{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CASEY   M RUFFNER","gend":1,"add":"214   LOCUST                                                ","city":"GALAX                         ","state":"VA","zip":"24333-2112","dob":"1986-12-31","age":"","mstatus":"","insh":6131147,"cliId":"","pno":2762353083,"cno":"","email":"","ename":"","eno":"","pphy":"FANT, VANESSA                                               ","ppno":8007657130,"pcpadd":"400 S Independence Ave,","pcpcity":"Independence                  ","pcpstate":"VA","pcpzip":243483972,"pcpcounty":"","pcpid":"","pcpname":"OLDTOWN MEDICAL CARE LLC","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"SOUTHWEST","aligned":"","ano":"","add2":"                                                            ","add3":"","madd1":"214 LOCUST ST","madd2":"                                                            ","madd3":"","mcity":"GALAX                         ","mstate":"VA","mzip":"24333-2112","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N92.6","R10.2","F31.5","N93.9","N92.0","N94.6","D25.9","N80.0","S63.502A","W22.8XXA","Y93.9","Y92.9","Y99.9","F41.9","S69.92XA","N85.2","N83.8","E66.01","Z68.41","Z20.822","Z01.810","J02.9","J06.9","Z20.828","J20.9","R05.9","R11.2","R19.7","Z90.710","F31.9","B35.9","R05.1"],"date":["2021-05-24","2021-07-27","2021-12-28","2021-09-30","2021-07-27","2021-09-30","2021-09-30","2021-08-11","2021-09-17","2021-09-17","2021-09-17","2021-09-17","2021-09-17","2021-09-17","2021-09-17","2021-09-30","2021-09-30","2021-09-30","2021-09-29","2021-12-17","2021-09-30","2021-10-13","2021-10-13","2021-10-13","2021-10-14","2021-10-15","2021-12-17","2021-10-14","2021-10-14","2021-10-14","2021-12-01","2021-12-17"],"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":[["","59762453701","MEDROXYPR","INJ 150MG\/ML","1","Select","Select",""],["","68180016011","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","59310057922","PROAIR","AER ","8.5","Select","Select",""],["","00378064205","PREDNISONE","TAB 20MG","10","Select","Select",""],["","68462010530","ONDANSETRON","TAB 4MG","10","Select","Select",""],["","70710113803","FLUCONAZOLE","TAB 100MG","7","Select","Select",""],["","49483060350","IBUPROFEN","TAB 600MG","60","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","10","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":""}]}]}