{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JOSEPH   D MCDONALD","gend":0,"add":"237   DANIELS  DRIVE                                        ","city":"PENNINGTON GAP                ","state":"VA","zip":"24277-7646","dob":"1994-02-01","age":"","mstatus":"","insh":10195755,"cliId":"","pno":2763180243,"cno":2763180243,"email":"","ename":"","eno":"","pphy":"ALMATARI, ABDULLATIEF                                       ","ppno":"","pcpadd":"127 Health Care Dr","pcpcity":"Pennington Gap                ","pcpstate":"VA","pcpzip":242772853,"pcpcounty":"","pcpid":"P0060078","pcpname":"PENNINGTON FAMILY HEALTH CENTER","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"SOUTHWEST","aligned":"","ano":"","add2":"                                                            ","add3":"","madd1":"237   DANIELS  DRIVE                                        ","madd2":"                                                            ","madd3":"","mcity":"PENNINGTON GAP                ","mstate":"VA","mzip":"24277-7646","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["B18.2","R11.2","R19.7","R63.4","R63.6","Z00.8","Z13.9","Z13.89","F17.220","R11.0","R39.11","K29.70","K31.89","K31.9","J98.01","J40","R06.2","Z71.89","J01.00","J01.10","B19.20","F17.200","H66.91","G43.009","G43.909","R11.14","H53.149","F17.210","R51","N13.2","R10.31","M54.5","N43.3","N50.3","N20.1","N50.811","F33.9","R45.851","F15.10","F14.10","F12.10","J45.909","Z91.51","R41.82","F19.10","Z20.822","F17.290","Z20.828","Z59.00"],"date":["2019-11-01","2019-11-15","2019-09-19","2019-11-15","2019-09-19","2019-11-19","2019-11-18","2019-11-19","2019-09-19","2019-09-19","2019-09-19","2019-11-15","2019-11-15","2019-11-15","2019-11-18","2019-11-19","2019-11-19","2019-11-18","2019-11-19","2019-11-19","2019-11-19","2019-11-19","2020-01-27","2020-03-02","2020-03-06","2020-03-02","2020-03-02","2021-11-13","2020-03-03","2020-04-27","2020-04-27","2020-04-27","2020-04-27","2020-04-27","2020-04-27","2020-04-27","2021-11-13","2021-11-13","2021-11-13","2021-11-13","2021-11-13","2021-11-13","2021-11-13","2021-11-13","2021-11-13","2021-11-13","2021-11-13","2021-11-19","2021-11-19"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","",null,"","","","","","","","",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":[["","65862053750","LEVOFLOXACIN","500MG","10","Select","Select",""],["","68382013201","TAMSULOSIN","0.4MG","7","Select","Select",""],["","68462019005","NAPROXEN","500MG","10","Select","Select",""],["","55111015330","ONDANSETRON","4MG","12","Select","Select",""],["","10702025301","BUT\/APAP\/CAF","","15","Select","Select",""],["","68382004101","PROMETHAZINE","25MG","15","Select","Select",""],["","65862053750","LEVOFLOXACIN ","TAB 500MG","10","Select","Select",""],["","68382013201","TAMSULOSIN ","CAP 0.4MG","7","Select","Select",""],["","68462019005","NAPROXEN ","TAB 500MG","10","Select","Select",""],["","55111015330","ONDANSETRON ","TAB 4MG","12","Select","Select",""],["","10702025301","BUT\/APAP\/CAF ","TAB ","15","Select","Select",""],["","68382004101","PROMETHAZINE ","TAB 25MG","15","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","",""],["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":""}]}]}