{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JOSHUA   B MULLINS","gend":0,"add":"2101   ROSE RIDGE                                           ","city":"CLINTWOOD                     ","state":"VA","zip":"24228-7737","dob":"1990-12-23","age":"","mstatus":"","insh":10191659,"cliId":"","pno":2768358498,"cno":"","email":"","ename":"","eno":"","pphy":"ABROKWAH, JAMES                                             ","ppno":"","pcpadd":"163 Number Ten St","pcpcity":"Clinchco                      ","pcpstate":"VA","pcpzip":242268694,"pcpcounty":"","pcpid":"P0060295","pcpname":"FULL CARE MEDICAL CENTER","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"SOUTHWEST","aligned":"","ano":"","add2":"                                                            ","add3":"","madd1":"2101   ROSE RIDGE                                           ","madd2":"                                                            ","madd3":"","mcity":"CLINTWOOD                     ","mstate":"VA","mzip":"24228-7737","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R06.02","J06.9","R05","R11.2","K85.90","E87.6","R50.9","J20.9","I95.9","H10.13","F41.9","R42","K21.9","R11.0","J30.9","H61.23","H66.91","H93.11"],"date":["2019-08-25","2019-08-25","2020-01-17","2020-01-17","2020-01-17","2020-01-17","2020-01-17","2020-01-17","2020-01-17","2020-06-05","2021-01-22","2021-08-17","2021-01-22","2021-08-17","2021-01-22","2020-09-10","2021-08-17","2021-08-17"],"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":[["","59746012106","MECLIZINE","25MG","255","Select","Select",""],["","43598081115","CETIRIZINE","10MG","30","Select","Select",""],["","65862078430","ESOMEPRA","40MG DR","30","Select","Select",""],["","00115165901","PROPRANOLOL","10MG","90","Select","Select",""],["","51224002230","AZITHROMYCIN","250MG","4","Select","Select",""],["","68462015813","ONDANSETRON","8MG ODT","20","Select","Select",""],["","00591544305","PREDNISONE","20MG","10","Select","Select",""],["","00172572860","FAMOTIDINE","20MG","60","Select","Select",""],["","67877054360","CEFDINIR","300MG","20","Select","Select",""],["","59746012106","MECLIZINE ","TAB 25MG","255","Select","Select",""],["","43598081115","CETIRIZINE ","TAB 10MG","30","Select","Select",""],["","65862078430","ESOMEPRA ","CAP 40MG DR","30","Select","Select",""],["","00115165901","PROPRANOLOL ","TAB 10MG","90","Select","Select",""],["","51224002230","AZITHROMYCIN ","TAB 250MG","4","Select","Select",""],["","68462015813","ONDANSETRON ","TAB 8MG ODT","20","Select","Select",""],["","00591544305","PREDNISONE ","TAB 20MG","10","Select","Select",""],["","00172572860","FAMOTIDINE ","TAB 20MG","60","Select","Select",""],["","67877054360","CEFDINIR ","CAP 300MG","20","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","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["Yes","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":""}]}]}