{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ESTEPHANIE SOBALVARRO","gend":1,"add":"314 NATIONAL  AVENUE                                        ","city":"WINCHESTER                    ","state":"VA","zip":"22601-5209","dob":"1997-08-03","age":"","mstatus":"","insh":4520544,"cliId":"","pno":5408774851,"cno":"","email":"","ename":"","eno":"","pphy":"CUNNINGHAM, JENNIFER D                                      ","ppno":5404773808,"pcpadd":"5173 Main St,","pcpcity":"Mount Jackson                 ","pcpstate":"VA","pcpzip":228429513,"pcpcounty":"","pcpid":"","pcpname":"NOT FOUND","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"NORTHERN\/ WINCHESTER","aligned":"","ano":"","add2":"                                                            ","add3":"","madd1":"314 NATIONAL AVENUE","madd2":"                                                            ","madd3":"","mcity":"WINCHESTER                    ","mstate":"VA","mzip":"22601-5209","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N76.0","Z71.3","N92.6","M54.5","J02.9","R10.9","R39.9","M62.838","Z32.01","N91.2","Z12.4","N36.8","Z36.3","Z3A.01","N76.2","Z34.81","Z34.90","N34.0","Z3A.21","Z34.83","H57.89","Z36.85","Z01.818","O48.0","Z37.0","Z3A.40","O99.824","F32.9","O99.344","O99.214","Z90.49","Z82.5","Z82.49","Z83.3","Z82.3","Z80.9","Z30.09","Z30.016","R05","Z20.828","N72","N73.9","R10.2","R10.30","Z36.89","Z3A.09"],"date":["2019-04-15","2019-10-25","2021-07-15","2019-06-05","2020-04-16","2021-02-26","2019-10-07","2019-10-10","2019-10-18","2021-08-18","2019-10-22","2019-10-28","2020-02-05","2019-10-23","2019-10-25","2019-10-30","2020-06-16","2020-01-20","2020-02-05","2020-03-19","2020-05-18","2020-06-02","2020-06-08","2020-06-19","2020-06-19","2020-06-19","2020-06-19","2020-06-19","2020-06-19","2020-06-19","2020-06-19","2020-06-19","2020-06-19","2020-06-19","2020-06-19","2020-06-19","2020-10-08","2020-10-08","2021-01-06","2021-01-06","2021-02-26","2021-02-26","2021-02-26","2021-02-26","2021-08-28","2021-08-28"],"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":[["","63304061650","DOXYCYC","CAP 100MG","20","Select","Select",""],["","13925011601","SE-NATAL","TAB ","30","Select","Select",""],["","42806071401","BENZONATATE","CAP 100MG","30","Select","Select",""],["","59746017509","PREDNISONE","TAB 20MG","10","Select","Select",""],["","00378334053","XULANE","DIS 150-35","3","Select","Select",""],["","61314023710","CROMOLYN","SOL 4% OP","10","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","21","Select","Select",""],["","68645052254","SERTRALINE","TAB 50MG","30","Select","Select",""],["","68462030529","NORETHINDRON","TAB 0.35MG","56","Select","Select",""],["","68645051890","CYCLOBENZAPR","TAB 10MG","8","Select","Select",""],["","65162046510","IBUPROFEN","TAB 600MG","30","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","14","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":""}]}]}