{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JAMIE   P SPENCE","gend":1,"add":"333 OLD BETHEL CHURCH ROAD","city":"WINCHESTER","state":"VA","zip":"22603-4049","dob":"1977-05-26","age":"","mstatus":"","insh":4800593,"cliId":"","pno":5403275672,"cno":"","email":"","ename":"","eno":"","pphy":"SMITH, EDWARD P","ppno":5406626135,"pcpadd":"190 Campus Blvd Ste 200, ","pcpcity":"Winchester","pcpstate":"VA","pcpzip":226012872,"pcpcounty":"","pcpid":"","pcpname":"WINCHESTER CARDIOLOGY AND INTERNAL MEDICINE","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"NORTHERN\/ WINCHESTER","aligned":"","ano":"","add2":"","add3":"","madd1":"333 OLD BETHEL CHURCH ROAD","madd2":"","madd3":"","mcity":"WINCHESTER","mstate":"VA","mzip":"22603-4049","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E22.2","Z71.3","Z68.28","Z71.82","F41.9","R21","Z90.13","Z85.3","C50.912","Z01.411","N89.8","N76.0","B96.89","R35.0","R39.11","R82.90","N89.9","M25.50","R30.0","N39.0","N92.1","M05.9","R55","Z87.898","F90.9","M79.604","M79.89","Z87.2","Z87.39","M79.661","N30.00","R07.9","R22.2","R06.02","C50.919","R94.31","F32.9","F15.23","Z76.0","F90.0","Z79.899","N95.0","R10.31","M79.605","F41.1","N76.2","Z11.3","J40","R91.8","M79.652","R07.81","R77.8","Z53.20","Z00.00","L03.011","Z23"],"date":["2020-03-30","2020-03-02","2020-03-02","2020-03-02","2020-08-21","2021-11-20","2020-07-06","2021-06-04","2020-07-06","2020-07-27","2020-07-27","2020-07-27","2020-07-27","2021-06-04","2020-07-27","2020-07-27","2020-12-07","2021-10-07","2021-06-04","2021-06-04","2021-06-04","2021-10-07","2021-10-07","2021-10-07","2021-10-07","2021-11-20","2021-11-20","2021-11-20","2021-11-20","2021-11-21","2019-03-10","2019-04-05","2019-03-10","2019-03-10","2019-03-10","2019-03-10","2019-03-29","2019-04-01","2019-07-22","2019-07-22","2019-04-03","2019-06-25","2019-04-05","2019-04-05","2019-07-22","2019-06-25","2019-06-25","2019-09-04","2019-09-04","2019-09-04","2019-09-04","2019-09-04","2019-09-04","2019-09-19","2019-11-03","2019-11-03"],"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":[["","13668001101","CITALOPRAM","TAB 40MG","30","Select","Select",""],["","00555097302","AMPHET\/DEXTR","TAB 20MG","90","Select","Select",""],["","67877025001","QUETIAPINE","TAB 100MG","30","Select","Select",""],["","00781107905","ALPRAZOLAM","TAB 1MG","90","Select","Select",""],["","45802006335","TRIAMCINOLON","CRE 0.00025","15","Select","Select",""],["","00143992801","CIPROFLOXACN","TAB 500MG","14","Select","Select",""],["","57237000511","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","57237002801","AMOXICILLIN","TAB 500MG","28","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","51672128901","NYSTATIN","CRE 100000","15","Select","Select",""],["","00143980305","DOXYCYCL","CAP 100MG","20","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":""}]}]}