{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SYDALGSLAID ","gend":1,"add":"     DAOR EGDIRKCALB 1012                         ","city":"FLOYD                    ","state":"VA","zip":"24091-9998","dob":"1947-08-27","age":"","mstatus":"","insh":"00110148","cliId":"","pno":"4704562085","cno":"","email":"","ename":"","eno":"","pphy":"HULLETT, JOEL","ppno":5407455700,"pcpadd":"249 FRANKLIN PIKE SE,  ","pcpcity":"Floyd","pcpstate":"VA","pcpzip":240912893,"pcpcounty":"","pcpid":"","pcpname":"CARILION CLINIC PRIMARY CARE ASSOCIATES FLOYD","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"2101 BLACKRIDGE ROAD                              ","madd2":"                                                  ","madd3":"","mcity":"FLOYD                    ","mstate":"VA","mzip":"24091-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["D04.39","D04.62","L81.4","L82.1","Z08","Z85.828","Z71.89","Z80.8","Z09","Z87.2","L57.0","E03.9","E78.5","I10","L98.9","Z28.21","D22.61","D22.5","D22.62","D22.22","D48.5","M54.50","M48.56XA","L82.0","E55.9","H93.A1","R22.1","H90.3","R23.8","R10.9","Z00.00","R53.83","H91.91","D22.39","S32.010D","B02.7","M43.8X6","S32.019D","M48.07"],"date":["2021-10-14","2021-10-14","2022-06-16","2022-06-16","2022-06-16","2022-06-16","2022-06-16","2022-06-16","2022-06-16","2022-06-16","2022-06-16","2022-07-22","2022-07-22","2022-07-22","2021-09-22","2020-09-18","2021-09-30","2021-09-30","2021-09-30","2021-09-30","2021-09-30","2022-03-18","2022-03-18","2021-01-19","2022-07-22","2020-01-09","2020-01-20","2020-01-09","2020-05-19","2022-03-04","2021-09-22","2020-05-19","2019-12-19","2021-12-16","2022-04-03","2022-05-06","2022-04-03","2022-04-03","2022-04-03"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"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":[["","00378180510","LEVOTHYROXIN","TAB 75MCG","90","Select","Select",""],["","68382002210","ATENOLOL","TAB 25MG","90","Select","Select",""],["","49281012065","FLUZONE","INJ PF 20-21","0.7","Select","Select",""],["","00378479106","FLUOROURACIL","CRE 0.05","40","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","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":["",""]}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"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":""}]}]}