{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ESMERALDA   R CASTILLO-ANIMAS","gend":1,"add":"201   FOREST LAKE DRIVE                                     ","city":"STEPHENS CITY                 ","state":"VA","zip":"22655-3306","dob":"2003-03-26","age":"","mstatus":"","insh":4302123,"cliId":"","pno":5406609481,"cno":"","email":"","ename":"","eno":"","pphy":"KAISER, SHERIF                                              ","ppno":5409559995,"pcpadd":"115 S Church St,","pcpcity":"Berryville                    ","pcpstate":"VA","pcpzip":226111369,"pcpcounty":"","pcpid":"","pcpname":"BERRYVILLE MEDICAL ASSOCIATES PLC","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"NORTHERN\/ WINCHESTER","aligned":"","ano":"","add2":"APT 60                                                      ","add3":"","madd1":"211 FOREST LAKE DRIVE","madd2":"APT 60","madd3":"","mcity":"STEPHENS CITY                 ","mstate":"VA","mzip":"22655-3306","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["O09.92","Z3A.26","Z36.9","Z3A.28","O09.93","O09.293","Z3A.30","K52.9","O99.613","O21.2","O26.893","R10.9","Z3A.31","O12.13","R11.10","O26.899","E86.0","R11.2","Z3A.33","Z3A.36","O14.14","O14.90","O99.12","Z37.0","Z3A.38","O32.1XX0","D69.6","Z20.822","Z82.49","Z83.3","O14.03","R10.31","O75.82","Z3A.39","O14.15","O99.13","Z39.0","Z48.816","O14.13","O90.81","Z39.2","Z30.09"],"date":["2021-07-06","2021-07-06","2021-11-08","2021-07-06","2021-08-31","2021-08-04","2021-07-20","2021-07-26","2021-07-26","2021-07-26","2021-09-09","2021-07-26","2021-07-26","2021-07-26","2021-07-26","2021-07-26","2021-07-26","2021-07-26","2021-08-04","2021-08-31","2021-09-09","2021-09-09","2021-09-09","2021-09-09","2021-09-09","2021-09-09","2021-09-10","2021-09-09","2021-09-09","2021-09-09","2021-09-09","2021-09-09","2021-09-09","2021-09-09","2021-09-10","2021-09-10","2021-09-12","2021-09-20","2021-09-20","2021-11-08","2021-11-08","2021-11-08"],"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":[["","00116200116","CHLORHEX","SOL 0.0012","473","Select","Select",""],["","00406055201","OXYCODONE","TAB 5MG","42","Select","Select",""],["","00574060801","FERROUS","TAB 324MG EC","60","Select","Select",""],["","00904699860","DOCUSATE","CAP 100MG","60","Select","Select",""],["","68462010630","ONDANSETRON","TAB 8MG","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":""}]}]}