{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MARY   A PURYEAR","gend":1,"add":"PO BOX 783","city":"SOUTH HILL                    ","state":"VA","zip":"23970-0783","dob":"1980-03-06","age":"","mstatus":"","insh":5606061,"cliId":"","pno":4342628371,"cno":"","email":"","ename":"","eno":"","pphy":"ACKERMAN, CHRISTOPHER J","ppno":4348480771,"pcpadd":"203 Sharp St,","pcpcity":"Lawrenceville                 ","pcpstate":"VA","pcpzip":238681615,"pcpcounty":"","pcpid":"","pcpname":"LAWRENCEVILLE PRIMARY CARE","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"CENTRAL","aligned":"","ano":"","add2":"PO BOX 783","add3":"","madd1":"PO BOX 783","madd2":"","madd3":"","mcity":"SOUTH HILL                    ","mstate":"VA","mzip":"23970-0783","pcpfaxno":4348483814,"pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["D86.9","J44.1","J45.909","I51.7","G47.33","R91.8","K21.9","J98.4","G47.30","M16.11","I89.0","R68.89","I49.3","R53.83","R94.31","Z01.818","J84.10","R06.02","Z68.43","E66.01","D86.0","E78.00","Z79.51","Z48.813","J81.1","Z90.2","J90","R91.1","R06.00","Z79.899","A41.9","J86.9","J81.0","J96.01","J96.02","R65.21","J98.11","N17.9","D62","E87.0","I95.9","J96.11","I11.9","R09.02","R05","R00.0","Z98.890","Z46.82","Z46.59","K63.89","J98.19","J18.1","D68.9","Q65.2","R09.89","I10","E03.9","J96.10","Z23","U07.1","D50.9","E11.9","M16.4"],"date":["2021-11-29","2020-03-02","2021-09-14","2020-09-14","2021-09-22","2020-09-22","2020-07-08","2020-08-27","2021-06-17","2020-10-05","2020-07-09","2020-09-14","2020-08-22","2020-07-20","2020-08-22","2020-07-29","2020-08-05","2020-08-20","2020-08-05","2020-10-05","2021-06-18","2020-08-05","2020-08-05","2020-10-05","2020-09-14","2020-09-22","2020-09-14","2020-08-06","2020-08-12","2021-06-17","2020-08-20","2020-10-05","2020-08-26","2020-08-22","2020-08-24","2020-08-20","2020-08-26","2020-08-27","2020-08-20","2020-08-20","2020-08-20","2020-08-20","2021-02-17","2020-08-20","2020-08-20","2020-08-21","2020-09-14","2020-08-21","2020-08-22","2020-08-22","2020-08-26","2020-08-26","2020-08-27","2020-10-05","2020-09-14","2021-04-29","2021-11-08","2020-10-01","2021-11-08","2021-11-29","2021-11-08","2021-11-08","2021-11-29"],"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":[["","00378021610","FUROSEMIDE","TAB 40MG","60","Select","Select",""],["","00378967130","IPRATROPIUM\/","SOL ALBUTER","90","Select","Select",""],["","00378699252","ALBUTEROL","NEB 1.25MG\/3","75","Select","Select",""],["","68180012101","CEPHALEXIN","CAP 250MG","21","Select","Select",""],["","00378064010","PREDNISONE","TAB 5MG","14","Select","Select",""],["","57664047758","METOPROL","TAB 50MG","60","Select","Select",""],["","58657050016","CODEINE\/GG","SOL 10-100\/5","120","Select","Select",""],["","00173071920","FLOVENT","AER 110MCG","12","Select","Select",""],["","70377002711","ATORVASTATIN","TAB 10MG","30","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","12","Select","Select",""],["","64380080307","RANITIDINE","TAB 150MG","60","Select","Select",""],["","59651000305","OMEPRAZOLE","CAP 40MG","30","Select","Select",""],["","65162018910","NAPROXEN","TAB 375MG","60","Select","Select",""],["","00245531911","KLOR-CON","TAB 20MEQ ER","30","Select","Select",""],["","00603154258","POT  CHLORIDE","SOL 0.1","450","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":""}]}]}