{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BRIA   L ROSE","gend":1,"add":"1401   KEMPER STREET                                        ","city":"LYNCHBURG                     ","state":"VA","zip":"24501-1957","dob":"2003-06-28","age":"","mstatus":"","insh":4469862,"cliId":"","pno":4348491696,"cno":"","email":"","ename":"","eno":"","pphy":"CROW, WILLIAM C","ppno":4342005200,"pcpadd":"2323 memorial ave                                           ,                                                            ","pcpcity":"LYNCHBURG                     ","pcpstate":"VA","pcpzip":245012661,"pcpcounty":"","pcpid":"","pcpname":"LYNCHBURG FAMILY MEDICINE CENTER","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"WESTERN\/ CHARLOTTESVILLE","aligned":"","ano":"","add2":"1401   KEMPER STREET                                        ","add3":"","madd1":"1401   KEMPER STREET                                        ","madd2":"APT 307                                                     ","madd3":"","mcity":"LYNCHBURG                     ","mstate":"VA","mzip":"24501-1957","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F90.2","R45.4","F90.9","F17.290","F91.9","S69.91XA","L08.9","J02.9","Z20.828","Z11.59","J02.0"],"date":["2021-05-27","2020-01-28","2020-01-28","2020-01-28","2020-07-28","2020-09-14","2020-09-14","2021-09-22","2020-09-30","2021-01-14","2021-09-22"],"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":[["","00781808931","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","65862021960","CEFDINIR","SUS 250\/5ML","120","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","10","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","30","Select","Select",""],["","60505283203","ATOMOXETINE","CAP 25MG","30","Select","Select",""],["","65862041901","SMZ-TMP","TAB 400-80MG","14","Select","Select",""],["","59417010310","VYVANSE","CAP 30MG","30","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":""}]}]}