{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DAKOTA   L MITCHELL","gend":0,"add":"3412 NOVELTY  ROAD                                          ","city":"PENHOOK                       ","state":"VA","zip":"24137-3355","dob":"2004-10-30","age":"","mstatus":"","insh":4200173,"cliId":"","pno":5404882824,"cno":"","email":"","ename":"","eno":"","pphy":"BRECH, KILIAN H                                             ","ppno":5403449213,"pcpadd":"21 Highland Ave SE                                          ,Ste 100                                                     ","pcpcity":"Roanoke                       ","pcpstate":"VA","pcpzip":240132218,"pcpcounty":"","pcpid":"","pcpname":"PHYSICIANS TO CHILDREN INC","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"3412 NOVELTY  ROAD                                          ","add3":"","madd1":"3412 NOVELTY  ROAD                                          ","madd2":"                                                            ","madd3":"","mcity":"PENHOOK                       ","mstate":"VA","mzip":"24137-3355","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z00.129","Z23","Z13.31","Z68.54","H10.45","H52.13","H52.223","F33.8","Z71.3","Z71.82","Z20.822","R19.7","H66.91","R07.89","Y93.9","Y92.9","T36.1X5A","T78.40XA","R10.13","R10.9","K58.0","R11.2","R11.10","R51.9"],"date":["2021-06-10","2021-06-10","2021-06-10","2021-06-10","2021-01-20","2021-01-20","2021-01-20","2021-06-10","2021-06-10","2021-06-10","2021-07-25","2022-04-22","2022-04-14","2022-04-15","2022-04-15","2022-04-15","2022-04-15","2022-04-15","2022-04-22","2022-04-22","2022-06-07","2022-10-23","2022-10-23","2022-10-23"],"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":[["","59651000305","OMEPRAZOLE","CAP 40MG","30","Select","Select",""],["","67877054360","CEFDINIR","CAP 300MG","20","Select","Select",""],["","68180016011","AZITHROMYCIN","TAB 250MG","6","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":""}]}]}