{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ELIZABETH   A VANHOOZER","gend":1,"add":"306 DOUGLAS STREET","city":"MARION","state":"VA","zip":"24354-2936","dob":"1992-01-31","age":"","mstatus":"","insh":7973758,"cliId":"","pno":2766133437,"cno":2766133437,"email":"","ename":"","eno":"","pphy":"PARKER, DAVID G","ppno":2767837167,"pcpadd":"1020 Terrace Dr, Ste 100","pcpcity":"Marion","pcpstate":"VA","pcpzip":243544392,"pcpcounty":"","pcpid":"","pcpname":"","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"SOUTHWEST","aligned":"","ano":2765250626,"add2":"APT 7","add3":"","madd1":"306 DOUGLAS STREET","madd2":"APT 7","madd3":"","mcity":"MARION","mstate":"VA","mzip":"24354-2936","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M62.838","R29.898","E78.5","D76.3","E55.9","R73.9","I10","R25.2","F31.81","F60.3","Z68.41","E66.01","M25.561","K21.9","R42","R11.0","E11.65","F39","G47.33","R40.0","Z23","Z68.42","D12.8","K64.8","K59.00","R19.7","K44.9","R93.3","B37.3","R19.4","K76.0","Z88.0","R11.10","Z88.6","Z88.8","Z79.899","Z79.84","F41.9","F31.9","E11.9","G25.81","F17.210","R07.89","R10.13","M79.604","F32.9","Z72.0","R10.84","R11.2","G47.31","F33.8","I15.8","R10.9","R12","F41.8","K64.0","F33.0","F41.1","F31.32","Z86.59","K52.9","F33.1","R10.32","H66.001","R07.9","F31.4","R16.2","H66.91","N39.46","R35.0","R10.12","K58.9","R19.8","H92.01","J02.9","R05","Z87.898","M54.5","H10.9","G40.A09","J40","R06.2","R56.9","K62.5","R07.2","H10.45","H40.013","F17.208","K62.4","R06.02","R93.89","Z30.017","K62.1","N76.0","B96.89","Z12.4","Z11.51","Z11.3","Z30.09"],"date":["2019-05-05","2019-05-05","2019-06-12","2020-09-01","2019-05-13","2019-11-19","2020-11-09","2019-05-09","2019-08-29","2019-11-29","2021-02-26","2020-01-14","2019-05-09","2020-11-09","2019-11-26","2020-03-03","2019-11-29","2019-11-29","2020-11-09","2019-11-29","2020-11-09","2020-05-07","2020-01-14","2020-03-11","2020-01-14","2020-08-30","2020-08-03","2020-01-14","2020-03-26","2020-04-07","2020-04-07","2020-06-10","2020-06-10","2020-06-10","2020-06-10","2020-09-01","2020-07-29","2020-08-30","2020-08-03","2020-11-09","2020-11-09","2020-09-01","2020-07-29","2020-10-06","2019-05-05","2020-02-24","2020-08-30","2020-03-03","2020-08-30","2019-05-20","2019-05-20","2019-05-20","2020-08-30","2020-03-03","2020-03-03","2020-03-17","2020-08-10","2020-11-09","2021-02-22","2019-06-24","2019-07-29","2020-04-21","2019-10-27","2020-02-25","2020-09-01","2020-11-09","2019-10-27","2020-02-24","2021-02-26","2021-02-26","2019-10-27","2019-10-27","2019-12-03","2020-02-24","2020-02-24","2020-02-24","2020-04-21","2019-06-14","2019-08-29","2019-08-29","2019-08-29","2019-08-29","2019-10-22","2020-08-14","2020-07-29","2019-03-21","2019-03-21","2019-03-21","2020-08-14","2020-09-01","2020-09-01","2020-11-30","2020-01-14","2020-03-26","2020-03-26","2020-03-26","2020-03-26","2020-11-20","2020-11-20"],"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":[["","68462013701","OXCARBAZEPIN ","TAB 150MG","30","Select","Select",""],["","60505265901","TRAZODONE ","TAB 300MG","30","Select","Select",""],["","00115166001","PROPRANOLOL ","TAB 20MG","30","Select","Select",""],["","99073070827","FREESTYLE    TES LITE","TES LITE","100","Select","Select",""],["","00378668999","PANTOPRAZOLE ","TAB 40MG","30","Select","Select",""],["","53489012002","DOXYCYCL ","TAB 100MG","20","Select","Select",""],["","00185012201","NITROFURANTN ","CAP 100MG","20","Select","Select",""],["","13668021730","ARIPIPRAZOLE ","TAB 5MG","30","Select","Select",""],["","51991074710","DULOXETINE ","CAP 30MG","30","Select","Select",""],["","57237007710","ONDANSETRON ","TAB 4MG ODT","20","Select","Select",""],["","68462025501","ROPINIROLE ","TAB 1MG","30","Select","Select",""],["","63402030430","LATUDA ","TAB 40MG","30","Select","Select",""],["","00169406013","VICTOZA ","INJ 18MG\/3ML","9","Select","Select",""],["","59746036030","VALSARTAN ","TAB 40MG","30","Select","Select",""],["","13668011390","LOSARTAN ","TAB 25MG","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":[[["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":""}]}]}