{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ANGELICA   S COX","gend":1,"add":"405 S 22ND STREET","city":"WYTHEVILLE","state":"VA","zip":"24382-2465","dob":"1997-03-04","age":"","mstatus":"","insh":4269393,"cliId":"","pno":2764846185,"cno":2764846185,"email":"","ename":"","eno":"","pphy":"MCCONNELL, JAMES J","ppno":2762288951,"pcpadd":"365 W Ridge Rd, ","pcpcity":"Wytheville","pcpstate":"VA","pcpzip":243821008,"pcpcounty":"","pcpid":"","pcpname":"","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":2766204000,"add2":"APT G","add3":"","madd1":"405 S 22ND STREET","madd2":"APT G","madd3":"","mcity":"WYTHEVILLE","mstate":"VA","mzip":"24382-2465","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I10","R03.0","J90","J98.11","I16.0","I51.7","I34.0","I36.1","E01.0","Z30.09","N88.3","Z3A.12","O34.31","O14.94","O13.3","Z37.0","O34.33","I21.A1","O99.43","Z3A.36","O62.2","O70.1","O90.81","D50.0","O90.89","E87.6","I08.1","R00.0","Z79.899","Z48.02","O60.13X0","O76","Z39.2","S02.2XXA","R68.84","R04.0","Y04.8XXA","O26.893","R10.10","Z3A.28","Z34.93","Z3A.34","H57.12","S05.92XA","F17.210","J10.1","R05","S01.25XA","Y04.1XXA","Y92.009","Z32.01","Z11.3","Z11.8","O34.30","Z39.1","Z34.82","Z34.83","O69.3XX0","O41.1430","Z3A.37","Z37.9","Z34.81","Z01.411","S09.92XA","H92.01","O09.211","Z3A.09","O60.14X0","O34.32","Z3A.17","Z34.90","O13.9","G89.18","D64.9","Z3A.18"],"date":["2020-06-22","2020-06-04","2020-06-04","2020-06-04","2020-06-08","2020-06-08","2020-06-08","2020-06-08","2020-08-11","2020-08-11","2021-03-25","2021-02-10","2019-12-31","2020-06-03","2020-06-03","2020-06-04","2020-06-03","2020-06-03","2020-06-03","2020-06-04","2020-06-03","2020-06-03","2020-06-03","2020-06-03","2020-06-03","2020-06-06","2020-06-03","2020-06-03","2020-06-03","2020-06-03","2020-06-03","2020-06-03","2020-07-23","2019-02-27","2019-02-27","2019-02-27","2019-02-27","2020-04-10","2020-04-10","2020-04-10","2020-05-26","2020-05-28","2019-01-20","2019-01-20","2019-02-27","2019-02-19","2019-02-19","2019-02-27","2019-02-27","2019-02-27","2021-01-19","2021-01-19","2021-01-19","2021-03-30","2020-02-17","2020-03-30","2020-05-21","2020-06-08","2020-06-08","2020-06-08","2020-06-08","2021-02-10","2019-12-04","2019-02-28","2019-02-28","2019-12-04","2019-12-04","2020-06-04","2021-03-30","2021-03-25","2019-12-19","2020-05-28","2020-06-04","2020-06-04","2021-03-30"],"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":[["","31722063231","OSELTAMIVIR ","CAP 75MG","10","Select","Select",""],["","00143924920","AMOX\/K ","TAB 875-125","20","Select","Select",""],["","68645056354","IBUPROFEN ","TAB 800MG","30","Select","Select",""],["","00591060601","LABETALOL ","TAB 200MG","40","Select","Select",""],["","50111032801","HYDRALAZINE ","TAB 50MG","60","Select","Select",""],["","00527058601","DICYCLOMINE ","CAP 10MG","20","Select","Select",""],["","69543038810","KETOROLAC ","TAB 10MG","20","Select","Select",""],["","00603158658","PROMETHAZINE ","SYP DM","200","Select","Select",""],["","65162025425","RANITIDINE ","TAB 300MG","30","Select","Select",""],["","00093220301","METOCLOPRAM ","TAB 10MG","20","Select","Select",""],["","68645019159","METOPROL ","TAB 100MG","60","Select","Select",""],["","45802042578","FEXOFENADINE ","TAB 60MG","20","Select","Select",""],["","61314063705","PREDNISOLONE ","SUS 1% OP","5","Select","Select",""],["","55111015430","ONDANSETRON ","TAB 8MG","28","Select","Select",""],["","00093834301","GLYBURIDE ","2.5MG","30","Select","Select",""],["","55111064530","OMEPRAZOLE ","40MG","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","",""],["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":""}]}]}