{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MEGAN   B MCNEW","gend":1,"add":"127   SALLING STREET                                        ","city":"DUFFIELD                      ","state":"VA","zip":"24244-5105","dob":"1990-06-22","age":"","mstatus":"","insh":10195762,"cliId":"","pno":2769951607,"cno":2762823190,"email":"","ename":"","eno":"","pphy":"CASSEL, TODD A                                              ","ppno":"","pcpadd":"17285 Veterans Memorial Hwy","pcpcity":"Dungannon                     ","pcpstate":"VA","pcpzip":242453937,"pcpcounty":"","pcpid":"P0124083","pcpname":"CLINCH RIVER HEALTH SERVICES INC","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"SOUTHWEST","aligned":"","ano":"","add2":"APT 101                                                     ","add3":"","madd1":"127   SALLING STREET                                        ","madd2":"APT 101                                                     ","madd3":"","mcity":"DUFFIELD                      ","mstate":"VA","mzip":"24244-5105","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["O44.02","O36.5930","Z3A.38","Z34.80","O34.211","N85.8","Z3A.39","Z37.0","Z30.2","Z01.10","Z71.89","Z91.89","Z00.129","L22","Z23","F32.1","F15.20","F11.21","Z20.822","Z11.52","Z20.828"],"date":["2019-09-17","2019-12-05","2019-12-05","2019-12-05","2019-12-10","2019-12-10","2019-12-10","2019-12-10","2019-12-10","2019-12-11","2020-10-22","2020-09-17","2020-10-26","2020-10-26","2020-10-26","2020-11-23","2021-04-08","2021-04-08","2021-04-23","2021-04-26","2021-04-26"],"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":[["","13668000905","CITALOPRAM","10MG","30","Select","Select",""],["","13668000905","CITALOPRAM ","TAB 10MG","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","",""],["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":""}]}]}