{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DANIEL REDIFER","gend":0,"add":"292MEADOW RUE  LANE  ","city":"CRIMORA  ","state":"VA","zip":"24431-2324","dob":"2000-10-30","age":"","mstatus":"","insh":11015480,"cliId":"3PX8Q27DU52","pno":5408364433,"cno":5408364433,"email":"","ename":"","eno":"","pphy":"DEVRIES, PETER R  ","ppno":5409490118,"pcpadd":"108 Community Dr","pcpcity":"Waynesboro  ","pcpstate":"VA","pcpzip":229809505,"pcpcounty":"","pcpid":"P9120225","pcpname":"VALLEY PEDIATRIC GROUP PLC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"","add3":"","madd1":"292MEADOW RUE  LANE  ","madd2":"","madd3":"","mcity":"CRIMORA  ","mstate":"VA","mzip":"24431-2324","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["F11.20","Z79.899","F31.81","F90.9","F33.9","Z20.822","R53.83","R50.9","R51.9","L03.116","R09.81","Z00.00","E66.01","Z68.42","Z83.3","I10"],"date":["2020-12-01","2021-10-13","2020-12-01","2020-12-01","2020-12-01","2021-10-04","2021-05-27","2021-05-27","2021-05-27","2021-09-10","2021-10-04","2021-10-13","2021-10-13","2021-10-13","2021-10-13","2021-10-13"],"priorHcc":["",null,"","","","","","","","","","","","","",""]}},{"a":[]}]},{"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":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}}]},{"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":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","55111052130","ATOMOXETINE","CAP 40MG","","Select","Select",""],["","68001032104","BUPROPN HCL","TAB 300MG XL","","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","","Select","Select",""],["","55111052130","ATOMOXETINE ","CAP 40MG","30","Select","Select",""],["","68001032104","BUPROPN ","TAB 300MG XL","30","Select","Select",""],["","66993001968","ALBUTEROL ","HFA","18","Select","Select",""],["","68001032205","BUPROPN","150MG XL","30","Select","Select",""],["","00143211250","DOXYCYCL","100MG","20","Select","Select",""],["","59310057922","PROAIR","","8.5","Select","Select",""],["","00143211250","DOXYCYCL ","TAB 100MG","20","Select","Select",""],["","59310057922","PROAIR ","AER ","8.5","Select","Select",""]]}},{"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":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[[["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""]]]},{"t":"Mini-Cog","q":[{"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":""}]}]}