{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"HEAVEN   M ROBERTSON","gend":1,"add":"780   BELMORT DRIVE                                         ","city":"AXTON                         ","state":"VA","zip":"24054-3256","dob":"2004-02-27","age":"","mstatus":"","insh":4366538,"cliId":"","pno":4349411868,"cno":2762265520,"email":"","ename":"","eno":"","pphy":"NOONAN, MARY E","ppno":2766385437,"pcpadd":"1109 Brookdale St                                           ,Ste C                                                       ","pcpcity":"Martinsville                  ","pcpstate":"VA","pcpzip":241124543,"pcpcounty":"","pcpid":"","pcpname":"CHILDREN FIRST PEDIATRICS OF VIRGINIA PC","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"780   BELMORT DRIVE                                         ","madd2":"                                                            ","madd3":"","mcity":"AXTON                         ","mstate":"VA","mzip":"24054-3256","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J30.1","J01.90","E66.9","S20.461A","L03.818","S20.461D","Z00.121","Z68.54","Z00.129","Z01.00","Z71.3","L72.3","D17.1","D17.39","Z53.29","R20.8","E66.01","E11.9","Z91.010","Z91.018","Z79.899","Z68.43","D17.20","G43.909","A08.4","M62.838","R20.0","M54.2","R51.9","M25.522","M62.81","J02.9","Z23","N92.0","D50.9","B33.8","Z20.822","S90.562A","W57.XXXA","Z32.02","R10.30","J06.9","J02.0","R07.0","R10.9","M54.9","E16.2","N92.6","Z32.01","O20.9","N93.9","Z3A.01","L08.89","Z30.013","Z03.89","M79.10","S93.401A","M25.571","X50.9XXA","S99.911A","S99.921A","Z02.5","K62.5","K92.1","F32.9","F41.9","K64.8","O99.519","Z3A.00","Z30.46"],"date":["2020-02-05","2020-02-12","2020-03-07","2020-07-15","2020-07-17","2020-07-17","2021-07-30","2021-07-30","2021-07-30","2021-07-30","2020-07-29","2020-11-23","2021-01-14","2020-12-14","2020-12-14","2021-01-14","2022-04-27","2021-01-14","2021-03-29","2021-01-14","2021-03-29","2021-01-14","2021-01-14","2022-08-29","2021-03-16","2021-03-29","2021-03-29","2021-05-19","2022-04-25","2021-05-19","2021-05-19","2022-09-29","2021-09-28","2021-07-30","2021-08-30","2021-08-18","2022-09-29","2021-10-17","2021-10-17","2021-11-11","2021-11-11","2021-11-29","2022-01-02","2022-01-02","2022-07-11","2022-01-31","2022-02-23","2022-11-01","2022-02-24","2022-02-24","2022-02-24","2022-02-24","2022-03-15","2022-03-18","2022-04-04","2022-04-25","2022-04-27","2022-04-27","2022-04-27","2022-04-27","2022-04-27","2022-05-09","2022-08-29","2022-07-11","2022-08-29","2022-08-29","2022-09-07","2022-09-29","2022-09-29","2022-10-04"],"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":[["","57237023305","SMZ-TMP","TAB 800-160","20","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","20","Select","Select",""],["","69367020301","BUT\/APAP\/CAF","TAB ","12","Select","Select",""],["","51224002218","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","78206014501","NEXPLANON","IMP 68MG","1","Select","Select",""],["","50228011401","FLUOXETINE","CAP 20MG","30","Select","Select",""],["","00527411837","PROPRANOLOL","CAP 120MG ER","30","Select","Select",""],["","57896040101","STOOL","CAP 100MG","60","Select","Select",""],["","00093416173","AMOXICILLIN","SUS 400\/5ML","300","Select","Select",""],["","00555901658","SPRINTEC","TAB 28 DAY","28","Select","Select",""],["","00378077101","CYCLOBENZAPR","TAB 5MG","21","Select","Select",""],["","65862014736","SUMATRIPTAN","TAB 50MG","12","Select","Select",""],["","00179805401","FERROUS","TAB 325MG","30","Select","Select",""],["","00143314205","DOXYCYCL","CAP 100MG","2","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","30","Select","Select",""],["","00591293201","CLINDAMYCIN","CAP 300MG","40","Select","Select",""],["","51672400202","NORTRIPTYLIN","CAP 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":""}]}]}