{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"WHITNEY   A ATKINS","gend":0,"add":"PO BOX 177","city":"CLINCHCO","state":"VA","zip":"24226-0177","dob":"1982-05-04","age":"","mstatus":"","insh":7546205,"cliId":"","pno":2768352169,"cno":2768352169,"email":"","ename":"","eno":"","pphy":"ABROKWAH, JAMES","ppno":2768351122,"pcpadd":"163 Number Ten St, ","pcpcity":"Clinchco","pcpstate":"VA","pcpzip":242268694,"pcpcounty":"","pcpid":"","pcpname":"FULL CARE MEDICAL CENTER","ano":"","add2":"                                                            ","add3":"","madd1":"PO BOX 177","madd2":"                                                            ","madd3":"","mcity":"CLINCHCO","mstate":"VA","mzip":"24226-0177","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"SOUTHWEST","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K85.90","R50.9","R05","N39.0","E11.9","Z72.0","I10","E78.5","F41.9","F32.9","J98.11","J90","K76.0","R10.84","F32.0","Z71.89","Z13.89","Z13.9","Z00.8","E66.9","K29.70","D72.829","R17","R00.0","E87.6","F41.8","Z23","F17.210","Z79.899","R10.9","J45.909"],"date":["2020-08-27","2020-03-22","2020-03-21","2020-03-21","2021-02-03","2020-03-21","2021-02-03","2021-02-03","2020-03-21","2020-03-21","2020-03-22","2020-03-22","2020-03-24","2020-03-21","2020-08-27","2020-08-27","2020-08-27","2020-08-27","2020-08-27","2020-08-27","2020-03-21","2020-03-24","2020-03-24","2020-03-24","2020-03-24","2020-03-24","2020-10-06","2020-03-21","2020-03-21","2020-03-21","2020-03-22"],"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":[["","00006057761","JANUMET ","TAB 50-1000","60","Select","Select",""],["","64980028005","GLIPIZIDE ","TAB 5MG","30","Select","Select",""],["","64380073706","VITAMIN ","CAP 50000UNT","3","Select","Select",""],["","68180047803","SIMVASTATIN ","TAB 10MG","30","Select","Select",""],["","45802065078","LORATADINE ","TAB 10MG","30","Select","Select",""],["","65862037501","ESCITALOPRAM ","TAB 20MG","30","Select","Select",""],["","64380074206","BUSPIRONE ","TAB 10MG","60","Select","Select",""],["","68180098003","LISINOPRIL ","TAB 10MG","30","Select","Select",""],["","50111043302","TRAZODONE ","TAB 50MG","30","Select","Select",""],["","51660052653","ALLERGY ","TAB 10MG","30","Select","Select",""],["","00406012301","HYDROCO\/APAP ","TAB 5-325MG","12","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":[[["Yes","Select","","","","","Select","",""],["Yes","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":""}]}]}