{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ARDNAXELASNAVE K ","gend":1,"add":"   403 TPA DR DRAYNET 094                         ","city":"ROCKY MOUNT              ","state":"VA","zip":"24151-9998","dob":"2000-12-12","age":"","mstatus":"","insh":"10112218","cliId":"","pno":"2267285519","cno":5403931873,"email":"","ename":"","eno":"","pphy":"COUTURE, STEPHEN A","ppno":5402832570,"pcpadd":"5304 INDIAN GRAVE RD STE B,","pcpcity":"Roanoke","pcpstate":"VA","pcpzip":240189100,"pcpcounty":"","pcpid":"","pcpname":"LEWIS GALE PHYSICIANS","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"789 BREMBLE DR                                    ","madd2":"                                                  ","madd3":"","mcity":"MONETA                   ","mstate":"VA","mzip":"24121-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","1",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F20.9","F29","R11.2","R19.7","E66.9","F17.290","R00.0","R03.0","R74.8","R79.89","R11.10","Z79.899","R94.5","N30.00","R30.9","R11.0","K59.1","K08.89","F17.200","F84.0","E11.9","D35.2","H60.502","H92.02","N89.8","Z86.69","H60.22","H91.92","B95.7","F41.9","F32.3","R73.03","H60.92","Z00.00","R68.83","H65.02","H60.332","H60.552","L29.8","H60.312","H92.09"," ","E23.7","R10.84","R07.9","K92.0","R32","F99","E23.6","K92.2","R07.89"],"date":["2022-11-30","2022-11-17","2022-12-03","2021-07-23","2021-06-19","2022-09-06","2022-09-03","2021-06-19","2021-11-09","2021-07-25","2021-07-25","2022-09-06","2021-07-25","2021-08-05","2021-08-05","2021-11-09","2021-11-09","2022-03-14","2022-03-14","2022-03-14","2022-08-30","2022-08-30","2022-09-03","2022-09-06","2022-09-03","2022-09-13","2022-09-06","2022-09-06","2022-09-06","2022-09-06","2022-09-06","2022-09-06","2022-09-05","2022-10-05","2022-09-06","2022-08-29","2022-09-06","2022-09-03","2022-09-03","2022-09-05","2022-09-06","2022-12-03","2022-11-23","2022-12-03","2022-12-03","2022-12-03","2022-11-10","2022-11-10","2022-11-23","2022-12-03","2022-12-03"],"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":[["","42806016005","HYDROXYZ","TAB 25MG","90","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","12","Select","Select",""],["","33342002332","LEVOFLOXACIN","TAB 750MG","9","Select","Select",""],["","69097083512","SERTRALINE","TAB 100MG","30","Select","Select",""],["","50111056001","TRAZODONE","TAB 50MG","30","Select","Select",""],["","67877021905","CEPHALEXIN","CAP 500MG","40","Select","Select",""],["","23155000810","HYDROCHLOROT","TAB 25MG","90","Select","Select",""],["","65862070360","ZIPRASIDONE","CAP 40MG","30","Select","Select",""],["","68180051901","LISINOP\/HCTZ","TAB 20-12.5","90","Select","Select",""],["","68462010530","ONDANSETRON","TAB 4MG","10","Select","Select",""],["","65862050320","AMOX\/K","TAB 875-125","20","Select","Select",""],["","65162018910","NAPROXEN","TAB 375MG","14","Select","Select",""],["","70377000712","ROSUVASTATIN","TAB 10MG","90","Select","Select",""],["","49483060450","IBUPROFEN","TAB 800MG","15","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":["",""]}},{"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":""}]}]}