{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ALICAN   R SNEAD","gend":1,"add":"520   HEATHER STREET                                        ","city":"DANVILLE                      ","state":"VA","zip":"24541-7200","dob":"1980-04-21","age":"","mstatus":"","insh":4365855,"cliId":"","pno":4342283649,"cno":4342035074,"email":"","ename":"","eno":"","pphy":"LAHURD JR, NEIL J                                           ","ppno":4344461070,"pcpadd":"949 PINEY FOREST RD                                         ,                                                            ","pcpcity":"DANVILLE                      ","pcpstate":"VA","pcpzip":245401591,"pcpcounty":"","pcpid":"","pcpname":"GODOCS","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"WESTERN\/ CHARLOTTESVILLE","aligned":"","ano":"","add2":"520   HEATHER STREET                                        ","add3":"","madd1":"520   HEATHER STREET                                        ","madd2":"                                                            ","madd3":"","mcity":"DANVILLE                      ","mstate":"VA","mzip":"24541-7200","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M19.90","F31.9","F41.1","G47.33","G56.03","G89.4","M54.16","Z79.891","G25.81","Z01.419","R20.2","R68.89","E66.01","Z68.43","R74.8","K76.0","H10.413","D31.31","J44.9","F41.9","F32.9","E78.5"],"date":["2020-03-19","2020-06-25","2020-09-25","2020-10-05","2020-09-25","2020-03-19","2020-09-25","2020-06-25","2020-06-25","2020-09-24","2020-06-25","2020-09-25","2020-08-12","2020-08-12","2020-08-28","2020-09-25","2020-12-08","2020-12-08","2022-04-18","2022-04-18","2022-04-18","2022-04-18"],"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":[]},{"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":[["","59762219803","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","00054001925","PREDNISONE","TAB 50MG","6","Select","Select",""],["","00781729685","ALBUTEROL","AER HFA","6.7","Select","Select",""],["","16729044410","BUPROPN","TAB 300MG XL","30","Select","Select",""],["","43547028211","ESCITALOPRAM","TAB 20MG","90","Select","Select",""],["","00781261305","AMOXICILLIN","CAP 500MG","21","Select","Select",""],["","31722094105","HYDROCO\/APAP","TAB 5-325MG","12","Select","Select",""],["","55111068405","IBU","TAB 800MG","20","Select","Select",""],["","71093012105","GABAPENTIN","CAP 300MG","90","Select","Select",""],["","60505058401","EPINASTINE","DRO 0.0005","5","Select","Select",""],["","43547026810","ROPINIROLE","TAB 0.25MG","90","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":""}]}]}