{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"REBECCA   M GRIFFITH","gend":1,"add":"325 AYLOR GRUBBS AVENUE","city":"STANLEY                       ","state":"VA","zip":"22851-3702","dob":"2002-07-11","age":"","mstatus":"","insh":4479567,"cliId":"","pno":5403956256,"cno":5402250165,"email":"","ename":"","eno":"","pphy":"LONG, KEITH C","ppno":5404773808,"pcpadd":"1661 S Main St,","pcpcity":"Harrisonburg                  ","pcpstate":"VA","pcpzip":228012728,"pcpcounty":"","pcpid":"","pcpname":"MOUNT JACKSON MEDICAL CENTER","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"NORTHERN\/ WINCHESTER","aligned":"","ano":"","add2":"325 AYLOR GRUBBS AVENUE","add3":"","madd1":"325 AYLOR GRUBBS AVENUE","madd2":"APARTMENT 7","madd3":"","mcity":"STANLEY                       ","mstate":"VA","mzip":"22851-3702","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.0","N30.00","F90.0","F34.1","L70.0","Z30.09","S01.01XA","W20.8XXA","J45.20","J45.901","J45.909","J45.51","E87.6","D72.829","Z20.822","Z81.8","R00.0","R06.03","R42","R51.9","R00.2","Z79.899","Z88.0","Z88.8","Z91.09","J96.01","J30.9","R07.9","Z09","F33.1","Z30.42"],"date":["2020-04-07","2020-04-27","2021-04-24","2020-04-27","2020-02-18","2021-05-07","2020-04-11","2020-04-11","2021-05-05","2021-04-23","2021-04-23","2021-04-27","2021-04-24","2021-04-24","2021-04-24","2021-04-24","2021-04-24","2021-04-24","2021-04-24","2021-04-24","2021-04-24","2021-04-24","2021-04-24","2021-04-24","2021-04-24","2021-04-24","2021-04-24","2021-04-24","2021-05-05","2021-05-05","2021-05-07"],"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":[["","47781030301","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","69097014260","ALBUTEROL","AER HFA","13.4","Select","Select",""],["","68180016011","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","65862057490","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","59746017509","PREDNISONE","TAB 20MG","24","Select","Select",""],["","59762453802","MEDROXYPR","INJ 150MG\/ML","1","Select","Select",""],["","70436001002","BUPROPN","TAB 150MG XL","90","Select","Select",""],["","53489011905","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","00378730053","DROSPIR\/ETHI","TAB 3-0.03MG","28","Select","Select",""],["","00173068220","VENTOLIN","AER ","36","Select","Select",""],["","00527150537","AMPHET\/DEXTR","TAB 20MG","60","Select","Select",""],["","00093310905","AMOXICILLIN","CAP 500MG","30","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","6","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":""}]}]}