{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"IZAYA   R LARSON","gend":0,"add":"1000   RANDOLPH STREET                                      ","city":"LYNCHBURG                     ","state":"VA","zip":"24504-2144","dob":"2003-03-26","age":"","mstatus":"","insh":4479788,"cliId":"","pno":4342135594,"cno":"","email":"","ename":"","eno":"","pphy":"SULLIVAN, STEPHANIE J                                       ","ppno":4342378846,"pcpadd":"1212 McConville Rd                                          ,                                                            ","pcpcity":"Lynchburg                     ","pcpstate":"VA","pcpzip":245024536,"pcpcounty":"","pcpid":"","pcpname":"F READ HOPKINS PEDIATRICS","plan":"VPHP","program":"MEDICAID","lob":"MLTSS","region":"WESTERN\/ CHARLOTTESVILLE","aligned":"","ano":"","add2":"1000   RANDOLPH STREET                                      ","add3":"","madd1":"1000   RANDOLPH STREET                                      ","madd2":"APARTMENT 3                                                 ","madd3":"","mcity":"LYNCHBURG                     ","mstate":"VA","mzip":"24504-2144","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F90.2","F43.9","F43.29","F43.25","F84.0","F91.3","F90.9","Z86.73","Z79.899","Z77.22","L75.0","Z23","J02.9","Z20.828","Z00.00","S21.219A","W26.8XXA","U07.1","R51.9","R11.2","R10.9","J10.1","R50.9","R07.0","I47.1","F90.1","Z20.822","J02.0","S60.222A","S69.92XA","M79.645","F39","W22.8XXA"],"date":["2020-07-10","2020-07-10","2020-06-26","2020-06-05","2022-11-25","2020-09-22","2022-11-25","2022-11-25","2020-09-22","2020-09-22","2021-02-12","2021-10-23","2021-08-19","2021-08-19","2021-09-23","2021-10-23","2021-10-23","2021-12-18","2022-11-03","2021-12-18","2021-12-18","2022-11-03","2022-11-03","2022-11-03","2022-11-25","2022-11-03","2022-11-03","2022-11-03","2022-11-25","2022-11-25","2022-11-25","2022-11-25","2022-11-25"],"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":[["","57237002801","AMOXICILLIN","TAB 500MG","21","Select","Select",""],["","57237007710","ONDANSETRON","TAB 4MG ODT","10","Select","Select",""],["","59762374401","CLINDAMYCIN","LOT 10MG\/ML","60","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":""}]}]}