{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TAYLOR   A GALLIER","gend":1,"add":"229   WINESAP ROAD                                          ","city":"MADISON HEIGHTS               ","state":"VA","zip":"24572-2802","dob":"2002-04-05","age":"","mstatus":"","insh":4476901,"cliId":"","pno":4345466461,"cno":"","email":"","ename":"","eno":"","pphy":"THOMAS E DOBYNS MD                                          ","ppno":4345284312,"pcpadd":"4579 S Amherst Hwy                                          ,                                                            ","pcpcity":"MADISON HEIGHTS               ","pcpstate":"VA","pcpzip":245725343,"pcpcounty":"","pcpid":"","pcpname":"THOMAS E DOBYNS FAMILY PRACTICE","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"WESTERN\/ CHARLOTTESVILLE","aligned":"","ano":"","add2":"229   WINESAP ROAD                                          ","add3":"","madd1":"229   WINESAP ROAD                                          ","madd2":"                                                            ","madd3":"","mcity":"MADISON HEIGHTS               ","mstate":"VA","mzip":"24572-2802","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J11.89","H65.00","J02.9","Z68.29","F32.1","N12","R42","M54.9","R50.9","R11.0","R00.0","R94.31","R05.8","N39.0","Z68.33","J20.9","J01.00","Z68.34","S91.302A","Z68.35","M79.672","J39.9","S90.852A","W45.8XXA","Z82.49","Z83.3","Z20.822","S90.859A","S90.922A","A08.39","S43.409A"],"date":["2020-02-24","2021-11-10","2020-10-07","2020-10-07","2021-05-13","2021-11-03","2021-11-03","2022-11-01","2021-11-03","2021-11-03","2021-11-03","2021-11-03","2021-11-03","2022-11-01","2021-11-10","2021-11-30","2021-11-30","2021-11-30","2021-12-15","2022-05-17","2021-12-16","2022-01-13","2022-02-10","2022-01-21","2022-01-21","2022-01-21","2022-01-21","2022-01-21","2022-02-10","2022-05-17","2022-08-12"],"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":[["","67877054360","CEFDINIR","CAP 300MG","20","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","20","Select","Select",""],["","16571020210","DICLOFENAC","TAB 50MG DR","30","Select","Select",""],["","00093342210","CYCLOBENZAPR","TAB 10MG","30","Select","Select",""],["","00093005805","TRAMADOL","TAB 50MG","10","Select","Select",""],["","00555901658","SPRINTEC","TAB 28 DAY","28","Select","Select",""],["","68462030929","NORGEST\/ETHI","TAB 0.25\/35","28","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","56","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","10","Select","Select",""],["","68180016013","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","69238126601","OSELTAMIVIR","CAP 75MG","10","Select","Select",""],["","65862050220","AMOX\/K","TAB 500-125","20","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":""}]}]}