{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CHEYENNE   E PEAKE","gend":1,"add":"1147 HWY 16                                                 ","city":"MARION                        ","state":"VA","zip":"24354-4443","dob":"1997-04-28","age":"","mstatus":"","insh":7973716,"cliId":"","pno":2766857419,"cno":2766857419,"email":"","ename":"","eno":"","pphy":"MCGLOTHIN, JAMES R                                          ","ppno":"","pcpadd":"1046 Terrace Dr","pcpcity":"Marion                        ","pcpstate":"VA","pcpzip":243544138,"pcpcounty":"","pcpid":"P9059072","pcpname":"SMYTH COUNTY FAMILY PHYSICIANS","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"SOUTHWEST","aligned":"","ano":"","add2":"APARTMENT 3                                                 ","add3":"","madd1":"1147 HWY 16                                                 ","madd2":"APARTMENT 3                                                 ","madd3":"","mcity":"MARION                        ","mstate":"VA","mzip":"24354-4443","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["C81.18","C81.90","R82.90","N91.2","E66.01","F32.9","F41.1","R68.89","R53.83","G90.09","F33.9","K02.9","K08.89","R22.0","I10","Z79.899","K04.7","K56.7","R11.2","R19.7","Z85.71","R10.13","L02.211","F43.10","K21.9","E11.9","L50.0","L50.9","F17.210","R73.03","F41.8","Z32.02","R35.0","Z53.21","R30.9","L02.415","L02.91","L03.90","R30.0","J02.9","Z72.51","N94.6","N93.9","R10.2","N94.89","F41.9","H10.31","H10.9","H57.11","F33.3","R10.11","T43.625A","T43.621A","R10.10","F19.10","K59.00","F15.10","F19.11","F15.20","N61.0","Z87.891","F43.23","F15.21","O20.9","Z3A.16","O46.92","R25.2","Z36.9","J30.9","R06.02","R09.81","R05","Z20.822","Z33.1","R06.2","R06.00","R07.9","Z92.21","O99.322","Z3A.19","J45.990","O99.212","Z68.41","Z3A.23","O26.892","O26.852","O36.8120","R10.9","O36.8190","R10.30","R00.0","Z68.43","O28.3","Z3A.27","Z3A.28","Z23","O99.343","Z3A.30","O36.8130","O99.323","O10.013","Z00.00","O10.919","O40.3XX0","Z3A.32","O10.913","Z3A.33","Z3A.34","O11.4","Z34.90","D62","O61.9","O62.0","O90.81","Z37.0","Z3A.36","O43.813","O43.893","O60.14X0","Z37.9","P91.60"],"date":["2019-05-01","2020-05-04","2019-04-24","2019-04-24","2021-08-21","2021-08-21","2021-10-07","2019-04-25","2019-05-01","2019-06-24","2020-04-14","2020-11-10","2020-11-10","2019-06-26","2021-11-02","2021-08-21","2021-08-21","2019-07-20","2019-08-28","2019-07-20","2021-11-18","2019-07-20","2019-08-28","2019-08-31","2019-11-26","2019-08-28","2019-08-31","2019-08-31","2019-08-31","2020-05-10","2021-07-11","2019-09-09","2019-11-20","2019-11-20","2019-11-20","2019-11-22","2020-11-10","2019-11-22","2021-09-10","2019-11-22","2019-11-22","2019-11-26","2019-11-26","2019-11-26","2019-11-26","2021-08-21","2020-04-16","2020-04-16","2020-04-16","2020-04-17","2020-05-10","2020-05-04","2020-05-04","2020-05-04","2020-05-10","2020-05-10","2021-11-18","2020-05-10","2021-09-07","2020-11-10","2021-11-18","2020-11-16","2020-11-16","2021-07-02","2021-07-02","2021-08-21","2021-07-02","2021-09-10","2021-07-11","2021-11-18","2021-11-17","2021-07-11","2021-11-18","2021-07-11","2021-07-13","2021-07-13","2021-07-20","2021-07-13","2021-07-21","2021-07-21","2021-08-11","2021-08-18","2021-08-18","2021-08-21","2021-08-21","2021-08-21","2021-08-21","2021-08-21","2021-08-21","2021-08-21","2021-08-21","2021-11-18","2021-09-16","2021-09-16","2021-09-24","2021-09-24","2021-10-07","2021-10-07","2021-10-11","2021-10-11","2021-11-04","2021-10-11","2021-11-11","2021-11-18","2021-10-22","2021-11-01","2021-11-01","2021-11-04","2021-11-18","2021-11-18","2021-11-18","2021-11-18","2021-11-18","2021-11-18","2021-11-18","2021-11-19","2021-11-19","2021-11-19","2021-11-19","2021-11-19","2021-11-19"],"priorHcc":["","","","","","","","","","","","","","",null,"","","","","",null,"","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",null,"","","",null,"","","","","","","","",null,null,"",null,"","","","","","","","","","","","","","","","","","",null,"","","","","","","","",null,null,null,null,null,null,null,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":[["","07610010418","PRENATAL","28-0.8MG","30","Select","Select",""],["","65162074510","PROMETHAZINE","12.5MG","30","Select","Select",""],["","69097083412","SERTRALINE","50MG","30","Select","Select",""],["","66993001968","ALBUTEROL","HFA","18","Select","Select",""],["","65862001501","AMOXICILLIN","875MG","14","Select","Select",""],["","45802065078","LORATADINE","10MG","30","Select","Select",""],["","69097081507","GABAPENTIN","400MG","90","Select","Select",""],["","00116200116","CHLORHEX","0.12%","473","Select","Select",""],["","68180012202","CEPHALEXIN","500MG","30","Select","Select",""],["","63304069301","CLINDAMYCIN","300MG","30","Select","Select",""],["","00169280015","SAXENDA","18MG\/3ML","15","Select","Select",""],["","50111064801","FLUOXETINE","20MG","30","Select","Select",""],["","08290320109","BD PEN NEEDL","31GX8MM","100","Select","Select",""],["","69097083412","SERTRALINE ","TAB 50MG","30","Select","Select",""],["","07610010418","PRENATAL ","TAB 28-0.8MG","30","Select","Select",""],["","65162074510","PROMETHAZINE ","TAB 12.5MG","30","Select","Select",""],["","65862085901","FAMOTIDINE ","TAB 20MG","60","Select","Select",""],["","66993001968","ALBUTEROL ","AER HFA","18","Select","Select",""],["","65862001501","AMOXICILLIN ","TAB 875MG","14","Select","Select",""],["","45802065078","LORATADINE ","TAB 10MG","30","Select","Select",""],["","69097081507","GABAPENTIN ","CAP 400MG","90","Select","Select",""],["","00116200116","CHLORHEX ","SOL 0.0012","473","Select","Select",""],["","68180012202","CEPHALEXIN ","CAP 500MG","30","Select","Select",""],["","63304069301","CLINDAMYCIN ","CAP 300MG","30","Select","Select",""],["","00603254428","BUT\/APAP\/CAF ","TAB ","30","Select","Select",""],["","00169280015","SAXENDA ","INJ 18MG\/3ML","15","Select","Select",""],["","50111064801","FLUOXETINE ","CAP 20MG","30","Select","Select",""],["","08290320109","BD  PEN NEEDL","MIS 31GX8MM","100","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":""}]}]}