{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" J MADAOZIRAP","gend":0,"add":"     rD nelG rehtaeH 4001                         ","city":"Radford                  ","state":"VA","zip":"24141-3441","dob":"1994-11-29","age":"","mstatus":"","insh":"10112875","cliId":"","pno":"4404580899","cno":"","email":"","ename":"","eno":"","pphy":"FREEMAN, JEREMY","ppno":5409518380,"pcpadd":"1420 N MAIN ST,  ","pcpcity":"Blacksburg","pcpstate":"VA","pcpzip":240602522,"pcpcounty":"","pcpid":"","pcpname":"CARILION FAMILY MEDICINE NORTH MAIN","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"1004 Heather Glen Dr                              ","madd2":"                                                  ","madd3":"","mcity":"Radford                  ","mstate":"VA","mzip":"24141-3441","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","1",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R26.2","M25.561","M25.661","M22.2X9","R16.0","R79.89","K76.0","R10.9","R10.10","G47.33","M21.6X9","M76.61","M76.62","M21.171","M21.172","E66.01","G47.00","R10.13","E78.6","Z83.3","K21.9","R63.5","R07.9"],"date":["2021-04-02","2021-04-02","2021-04-02","2021-04-02","2022-06-15","2022-06-15","2022-06-15","2022-06-29","2022-07-06","2022-07-23","2021-12-14","2022-02-01","2022-02-01","2022-02-01","2022-02-01","2021-08-16","2022-07-06","2022-07-11","2022-01-05","2021-07-05","2022-01-05","2022-07-06","2021-01-04"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","",""]}}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":{"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":[["","00093598627","EPINEPHRINE","INJ 0.3MG","2","Select","Select",""],["","68382080510","TRAZODONE","TAB 50MG","90","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":""}]}]}