{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JA'ANDRA BROWN","gend":1,"add":"3167 W 3RD STREET                                           ","city":"FARMVILLE                     ","state":"VA","zip":"23901-5417","dob":"1999-10-29","age":"","mstatus":"","insh":6709791,"cliId":"","pno":4345695455,"cno":4348084732,"email":"","ename":"","eno":"","pphy":"CORBETT SR, TIMOTHY W","ppno":4343929366,"pcpadd":"324 Commerce Rd                                             ,Ste A                                                       ","pcpcity":"FARMVILLE                     ","pcpstate":"VA","pcpzip":239012794,"pcpcounty":"","pcpid":"","pcpname":"SOUTHSIDE AREA FAMILY MEDICINE INC","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"CENTRAL","aligned":"","ano":"","add2":"3167 W 3RD STREET                                           ","add3":"","madd1":"3167 W 3RD STREET                                           ","madd2":"APT.3                                                       ","madd3":"","mcity":"FARMVILLE                     ","mstate":"VA","mzip":"23901-5417","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K58.0","G35","Z88.0","R19.7","E66.01","D89.9","Z82.49","Z83.3","K21.9","N91.2","Z76.89","L50.0","L29.9","G43.709","G43.009","E55.9","F32.0","Z68.41","Z68.43","F33.0","R42","Z86.69","R68.89","G37.9","M54.9","K20.9","R07.89","R07.9","Z77.22","R10.9","R43.2","R43.0","G47.00","F41.8","R10.30","E66.9","R53.83","E78.5","Z72.51","N92.6","Z86.19","F41.9","F33.2","Z63.79","M54.5","F45.41","Z20.828","R06.2","R05","R06.02","R51.9","Z78.9","Z79.899","Z87.891","R53.1","R20.0","T80.90XA","R59.0","L72.3","R10.11","R20.2","G43.909","Z20.822","Z86.16","Z79.51","R50.9","S60.562A","S60.569A","N92.0","M79.606","R11.2","U07.1","R05.9","N92.1","A59.9","N89.8","N39.0","G89.29","R11.0"],"date":["2020-02-22","2021-12-14","2021-03-16","2022-11-30","2022-11-30","2020-09-09","2020-02-27","2020-02-27","2022-11-30","2020-12-09","2020-02-27","2020-03-15","2020-03-15","2021-05-13","2020-04-30","2022-11-30","2020-04-30","2020-04-30","2021-11-04","2020-08-10","2021-03-16","2020-06-26","2020-07-03","2020-08-07","2020-08-10","2020-08-16","2020-08-17","2020-08-17","2020-08-16","2021-02-05","2020-09-09","2020-09-09","2020-09-09","2020-09-09","2022-11-30","2021-11-04","2020-10-07","2020-10-07","2020-10-07","2020-10-07","2020-10-07","2022-11-30","2022-10-12","2022-10-12","2020-12-09","2020-12-09","2022-01-11","2021-01-28","2021-01-28","2021-01-28","2022-06-05","2021-02-05","2021-09-02","2021-09-02","2021-05-14","2021-09-02","2021-06-15","2021-07-08","2021-08-30","2021-08-31","2021-09-03","2021-09-02","2021-09-02","2021-09-02","2021-09-02","2022-06-05","2021-11-08","2021-11-08","2022-08-24","2022-02-22","2022-11-30","2022-06-05","2022-06-05","2022-08-24","2022-09-27","2022-09-27","2022-11-30","2022-11-30","2022-11-30"],"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":[["","00069108530","PAXLOVID","TAB 300-100","30","Select","Select",""],["","50111033401","METRONIDAZOL","TAB 500MG","4","Select","Select",""],["","75834002001","VITAMIN","CAP 50000UNT","4","Select","Select",""],["","70710122501","AMITRIPTYLIN","TAB 10MG","30","Select","Select",""],["","50428672550","ANTI-DIARRHE","TAB 2MG","9","Select","Select",""],["","45802001402","HYDROCORT","OIN 0.025","20","Select","Select",""],["","13668013601","ESCITALOPRAM","TAB 10MG","90","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","00574050810","FERROUS","TAB 324MG","90","Select","Select",""],["","16729020001","BUSPIRONE","TAB 5MG","60","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","51991081701","PROPRANOLOL","CAP 60MG ER","90","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","14","Select","Select",""],["","00116200116","CHLORHEX","SOL 0.0012","473","Select","Select",""],["","69097012303","TOPIRAMATE","TAB 50MG","180","Select","Select",""],["","55111015810","OMEPRAZOLE","CAP 20MG","30","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","20","Select","Select",""],["","67618012012","SENOKOT","TAB 17.2MG","3","Select","Select",""],["","00904772714","ACID","SUS ","355","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":""}]}]}