{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ZACHARY GUY","gend":0,"add":"52 SUNSET DRIVE                                             ","city":"ARRINGTON                     ","state":"VA","zip":"22922-2319","dob":"2004-04-14","age":"","mstatus":"","insh":4822537,"cliId":"","pno":4342213659,"cno":"","email":"","ename":"","eno":"","pphy":"SCHMITZ, STEPHEN P                                          ","ppno":5404566710,"pcpadd":"7849 Rockfish Valley Hwy                                    ,                                                            ","pcpcity":"Afton                         ","pcpstate":"VA","pcpzip":229203203,"pcpcounty":"","pcpid":"","pcpname":"AFTON FAMILY MEDICINE","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"WESTERN\/ CHARLOTTESVILLE","aligned":"","ano":"","add2":"","add3":"","madd1":"52 SUNSET DRIVE                                             ","madd2":"                                                            ","madd3":"","mcity":"ARRINGTON                     ","mstate":"VA","mzip":"22922-2319","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F32.1","H53.40","H52.223","F41.0","F32.9","R45.851","J06.9","J98.01","A08.4","M79.641","S63.696A","M79.642","R05","S83.92XA","M25.562","S83.002A","H00.021","Z20.822","H47.322","J02.9","R07.9"],"date":["2021-03-02","2020-02-03","2020-02-03","2021-01-14","2020-03-01","2020-03-01","2022-11-02","2022-01-31","2020-08-28","2020-09-13","2020-09-13","2020-09-13","2021-09-02","2022-09-30","2022-09-30","2021-01-04","2021-04-19","2021-01-20","2021-06-07","2022-01-31","2022-12-06"],"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":[["","59267102504","PFIZER","INJ ADLT RTU","0.3","Select","Select",""],["","50228043605","NAPROXEN","TAB 500MG","14","Select","Select",""],["","51224001050","BENZONATATE","CAP 100MG","42","Select","Select",""],["","65862014736","SUMATRIPTAN","TAB 50MG","9","Select","Select",""],["","00591544305","PREDNISONE","TAB 20MG","12","Select","Select",""],["","00781808926","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","70436015542","PROMETHAZINE","SOL DM","118","Select","Select",""],["","16571020150","DICLOFENAC","TAB 75MG DR","30","Select","Select",""],["","24208079535","NEO\/POLY\/DEX","OIN 0.1% OP","3.5","Select","Select",""],["","50111064801","FLUOXETINE","CAP 20MG","30","Select","Select",""],["","33342025866","OSELTAMIVIR","CAP 75MG","10","Select","Select",""],["","76204020025","ALBUTEROL","NEB 0.00083","75","Select","Select",""],["","65862018730","ONDANSETRON","TAB 4MG","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":""}]}]}