{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TAYLOR ESPARZA","gend":1,"add":"3410 CHAPARRAL DRIVE                                        ","city":"ROANOKE                       ","state":"VA","zip":"24018-4930","dob":"1998-12-20","age":"","mstatus":"","insh":4343469,"cliId":"","pno":5408926532,"cno":"","email":"","ename":"","eno":"","pphy":"BEHIRI, AMR                                                 ","ppno":7036877422,"pcpadd":"41816 Fenway Cir,","pcpcity":"Ashburn                       ","pcpstate":"VA","pcpzip":201488069,"pcpcounty":"","pcpid":"","pcpname":"ATLANTIC HEALTHCARE SERVICES","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"APARTMENT 113                                               ","add3":"","madd1":"92 Summit Way SW","madd2":"                                                            ","madd3":"","mcity":"Roanoke                       ","mstate":"VA","mzip":"24014-5101","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z36.89","Z3A.12","O99.331","Z36.82","K56.41","K64.9","O22.42","K62.89","K59.00","F17.200","Z3A.14","R82.71","B89","Z34.90","O21.0","R78.81","E87.6","Z3A.19","O99.282","O21.9","O26.892","Z87.891","F12.10","Z3A.20","R11.2","R51.9","O99.322","Z36.3","O36.8130","Z3A.28","O26.13","Z36.9","Z23","Z3A.36","L29.9","Z3A.37","N89.8","O99.824","O99.344","F31.9","O70.0","Z37.0","Z3A.38","Z91.040","O80"],"date":["2021-06-09","2021-06-09","2021-05-11","2021-05-11","2021-05-24","2021-05-24","2021-05-24","2021-05-24","2021-05-24","2021-05-24","2021-05-24","2021-06-30","2021-06-18","2021-06-18","2021-07-07","2021-06-30","2021-06-30","2021-06-30","2021-06-30","2021-06-30","2021-06-30","2021-06-30","2021-07-07","2021-07-07","2021-07-07","2021-07-07","2021-07-07","2021-07-07","2021-08-30","2021-09-01","2021-10-25","2021-09-01","2021-09-14","2021-10-25","2021-11-01","2021-11-01","2021-11-09","2021-11-09","2021-11-09","2021-11-09","2021-11-09","2021-11-10","2021-11-10","2021-11-09","2021-11-10"],"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":[["","47781030301","NITROFURANTN","CAP 100MG","6","Select","Select",""],["","27241005203","ARIPIPRAZOLE","TAB 5MG","30","Select","Select",""],["","59746011506","PROCHLORPER","TAB 10MG","60","Select","Select",""],["","57237007810","ONDANSETRON","TAB 8MG ODT","20","Select","Select",""],["","49884068905","METOCLOPRAM","TAB 10MG","60","Select","Select",""],["","65862069730","VENLAFAXINE","CAP 150MG ER","90","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","180","Select","Select",""],["","65862019201","FLUOXETINE","CAP 10MG","90","Select","Select",""],["","68462030329","HEATHER","TAB 0.35MG","84","Select","Select",""],["","65862017601","PENICILLN","TAB 500MG","40","Select","Select",""],["","00527132601","URSODIOL","CAP 300MG","28","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":""}]}]}