{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ADRIENNE STEVENS","gend":1,"add":"1001 HOPEMAN PARKWAY","city":"WAYNESBORO                    ","state":"VA","zip":"22980-1848","dob":"1996-06-12","age":"","mstatus":"","insh":4240237,"cliId":"","pno":5408366912,"cno":5404470435,"email":"","ename":"","eno":"","pphy":"LEE, DONALD W","ppno":5409498241,"pcpadd":"428 S Magnolia Ave Ste 1,","pcpcity":"Waynesboro                    ","pcpstate":"VA","pcpzip":229803629,"pcpcounty":"","pcpid":"","pcpname":"CFM ASSOCIATED PHYSICIANS WAYNESBORO","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"WESTERN\/ CHARLOTTESVILLE","aligned":"","ano":"","add2":"1001 HOPEMAN PARKWAY","add3":"","madd1":"1001 HOPEMAN PARKWAY","madd2":"APT Q8","madd3":"","mcity":"WAYNESBORO                    ","mstate":"VA","mzip":"22980-1848","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z36.9","Z36.89","Z3A.27","O36.0990","Z23","Z36.85","O47.1","Z04.3","Z3A.37","F39","F42.9","Z01.812","Z20.828","O13.4","Z34.83","O76","Z3A.39","Z37.0","O99.324","F12.90","O80","Z34.90","Z30.017","N91.0","M24.542","S66.912A","R45.86","Z01.818","Z20.822","M20.092","M62.442","G80.8","M79.89","Z98.1","Z98.890","Z47.89","Z00.00","F41.9","F32.9","R53.83","F32.A","Z30.46"],"date":["2020-07-08","2020-09-02","2020-09-02","2020-09-02","2020-10-14","2020-11-04","2020-11-09","2020-11-09","2020-11-09","2020-11-17","2020-11-17","2021-05-10","2020-11-19","2020-11-24","2020-11-24","2020-11-24","2020-11-25","2020-11-25","2020-11-24","2020-11-24","2020-11-25","2020-12-23","2021-01-25","2021-01-25","2021-03-23","2021-03-15","2021-03-08","2021-03-23","2021-09-10","2021-05-13","2021-05-13","2021-05-13","2021-05-25","2021-06-15","2021-06-15","2021-06-15","2021-09-17","2022-01-12","2021-09-17","2022-01-12","2022-01-12","2020-01-21"],"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":[["","68180029506","DULOXETINE","CAP 30MG","30","Select","Select",""],["","62559043130","HYDROCORTISO","CRE 0.025","30","Select","Select",""],["","62332003731","LAMOTRIGINE","TAB 25MG","120","Select","Select",""],["","43547030303","ARIPIPRAZOLE","TAB 5MG","90","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","30","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","15","Select","Select",""],["","66993068030","OLANZAPINE","TAB 2.5MG","30","Select","Select",""],["","68462015813","ONDANSETRON","TAB 8MG ODT","20","Select","Select",""],["","69097086107","ZONISAMIDE","CAP 100MG","60","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":""}]}]}