{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MEADOW   D HENRY","gend":1,"add":"43 NORTH ROYAL AVENUE","city":"FRONT ROYAL                   ","state":"VA","zip":"22630-2661","dob":"2003-10-06","age":"","mstatus":"","insh":4940066,"cliId":"","pno":5406920757,"cno":5406924114,"email":"","ename":"","eno":"","pphy":"NERI, ANTHONY","ppno":5404593435,"pcpadd":"759 S Main St,","pcpcity":"Woodstock                     ","pcpstate":"VA","pcpzip":226641127,"pcpcounty":"","pcpid":"","pcpname":"SHENANDOAH PEDIATRICS PC","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"NORTHERN\/ WINCHESTER","aligned":"","ano":"","add2":"43 NORTH ROYAL AVENUE","add3":"","madd1":"43 N Royal Ave Apt 1","madd2":"","madd3":"","mcity":"Front Royal                   ","mstate":"VA","mzip":"22630-2661","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J31.2","R05","B34.9","J02.9","E88.81","N92.6","R11.0","R30.0","M54.5","L02.92","R31.9","K59.00","Z30.46","Z30.011","Z01.419","Z11.3","Z30.017","N12","R10.32","N10","E87.1","F17.210","Z20.828","Q63.8","B96.20","K21.9","Z79.3","Z82.49","Z83.3","Z82.3","N15.1","R50.9","M54.9","R93.429","R10.9","R10.30","R10.31","Z20.822","H57.12","R51.9","R43.2","R06.02"],"date":["2020-01-13","2021-07-22","2020-03-14","2020-03-28","2021-01-27","2020-07-13","2020-07-13","2021-03-11","2021-03-23","2020-10-02","2020-10-02","2020-10-02","2021-02-03","2020-12-22","2020-12-22","2020-12-23","2020-12-22","2021-01-27","2021-03-11","2021-02-04","2021-01-27","2021-03-23","2021-03-11","2021-01-27","2021-01-27","2021-03-23","2021-01-27","2021-01-27","2021-01-27","2021-01-27","2021-02-04","2021-03-10","2021-03-10","2021-03-10","2021-03-11","2021-03-11","2021-03-11","2021-07-05","2021-06-29","2021-07-05","2021-07-22","2021-07-22"],"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":[["","70710113908","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","50111033401","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","68180065208","DOXYCYC","CAP 100MG","14","Select","Select",""],["","68180016106","AZITHROMYCIN","TAB 500MG","2","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","5","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","21","Select","Select",""],["","47781019601","OXYCOD\/APAP","TAB 5-325MG","10","Select","Select",""],["","65862077685","MILI","TAB 0.25\/35","28","Select","Select",""],["","13668042990","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","68462030929","NORGEST\/ETHI","TAB 0.25\/35","84","Select","Select",""],["","00052433001","NEXPLANON","IMP 68MG","1","Select","Select",""],["","16571020106","DICLOFENAC","TAB 75MG DR","20","Select","Select",""],["","45802086866","POLYETH","POW 3350 NF","28","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":""}]}]}