{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SAVANNAH   M SMITH","gend":1,"add":"145 VALLEY ROAD","city":"WAYNESBORO                    ","state":"VA","zip":"22980-5520","dob":"2003-08-08","age":"","mstatus":"","insh":4867968,"cliId":"","pno":5402416939,"cno":"","email":"","ename":"","eno":"","pphy":"SAUDER, KURTIS L","ppno":5409490118,"pcpadd":"401 Commerce Rd,Ste 421","pcpcity":"Staunton                      ","pcpstate":"VA","pcpzip":244014433,"pcpcounty":"","pcpid":"","pcpname":"VALLEY PEDIATRIC GROUP PLC","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"WESTERN\/ CHARLOTTESVILLE","aligned":"","ano":"","add2":"145 VALLEY ROAD","add3":"","madd1":"145 VALLEY ROAD","madd2":"","madd3":"","mcity":"WAYNESBORO                    ","mstate":"VA","mzip":"22980-5520","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["S39.012D","M54.2","M54.6","M54.5","X58.XXXD","M54.9","R52","R20.2","G89.29","M62.838","F41.9","R06.4","Z79.899","M62.830","R93.7","R53.1","G40.89","R56.9","R42","G47.00","E87.6","F43.23","R41.89","R68.89","Z11.59","F44.5","F32.4","F32.9","Z00.121","L20.84","Z13.89","Z68.52","F32.5","F42.9","F60.5","R46.81","F44.4","M67.431","L70.0","L30.9","N94.4","Z00.00","Z71.3","Z71.82","Z13.31","Z23","R51.9","R53.83","J00","J02.9"],"date":["2020-02-13","2020-06-09","2020-02-28","2020-03-11","2020-02-13","2020-06-09","2020-02-13","2020-02-13","2020-06-09","2020-02-13","2020-10-16","2020-02-13","2020-04-13","2020-04-16","2020-02-28","2020-04-13","2020-04-13","2020-09-08","2020-04-13","2021-01-07","2020-04-13","2021-12-17","2020-06-09","2020-08-03","2020-06-30","2021-01-07","2021-01-07","2021-01-07","2020-09-08","2020-09-08","2020-09-08","2021-12-17","2021-01-07","2021-01-07","2021-01-07","2020-10-30","2020-10-30","2021-04-28","2021-07-13","2021-07-13","2021-12-17","2021-12-17","2021-12-17","2021-12-17","2021-12-17","2021-12-17","2021-12-20","2021-12-20","2021-12-28","2021-12-28"],"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":[["","70700011985","ESTARYLLA","TAB 0.25-35","84","Select","Select",""],["","65862001205","SERTRALINE","TAB 50MG","30","Select","Select",""],["","00096070737","DRYSOL","SOL 0.2","37.5","Select","Select",""],["","51672125902","CLOBETASOL","OIN 0.0005","30","Select","Select",""],["","45802073684","CLINDAMY\/BEN","GEL 1.2-5%","45","Select","Select",""],["","00472011745","TRETINOIN","CRE 0.00025","45","Select","Select",""],["","68382080510","TRAZODONE","TAB 50MG","30","Select","Select",""],["","00116200116","CHLORHEX","SOL 0.0012","473","Select","Select",""],["","10702001850","OXYCODONE","TAB 5MG","10","Select","Select",""],["","68462022555","MOMETASONE","OIN 0.001","45","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":""}]}]}