{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BRANDY PAUL","gend":1,"add":"1905   ALPINE DRIVE                                         ","city":"CHRISTIANSBURG                ","state":"VA","zip":"24073-1155","dob":"1975-11-29","age":"","mstatus":"","insh":10056484,"cliId":"","pno":5408191308,"cno":5408191308,"email":"","ename":"","eno":"","pphy":"AMICK JR, ROBERT L                                          ","ppno":"","pcpadd":"434 Peppers Ferry Rd NW","pcpcity":"Christiansburg                ","pcpstate":"VA","pcpzip":240735780,"pcpcounty":"","pcpid":"","pcpname":"","plan":"VPHP","program":"MEDICAID","lob":"MLTSS","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"LOT 21                                                      ","add3":"","madd1":"1905   ALPINE DRIVE                                         ","madd2":"LOT 21                                                      ","madd3":"","mcity":"CHRISTIANSBURG                ","mstate":"VA","mzip":"24073-1155","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G50.1","R11.2","R19.7","J02.9","R05","M94.0","R21","B02.9","S93.401A"],"date":["2019-08-07","2019-11-25","2019-11-25","2020-02-09","2020-02-09","2020-02-09","2020-04-23","2020-04-23","2021-07-24"],"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":[]},{"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":[["","00378427677","VALACYCLOVIR","1GM","20","Select","Select",""],["","00254100752","ALBUTEROL","HFA","6.7","Select","Select",""],["","60432060416","PROMETHAZINE","DM","60","Select","Select",""],["","00054001729","PREDNISONE","10MG","42","Select","Select",""],["","00378427677","VALACYCLOVIR ","TAB 1GM","20","Select","Select",""],["","00254100752","ALBUTEROL ","AER HFA","6.7","Select","Select",""],["","60432060416","PROMETHAZINE ","SYP DM","60","Select","Select",""],["","00054001729","PREDNISONE ","TAB 10MG","42","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":""}]}]}