{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KEVIN   R MARROW","gend":0,"add":"30 WALNUT CREEK DRIVE","city":"STAUNTON                      ","state":"VA","zip":"24401-6903","dob":"1986-01-09","age":"","mstatus":"","insh":6653743,"cliId":"","pno":5406855491,"cno":"","email":"","ename":"","eno":"","pphy":"ALEXANDER, KERRY A","ppno":5408866259,"pcpadd":"42 Lambert St,Ste 511","pcpcity":"Staunton                      ","pcpstate":"VA","pcpzip":244012437,"pcpcounty":"","pcpid":"","pcpname":"STAUNTON MEDICAL ASSOCIATES","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"WESTERN\/ CHARLOTTESVILLE","aligned":"","ano":"","add2":"30 WALNUT CREEK DRIVE","add3":"","madd1":"30 WALNUT CREEK DRIVE","madd2":"","madd3":"","mcity":"STAUNTON                      ","mstate":"VA","mzip":"24401-6903","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F20.9","F29","Z04.6","F22","Z81.8","F23","F31.5","F31.9","F15.988","R68.89","I95.1","F19.10","G47.00","F17.210","H92.01","F60.0","R44.1","R44.0","H61.23","F31.64","F10.20","L28.2","T16.1XXA","Z72.0","C84.09","R21","Z11.59","C84.00","L81.4","L29.9","Z00.00","L53.9","F25.0","Z79.899","U07.1","Z68.24"],"date":["2020-06-25","2020-05-01","2020-04-12","2020-04-12","2020-04-12","2020-04-12","2020-04-15","2020-06-25","2020-04-12","2021-02-24","2020-05-01","2020-05-01","2020-05-01","2020-04-17","2020-04-24","2020-04-17","2020-04-17","2020-04-17","2020-04-23","2021-10-26","2020-07-23","2020-06-25","2020-06-25","2020-06-25","2021-04-29","2020-07-09","2020-09-12","2021-04-29","2020-10-15","2020-10-15","2021-04-29","2021-04-29","2021-12-29","2021-12-13","2021-12-19","2021-12-19"],"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":[["","50458056201","INVEGA","INJ 117\/0.75","0.75","Select","Select",""],["","66993089715","AUG","OIN 0.0005","120","Select","Select",""],["","69315013701","BENZTROPINE","TAB 1MG","28","Select","Select",""],["","00115166001","PROPRANOLOL","TAB 20MG","90","Select","Select",""],["","67877014801","TEMAZEPAM","CAP 7.5MG","90","Select","Select",""],["","33332042010","AFLURIA","INJ 2020-21","0.5","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":""}]}]}