{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SWANNITA   T FARROW","gend":1,"add":"212 PARKVIEW GARDENS","city":"FARMVILLE                     ","state":"VA","zip":"23901-2525","dob":"1981-03-23","age":"","mstatus":"","insh":6264740,"cliId":"","pno":4342019552,"cno":"","email":"","ename":"","eno":"","pphy":"HAHESY-CALHOUN, MARIAN A","ppno":4343928177,"pcpadd":"165 Legrande Ave,","pcpcity":"Charlotte Court House         ","pcpstate":"VA","pcpzip":239233747,"pcpcounty":"","pcpid":"","pcpname":"CHARLOTTE PRIMARY CARE","plan":"VPHP","program":"MEDICAID","lob":"MLTSS","region":"CENTRAL","aligned":"","ano":"","add2":"212 PARKVIEW GARDENS","add3":"","madd1":"212 PARKVIEW GARDENS","madd2":"APT E","madd3":"","mcity":"FARMVILLE                     ","mstate":"VA","mzip":"23901-2525","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J10.1","F17.210","F32.9","G89.29","R50.9","I10","D57.3","J11.1","Z71.89","Z71.3","R05","R09.89","R11.0","F41.8","Z88.8","M25.561","J30.9","F17.200","J02.9","R09.81","R06.00","R09.82","M17.0","M25.569","N12","F14.90","E66.01","N39.0","R10.84","R10.11","K76.0","R16.0","R10.31","Z79.891","Z68.43","M54.42","M22.40","B00.9","Z13.220","N89.8","Z01.419","J32.9","Z12.31","Z23","N75.0"],"date":["2020-01-30","2021-04-21","2021-04-21","2021-10-23","2020-01-30","2021-05-07","2021-04-22","2020-02-05","2021-10-05","2021-10-05","2020-02-05","2020-02-05","2020-02-05","2021-05-07","2020-04-11","2021-10-23","2020-11-30","2020-11-30","2020-11-30","2020-11-30","2020-11-30","2020-11-30","2021-10-23","2020-12-08","2021-04-22","2021-04-22","2021-04-22","2021-04-21","2021-04-21","2021-04-21","2021-04-21","2021-04-21","2021-04-21","2021-04-21","2021-04-21","2021-04-21","2021-04-21","2021-04-21","2021-05-07","2021-05-07","2021-09-23","2021-09-23","2021-09-23","2021-10-21","2021-10-05"],"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":[["","50111033401","METRONIDAZOL","TAB 500MG","4","Select","Select",""],["","68382079201","ACYCLOVIR","TAB 800MG","10","Select","Select",""],["","13668001005","CITALOPRAM","TAB 20MG","14","Select","Select",""],["","10702001050","HYDROXYZ","TAB 10MG","90","Select","Select",""],["","68382097001","CHLORTHALID","TAB 25MG","60","Select","Select",""],["","10370010150","BUPROPN","TAB 150MG XL","14","Select","Select",""],["","70710113908","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","14","Select","Select",""],["","68180071160","CEFDINIR","CAP 300MG","20","Select","Select",""],["","59779010112","PAIN","TAB 500MG","50","Select","Select",""],["","16729020201","BUSPIRONE","TAB 10MG","20","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","10","Select","Select",""],["","67877057305","BENZONATATE","CAP 100MG","21","Select","Select",""],["","50428887849","CVS","TAB 600MG","14","Select","Select",""],["","58657050016","CODEINE\/GG","SOL 10-100\/5","280","Select","Select",""],["","69097015907","MELOXICAM","TAB 15MG","30","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":""}]}]}