{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"STEPHANIE   E COPP","gend":1,"add":"231 W MAIN STREET","city":"DANVILLE                      ","state":"VA","zip":"24541-2851","dob":"1981-05-26","age":"","mstatus":"","insh":4734484,"cliId":"","pno":4344214889,"cno":"","email":"","ename":"","eno":"","pphy":"WINFIELD II, ALBERT C","ppno":4347930700,"pcpadd":"441 Piney Forest Rd,Ste E","pcpcity":"DANVILLE                      ","pcpstate":"VA","pcpzip":245404154,"pcpcounty":"","pcpid":"","pcpname":"CORNERSTONE COMPLETE CARE INC","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"WESTERN\/ CHARLOTTESVILLE","aligned":"","ano":"","add2":"231 W MAIN STREET","add3":"","madd1":"231 W MAIN STREET","madd2":"","madd3":"","mcity":"DANVILLE                      ","mstate":"VA","mzip":"24541-2851","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z00.00","Z68.41","F41.9","F32.9","M51.9","M19.90","H61.21","J45.909","H10.413","H40.053","R21","F17.200","Z20.828","Z03.818","F11.10","Z12.4","Z00.01","Z68.38","Z13.89","E87.0","E83.52","F14.10","E87.5","I10","G89.29","M54.9","L50.9","Z30.013","F14.20","F19.10","Z30.019","R60.9","L03.011","L03.019","A08.4","R11.2","K21.9"],"date":["2021-03-29","2020-01-14","2021-06-15","2021-06-15","2021-03-29","2021-03-29","2020-01-14","2020-04-10","2020-05-11","2020-05-11","2020-08-26","2021-02-10","2021-02-10","2021-02-10","2021-06-15","2021-03-29","2021-03-29","2021-03-29","2021-03-29","2021-06-15","2021-06-15","2021-06-01","2021-06-15","2021-06-15","2021-06-01","2021-06-15","2021-06-15","2021-06-01","2021-06-01","2021-06-15","2021-06-15","2021-06-24","2021-11-11","2021-11-11","2019-03-02","2019-03-24","2019-03-24"],"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":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"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":[["","53489011905","DOXYCYCL","CAP 100MG","14","Select","Select",""],["","65862052305","GABAPENTIN","TAB 600MG","90","Select","Select",""],["","59762453802","MEDROXYPR","INJ 150MG\/ML","1","Select","Select",""],["","49483060450","IBUPROFEN","TAB 800MG","60","Select","Select",""],["","65162083909","VALSARTAN","TAB 160MG","30","Select","Select",""],["","50111056003","TRAZODONE","TAB 50MG","30","Select","Select",""],["","23155050110","HYDROXYZ","TAB 25MG","30","Select","Select",""],["","71093014105","METHOCARBAM","TAB 750MG","30","Select","Select",""],["","70436005901","BUPROPION","TAB 150MG SR","180","Select","Select",""],["","00093317431","ALBUTEROL","FAT E","8.5","Select","Select",""],["","70000021306","ALLERGY","TAB 10MG","30","Select","Select",""],["","59267100002","PFIZER","INJ COVID-19","0.3","Select","Select",""],["","12496120803","SUBOXONE","MIS 8-2MG","7","Select","Select",""],["","13107003134","MIRTAZAPINE","TAB 15MG","30","Select","Select",""],["","74312019377","VITAMIN","CAP 5000UNIT","90","Select","Select",""],["","51991083675","EPINASTINE","DRO 0.0005","5","Select","Select",""],["","49281041950","FLUZONE","INJ 2019-20","0.5","Select","Select",""],["","00378064110","PREDNISONE","TAB 10MG","21","Select","Select",""],["","65862039110","ONDANSETRON","TAB 8MG ODT","15","Select","Select",""],["","64380080307","RANITIDINE","TAB 150MG","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":""}]}]}