-04-23","2021-05-07","2021-09-28","2021-04-27","2021-05-06","2021-05-05","2021-10-19","2021-05-05","2021-05-05","2021-05-07","2021-05-07","2021-05-07","2021-05-07","2021-05-07","2022-01-18","2021-05-14","2021-06-21","2021-07-19","2021-07-08","2021-07-09","2021-07-09","2021-09-28","2021-09-28","2021-09-28","2021-09-28","2021-09-28","2021-10-19","2021-10-18"],"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":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"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":[["","47781065490","LEVOTHYROXIN","TAB 112MCG","45.00","Select","Select",""],["","00555077902","MEDROXYPR","TAB 10MG","5.00","Select","Select",""],["","72305010030","EUTHYROX","TAB 100MCG","45.00","Select","Select",""],["","00487950125","ALBUTEROL","NEB 0.00083","75.00","Select","Select",""],["","55111015330","ONDANSETRON","TAB 4MG","10.00","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","20.00","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","30.00","Select","Select",""],["","00143924920","AMOX\/K","TAB 875-125","20.00","Select","Select",""],["","55111014512","FLUCONAZOLE","TAB 150MG","3.00","Select","Select",""],["","00832532511","POT  CL MICRO","TAB 20MEQ ER","6.00","Select","Select",""],["","00093532862","JUNEL","TAB 43831","28.00","Select","Select",""],["","65862007701","CIPROFLOXACN","TAB 500MG","14.00","Select","Select",""],["","51293081101","PHENAZOPYRID","TAB 200MG","9.00","Select","Select",""],["","55111064530","OMEPRAZOLE","CAP 40MG","90.00","Select","Select",""],["","81131031251","IRON","TAB 325MG","30.00","Select","Select",""],["","68382004001","PROMETHAZINE","TAB 12.5MG","15.00","Select","Select",""],["","68645014059","FAMOTIDINE","TAB 20MG","20.00","Select","Select",""],["","55111028130","LEVOFLOXACIN","TAB 750MG","7.00","Select","Select",""],["","69543038810","KETOROLAC","TAB 10MG","20.00","Select","Select",""],["","31722063231","OSELTAMIVIR","CAP 75MG","10.00","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":""}]}]}