{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"NATALIE TRAN","gend":1,"add":"2480 OAKTON HILL DRIVE  ","city":"OAKTON","state":"VA","zip":"22124-1528","dob":"1996-11-30","age":"","mstatus":"","insh":11015486,"cliId":"5DQ0PE9YG46","pno":5713326213,"cno":7038197984,"email":"","ename":"","eno":"","pphy":"HARRINGTON, KRISTIN A","ppno":7039380363,"pcpadd":"10530 Rosehaven St Ste 100","pcpcity":"Fairfax  ","pcpstate":"VA","pcpzip":220302888,"pcpcounty":"Fairfax","pcpid":"P9120134","pcpname":"INOVA FAMILY MEDICINE OAKTON","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"NORTHERN & WINCHESTER","aligned":"Y","ano":"","add2":"","add3":"","madd1":"2480 OAKTON HILL DRIVE  ","madd2":"","madd3":"","mcity":"OAKTON","mstate":"VA","mzip":"22124-1528","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["ASIAN\/PACIFIC"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["E11.9","E83.52","E55.9","E78.5"],"date":["2021-03-03","2021-03-03","2021-03-03","2020-10-14"],"priorHcc":["","","",""]}},{"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":[["","59762006701","SERTRALINE","CON 20MG\/ML","","Select","Select",""],["","51672128202","TRIAMCINOLON","CRE 0.001","","Select","Select",""],["","23155010410","METFORMIN","TAB 1000MG","","Select","Select",""],["","597014030","TRADJENTA","TAB 5MG","","Select","Select",""],["","52565003330","ERYTHROMYCIN","GEL 0.02","","Select","Select",""],["","69097089507","FENOFIBRATE","CAP 134MG","","Select","Select",""],["","60505257808","ATORVASTATIN","TAB 10MG","","Select","Select",""],["","69097089507","FENOFIBRATE ","CAP 134MG","30","Select","Select",""],["","597014030","TRADJENTA ","TAB 5MG","30","Select","Select",""],["","59762006701","SERTRALINE ","CON 20MG\/ML","180","Select","Select",""],["","60505257808","ATORVASTATIN ","TAB 10MG","30","Select","Select",""],["","23155010410","METFORMIN ","TAB 1000MG","60","Select","Select",""],["","51672128202","TRIAMCINOLON ","CRE 0.001","60","Select","Select",""],["","52565003330","ERYTHROMYCIN ","GEL 0.02","30","Select","Select",""],["","51672125803","CLOBETASOL","0.0005","60","Select","Select",""],["","67877021905","CEPHALEXIN","500MG","30","Select","Select",""],["","67877021905","CEPHALEXIN ","CAP 500MG","30","Select","Select",""],["","51672125803","CLOBETASOL ","CRE 0.0005","60","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":[[["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["Yes","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":""}]}]}