{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JAMES RIGGS","gend":0,"add":"123 W CHURCH ST","city":"WAKEFIELD","state":"VA","zip":"23888-9998","dob":"2003-01-15","age":"","mstatus":"","insh":"1594138*01","cliId":"","pno":"757\/742-2001","cno":"","email":"","ename":"","eno":"","pphy":"HOLLOMAN, HEATHER NP","ppno":"804\/834-8871","pcpadd":"344 W MAIN ST","pcpcity":"WAVERLY","pcpstate":"VA","pcpzip":23890,"pcpcounty":"","pcpid":"","pcpname":"HORIZON HEALTH SERVICES INC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/834-8875","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F90.2","F32.2","F41.8","T76.22XA","T76.32XA","R11.2","K59.00","A08.4","K92.0","R10.84","R11.11","R10.13","S80.02XA","F43.23","F90.9","J02.9","Z11.59","S29.9XXA","R10.33","K59.1","K52.9"],"date":["2020-07-09","2020-07-09","2020-07-09","2020-07-09","2020-07-09","2020-03-10","2020-03-04","2020-03-05","2020-03-13","2020-03-10","2020-03-13","2020-03-13","2019-01-10","2019-05-02","2019-10-14","2019-11-20","2019-11-20","2019-06-12","2019-03-01","2019-03-01","2019-09-04"],"priorHcc":["","","","","","","","","","","","","","","","","","","","",""]}}]},{"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":[]},{"a":[]},{"a":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"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":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","59267100002","PFIZER","INJ COVID-19","0","Select","Select",""],["","","ONDANSETRON","TAB 4MG ODT","","Select","Select",""],["","","ZYRTEC-D","TAB 5-120MG","","Select","Select",""],["","","PROMETHAZINE","TAB 12.5MG","","Select","Select",""],["","","DOK","CAP 100MG","","Select","Select",""],["","","FLUTICASONE","SPR 50MCG","","Select","Select",""],["","","WAL-ZYR","TAB 5-120MG","","Select","Select",""],["","65862001501","AMOXICILLIN","TAB 875MG","20","Select","Select",""],["","10702010001","METHYLPHENID","TAB 5MG","20","Select","Select",""],["","29300013510","CLONIDINE","TAB 0.1MG","120","Select","Select",""],["","00591079401","DICYCLOMINE","CAP 10MG","20","Select","Select",""]]}},{"a":[]},{"a":[]},{"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":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":[]}]},{"t":"Mini-Cog","q":[{"a":[]},{"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":"","a13":""}]}]}