{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" L DIVADRJ TSAE","gend":0,"add":"   DR REHPLUS WOLLEY 9072                         ","city":"CHRISTIANSBURG           ","state":"VA","zip":"24073-9998","dob":"1954-10-25","age":"","mstatus":"","insh":"10116258","cliId":"","pno":"7504545687","cno":"","email":"","ename":"","eno":"","pphy":"HANNAH, CARL R","ppno":5403826148,"pcpadd":"6 HICKOK ST,STE A","pcpcity":"Christiansburg","pcpstate":"VA","pcpzip":240733524,"pcpcounty":"","pcpid":"","pcpname":"LEWIS GALE PHYSICIANS","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"2709 YELLOW SULPHER RD                            ","madd2":"                                                  ","madd3":"","mcity":"CHRISTIANSBURG           ","mstate":"VA","mzip":"24073-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z00.00","Z11.59","Z12.2","F17.210","R91.1","Z13.6","I10","N20.0","N28.1","I70.0","C44.319","C44.311","D48.5","Z71.89","Z08","Z85.828","R76.8","D69.6","H93.13","H90.3","R07.81","J18.1","R07.9","R06.00","A41.9","J18.9","J96.01","Z20.822","E44.0","N17.8","J44.0","E11.22","N18.31","E78.49","E83.42","F17.200","I25.10","I25.2","Z79.84","R91.8","I77.1","I08.3","I11.0","I50.9","E11.9","N40.0","E78.5","J44.9","N17.9","N18.6","I13.0","J44.1","F32.A","Z86.73","R51.9","H53.8","R50.9","R05.9","R09.81","J02.9","R53.83","Z79.51","R06.9","R06.2","R53.1"," ","J90","R06.01","N18.4","I12.9","Z87.442","E87.5","R06.02","K59.00","R14.0"],"date":["2021-10-20","2021-10-20","2021-11-02","2021-11-02","2021-11-02","2021-11-02","2022-09-09","2021-11-02","2022-11-27","2022-07-12","2021-11-15","2021-11-15","2021-11-15","2021-11-15","2021-11-15","2021-11-15","2021-12-03","2021-12-03","2021-12-08","2021-12-08","2022-06-20","2022-11-26","2022-06-17","2022-07-12","2022-06-20","2022-11-23","2022-11-23","2022-11-23","2022-06-17","2022-06-17","2022-07-12","2022-07-12","2022-07-12","2022-06-17","2022-09-09","2022-11-23","2022-07-12","2022-07-12","2022-11-23","2022-07-12","2022-07-12","2022-07-12","2022-07-12","2022-07-13","2022-09-09","2022-06-27","2022-06-28","2022-09-09","2022-11-30","2022-06-17","2022-07-12","2022-11-23","2022-11-23","2022-11-23","2022-09-09","2022-09-09","2022-09-09","2022-09-09","2022-09-09","2022-09-09","2022-09-09","2022-09-09","2022-07-12","2022-07-12","2022-09-09","2022-12-01","2022-11-29","2022-11-29","2022-11-23","2022-11-23","2022-11-23","2022-11-23","2022-11-23","2022-12-01","2022-12-01"],"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":[["","68180096301","ALBUTEROL","AER HFA","8.5","Select","Select",""],["","68645051654","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","29300046801","CLONIDINE","TAB 0.1MG","180","Select","Select",""],["","00597015330","JARDIANCE","TAB 25MG","90","Select","Select",""],["","68645059354","LISINOPRIL","TAB 40MG","90","Select","Select",""],["","68645058459","METFORMIN","TAB 1000MG","180","Select","Select",""],["","72205000390","ROSUVASTATIN","TAB 10MG","90","Select","Select",""],["","68382013201","TAMSULOSIN","CAP 0.4MG","90","Select","Select",""],["","00093727156","PIOGLITAZONE","TAB 15MG","90","Select","Select",""],["","00310737020","BUDES\/FORMOT","AER 160-4.5","10.2","Select","Select",""],["","50111078810","AZITHROMYCIN","TAB 500MG","2","Select","Select",""],["","68180071160","CEFDINIR","CAP 300MG","12","Select","Select",""],["","59746017509","PREDNISONE","TAB 20MG","10","Select","Select",""],["","68382009305","CARVEDILOL","TAB 6.25MG","60","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":""}]}]}