{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"RACHEL   D SUDDUTH","gend":1,"add":"3380   PINE GROVE ROAD                                      ","city":"STANLEY                       ","state":"VA","zip":"22851-5411","dob":"2000-04-16","age":"","mstatus":"","insh":10034767,"cliId":"","pno":5402441390,"cno":5402441390,"email":"","ename":"","eno":"","pphy":"TIMMONS, JOHN                                               ","ppno":"","pcpadd":"505 Williams Ave","pcpcity":"Shenandoah                    ","pcpstate":"VA","pcpzip":228491263,"pcpcounty":"","pcpid":"P0060122","pcpname":"PAGE SHENANDOAH HEALTH CENTER","plan":"VPHP","program":"MEDICAID","lob":"MLTSS","region":"NORTHERN\/ WINCHESTER","aligned":"","ano":"","add2":"                                                            ","add3":"","madd1":"3380   PINE GROVE ROAD                                      ","madd2":"                                                            ","madd3":"","mcity":"STANLEY                       ","mstate":"VA","mzip":"22851-5411","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M25.561","H92.12","L92.9","Z96.22","Z00.00","H69.83","H61.22","R06.7","Z90.89","Q90.9","H04.209","H90.0","F71","Q14.2","Q07.8","H52.7","L70.0","J02.9","R21","B08.4","H61.23","H91.90","F90.2","G47.9","L23.2","L81.0","J30.2","K04.7","K08.89","Z01.818","D53.9","J30.1","H91.92","Z86.69","F51.01","L72.0","T14.8XXA","Z23"],"date":["2019-02-01","2019-05-16","2019-05-16","2019-11-22","2021-11-23","2019-11-22","2019-07-12","2019-07-12","2019-11-22","2021-11-23","2019-07-12","2019-07-12","2021-06-07","2019-09-24","2019-09-24","2019-09-24","2021-11-23","2019-10-18","2019-10-18","2019-10-22","2019-11-22","2019-11-22","2021-06-07","2021-06-07","2021-01-22","2021-01-22","2021-06-07","2021-11-23","2021-08-01","2021-11-23","2021-11-23","2021-11-23","2021-11-23","2021-11-23","2021-11-23","2021-11-23","2021-11-23","2021-11-23"],"priorHcc":["","","","",null,"","","","",null,"","","","","","",null,"","","","","","","","","","",null,"",null,null,null,null,null,null,null,null,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":[]},{"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":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","59746021701","SPIRONOLACT","50MG","60","Select","Select",""],["","33332032101","AFLURIA","2021-22","0.5","Select","Select",""],["","58160095509","MENVEO","","1","Select","Select",""],["","68001023803","CLONIDINE","0.2MG","30","Select","Select",""],["","46122044062","GNP","25MG","60","Select","Select",""],["","00781261305","AMOXICILLIN","500MG","30","Select","Select",""],["","59746021701","SPIRONOLACT ","TAB 50MG","60","Select","Select",""],["","33332032101","AFLURIA ","INJ 2021-22","0.5","Select","Select",""],["","58160095509","MENVEO ","INJ ","1","Select","Select",""],["","68001023803","CLONIDINE ","TAB 0.2MG","30","Select","Select",""],["","46122044062","GNP ","CAP 25MG","60","Select","Select",""],["","00781261305","AMOXICILLIN ","CAP 500MG","30","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","",""],["N\/A","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["No","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":""}]}]}