{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CLINTON HORNE","gend":0,"add":"1006 W RIVERSIDE DR LOT 1                                   ","city":"SALEM                         ","state":"VA","zip":"24153-4636","dob":"2004-08-06","age":"","mstatus":"","insh":4390452,"cliId":"","pno":5403895689,"cno":"","email":"","ename":"","eno":"","pphy":"DELANEY, RUSSELL E                                          ","ppno":"","pcpadd":"1802 Braeburn Dr                                            ,                                                            ","pcpcity":"Salem                         ","pcpstate":"VA","pcpzip":241537357,"pcpcounty":"","pcpid":"","pcpname":"LEWIS GALE PHYSICIANS LLC","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"1006 W RIVERSIDE DR LOT 1                                   ","add3":"","madd1":"1006 W RIVERSIDE DR LOT 1                                   ","madd2":"                                                            ","madd3":"","mcity":"SALEM                         ","mstate":"VA","mzip":"24153-4636","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J10.1","Z00.129","Z01.00","Z13.89","Z23","F32.9","T74.32XA","J02.9","J03.90","I88.9","Z20.828","F33.2","J35.8","J30.2","B34.9","Z20.822","J06.9","J11.1","J32.9","R05.9"],"date":["2020-02-04","2021-09-29","2020-09-24","2020-09-24","2021-09-29","2021-09-29","2020-09-24","2021-03-25","2020-10-26","2021-03-25","2021-04-23","2021-09-29","2021-03-25","2021-03-25","2021-10-06","2021-10-06","2021-12-14","2022-05-11","2022-05-25","2022-05-25"],"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":[["","65862050320","AMOX\/K","TAB 875-125","20","Select","Select",""],["","50428707032","CVS","LOZ THROAT","18","Select","Select",""],["","42192060716","BROM\/PSE\/DM","SYP ","118","Select","Select",""],["","45802065078","LORATADINE","TAB 10MG","30","Select","Select",""],["","67877021905","CEPHALEXIN","CAP 500MG","20","Select","Select",""],["","69097083305","SERTRALINE","TAB 25MG","30","Select","Select",""],["","57664049983","MIRTAZAPINE","TAB 15MG","15","Select","Select",""],["","69238126601","OSELTAMIVIR","CAP 75MG","10","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":""}]}]}