{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KIMBERLY   G CRUZ","gend":1,"add":"605 BRUCE STREET","city":"WINCHESTER                    ","state":"VA","zip":"22601-5632","dob":"2003-10-06","age":"","mstatus":"","insh":4696195,"cliId":"","pno":5403986825,"cno":"","email":"","ename":"","eno":"","pphy":"KORNREICH, BRYAN A","ppno":5406623853,"pcpadd":"1002 Amherst St,Ste C","pcpcity":"Winchester                    ","pcpstate":"VA","pcpzip":226013323,"pcpcounty":"","pcpid":"","pcpname":"PEDIATRIC ASSOCIATES OF WINCHESTER","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"NORTHERN\/ WINCHESTER","aligned":"","ano":"","add2":"605 BRUCE STREET","add3":"","madd1":"605 BRUCE STREET","madd2":"","madd3":"","mcity":"WINCHESTER                    ","mstate":"VA","mzip":"22601-5632","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J02.9","L53.9","W57.XXXA","Z00.121","N92.6","R51.9","Z00.129","R52","N88.9","M79.10","G40.89","F33.2","Z23","G40.209","G43.909","G47.00","F32.9","N88.8","G40.909","R56.9","Z91.14","E55.9","Z55.8","R00.1","Z91.19","S09.90XA","M54.9"],"date":["2020-01-02","2020-07-06","2020-07-06","2021-01-18","2021-01-27","2021-02-03","2021-01-18","2021-01-18","2021-01-27","2021-02-03","2021-02-03","2021-02-03","2021-02-03","2021-08-07","2021-08-07","2021-08-07","2021-08-07","2021-03-04","2021-06-01","2021-06-01","2021-03-22","2021-11-06","2021-08-07","2021-04-09","2021-06-01","2021-06-01","2021-07-23"],"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":[["","69097012203","TOPIRAMATE","TAB 25MG","1,080.00","Select","Select",""],["","50474050015","NAYZILAM","SPR 5MG","2","Select","Select",""],["","69452015120","VITAMIN","CAP 50000UNT","12","Select","Select",""],["","68180044102","CEPHALEXIN","SUS 250\/5ML","200","Select","Select",""],["","45802006435","TRIAMCINOLON","CRE 0.001","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":""}]}]}