{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"RANDY   H COLLINS","gend":0,"add":"907 PETERS CREEK DRIVE","city":"STUART","state":"VA","zip":"24171-3550","dob":"1966-11-11","age":"","mstatus":"","insh":8044152,"cliId":"","pno":2766942248,"cno":2766942248,"email":"","ename":"","eno":"","pphy":"COLE, RICHARD C","ppno":2766944466,"pcpadd":"18877 JEB STUART HWY, ","pcpcity":"STUART","pcpstate":"VA","pcpzip":241711019,"pcpcounty":"","pcpid":"","pcpname":"PIONEER HEALTH SERVICES OF PAT","ano":"","add2":"                                                            ","add3":"","madd1":"907 PETERS CREEK DRIVE","madd2":"                                                            ","madd3":"","mcity":"STUART","mstate":"VA","mzip":"24171-3550","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"ROANOKE\/ ALLEGHANY","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K76.0","R16.1","J96.01","A41.9","N17.0","I48.0","R78.81","I34.0","R65.21","I62.00","L02.612","A41.01","R27.9","Z74.3","R55","W19.XXXA","R57.0","R79.89","E87.0","S06.5X9A","M71.072","L97.428","R60.0","L97.422","I71.4","D69.6","E87.6","N17.9","E83.42","R74.0","I48.91","R34","E83.51","F17.210","R53.1","R40.4","R09.02","R06.89","R00.0","L03.116","Z79.899","B95.61","S06.4X9A","W17.81XA","D75.1","E78.2","R01.0","V29.3XXS","K72.00","Z20.828","E11.65","E11.22","E11.649","I12.9","N18.3","E87.2","D69.59","R91.8","R06.02","J12.9","Z00.121","J30.1","F90.1","R42","G93.9","I42.8","J18.9","R50.9","Z00.00","I51.7","I51.89","I34.1","L97.429","I62.03","R65.20","R10.11","R11.10","Z20.9","I08.1","R18.8","J90","N19"],"date":["2020-08-09","2020-08-08","2020-08-28","2020-09-09","2020-09-10","2020-11-20","2020-10-09","2020-08-28","2020-11-01","2020-08-18","2020-09-07","2020-09-10","2020-09-26","2020-09-26","2020-09-26","2020-09-26","2020-11-01","2020-08-25","2020-08-24","2020-08-17","2020-08-20","2020-08-21","2020-08-21","2020-09-10","2020-08-09","2020-08-08","2020-08-08","2020-08-08","2020-08-08","2020-08-08","2020-08-08","2020-08-08","2020-08-08","2020-09-26","2020-08-08","2020-08-08","2020-08-08","2020-08-08","2020-08-08","2020-10-09","2020-09-26","2020-10-09","2020-09-26","2020-09-26","2020-09-14","2019-03-05","2019-03-05","2019-03-05","2020-08-08","2020-08-08","2020-08-08","2020-08-08","2020-08-08","2020-08-08","2020-08-08","2020-08-08","2020-08-08","2020-08-13","2020-08-13","2020-09-14","2020-09-14","2020-09-14","2020-09-14","2020-09-26","2020-09-26","2020-10-08","2020-08-08","2020-08-08","2019-03-05","2020-08-10","2020-08-10","2020-11-20","2020-08-24","2020-09-28","2020-08-08","2020-08-08","2020-08-08","2020-08-08","2020-08-09","2020-08-09","2020-08-09","2020-08-09"],"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":[["","00093505898","ATORVASTATIN ","TAB 40MG","90","Select","Select",""],["","68382022714","AMIODARONE ","TAB 200MG","60","Select","Select",""],["","50742061710","METOPROL ","TAB 100MG ER","60","Select","Select",""],["","00904053961","THERA ","TAB ","30","Select","Select",""],["","67877041920","LINEZOLID ","TAB 600MG","12","Select","Select",""],["","00245014760","PACERONE ","TAB 200MG","30","Select","Select",""],["","49035019402","EQ ","DIS 21MG\/24H","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":""}]}]}