{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" REGORYELOOD","gend":0,"add":"        1 TPA EVA ELAH 53                         ","city":"SALEM                    ","state":"VA","zip":"24153-4067","dob":"1955-04-19","age":"","mstatus":"","insh":"10119733","cliId":"","pno":"9404573144","cno":"","email":"","ename":"","eno":"","pphy":"ISSA, MAYADA HUSSAIN","ppno":5402245170,"pcpadd":"3 RIVERSIDE CIR,","pcpcity":"Roanoke","pcpstate":"VA","pcpzip":240164955,"pcpcounty":"","pcpid":"","pcpname":"CARILION CLINIC INTERNAL MEDICINE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"35 HALE AVE APT 1                                 ","madd2":"                                                  ","madd3":"","mcity":"SALEM                    ","mstate":"VA","mzip":"24153-4067","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.29","E78.1","E78.2","I10","D64.9","R80.9","M10.9","Z00.00","E11.9","E53.8"," ","Z12.11","Z86.010","D12.2","D12.8","K57.90","K63.5","K64.8","Q27.39","K57.30","E11.40","E78.00","Z87.11","Z87.891","Z68.35","Z79.84","Z79.899"],"date":["2021-03-05","2022-03-28","2022-03-28","2022-11-10","2022-03-28","2021-03-05","2021-03-05","2022-03-21","2022-03-28","2022-03-21","2022-11-10","2022-11-10","2022-11-10","2022-11-10","2022-11-10","2022-11-10","2022-11-10","2022-11-10","2022-11-10","2022-11-10","2022-11-10","2022-11-10","2022-11-10","2022-11-10","2022-11-10","2022-11-10","2022-11-10"],"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":[["","00169406012","VICTOZA","INJ 18MG\/3ML","12","Select","Select",""],["","65862029590","ROSUVASTATIN","TAB 20MG","30","Select","Select",""],["","00193731221","CONTOUR","TES NEXT","400","Select","Select",""],["","68180098103","LISINOPRIL","TAB 20MG","90","Select","Select",""],["","00172208380","HYDROCHLOROT","TAB 25MG","90","Select","Select",""],["","69097082103","GEMFIBROZIL","TAB 600MG","60","Select","Select",""],["","71093012205","GABAPENTIN","CAP 400MG","180","Select","Select",""],["","55111073001","ALLOPURINOL","TAB 300MG","180","Select","Select",""],["","65862000899","METFORMIN","TAB 500MG","270","Select","Select",""],["","68180072003","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","16729043310","EZETIMIBE","TAB 10MG","90","Select","Select",""],["","00193658621","MICROLET","MIS LANCETS","400","Select","Select",""],["","08290320119","BD  PEN NEEDL","MIS 31GX5MM","100","Select","Select",""],["","31722093612","OMEGA-3-ACID","CAP 1GM","120","Select","Select",""],["","49281012065","FLUZONE","INJ PF 20-21","0.7","Select","Select",""],["","64980043810","ATENOLOL","TAB 50MG","90","Select","Select",""],["","59267030402","PFIZER","INJ BA4\/BA5","0.3","Select","Select",""],["","08214055080","PEN  NEEDLES","MIS 31GX3\/16","100","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":["",""],"sub":{"indx":[["","",""],[""],[""],[""],[""]],"comment":[["","",""],[""],[""],[""],[""]],"sub":[]}}},{"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":""}]}]}