{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JADE   A PHILLIPS","gend":0,"add":"1088 PETERS CREEK DRIVE                                     ","city":"STUART                        ","state":"VA","zip":"24171-3962","dob":"2001-11-10","age":"","mstatus":"","insh":6826753,"cliId":"","pno":3862107579,"cno":"","email":"","ename":"","eno":"","pphy":"COLE, RICHARD C                                             ","ppno":2766944466,"pcpadd":"18877 JEB STUART HWY                                        ,                                                            ","pcpcity":"STUART                        ","pcpstate":"VA","pcpzip":241711019,"pcpcounty":"","pcpid":"","pcpname":"PATRICK COUNTY FAMILY PRACTICE","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"1088 PETERS CREEK DRIVE                                     ","add3":"","madd1":"1088 PETERS CREEK DRIVE                                     ","madd2":"                                                            ","madd3":"","mcity":"STUART                        ","mstate":"VA","mzip":"24171-3962","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J45.901","J10.1","R05","R50.9","Z20.828","R11.10","Z03.818","Z72.51","F43.25","A74.9","M25.532","F17.290","I10","S01.81XA","S09.90XA","Y08.09XA","S01.112A","Z23","S09.93XA","S62.346A","M79.641","B34.8","J02.9","Z11.52","R51.9","Z20.822","F17.210","R05.9","J01.00","J06.9","M54.41"],"date":["2022-09-09","2022-04-04","2021-09-01","2022-09-09","2021-09-01","2020-10-11","2022-04-04","2020-10-23","2020-11-20","2020-11-20","2020-11-20","2020-11-20","2020-11-20","2020-11-29","2020-11-29","2020-11-29","2020-11-29","2020-11-29","2020-11-29","2021-03-19","2021-03-16","2021-09-01","2022-05-09","2022-09-09","2022-04-04","2022-04-04","2022-04-04","2022-05-09","2022-05-09","2022-09-09","2022-11-04"],"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":[["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","65862039110","ONDANSETRON","TAB 8MG ODT","30","Select","Select",""],["","69842081266","MUCUS","TAB 60-1200","28","Select","Select",""],["","65862050320","AMOX\/K","TAB 875-125","20","Select","Select",""],["","31722063231","OSELTAMIVIR","CAP 75MG","10","Select","Select",""],["","60505024701","MIRTAZAPINE","TAB 15MG","30","Select","Select",""],["","50111078810","AZITHROMYCIN","TAB 500MG","4","Select","Select",""],["","59746017310","PREDNISONE","TAB 10MG","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":""}]}]}