{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"W F TREBORRJ LLAHTLA","gend":0,"add":"AIROMEM 1002WS EUNEVA L","city":"ROANOKE                  ","state":"VA","zip":"24015-2031","dob":"1956-12-28","age":"","mstatus":"","insh":"10119868","cliId":"","pno":"9204527703","cno":"","email":"","ename":"","eno":"","pphy":"ROMAN, ANTONIO","ppno":5407720555,"pcpadd":"3369 COLONIAL AVE SW,STE A","pcpcity":"Roanoke","pcpstate":"VA","pcpzip":240183739,"pcpcounty":"","pcpid":"","pcpname":"CARILION FAMILY MEDICINE COLONIAL AVENUE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"N","ano":"","add2":"APT B","add3":"","madd1":"2001 MEMORIAL AVENUE SW","madd2":"APT B","madd3":"","mcity":"ROANOKE                  ","mstate":"VA","mzip":"24015-2031","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z20.822","C25.0","F31.9","G89.3","L60.1","M25.50","R05.9","R53.0","K12.1","G64","C25.9","C78.7","R91.8","Z79.899","Q12.0","K86.81","M19.90","Z51.11","Z45.2","R60.0","H93.8X2","M54.2","R53.1","F30.10","Z71.2","R51.9","R26.9","Z53.21","E78.00","Z85.05","Z85.46","F17.210","U07.1","N17.9","G89.29","M54.9","Z85.07","Z65.1","C22.9","K86.89","F17.200","Z90.89","F30.13","D72.829","R79.0","R91.1","R11.2","K59.00","R25.1","M62.81","D64.9","E87.2","E87.8","R41.82","F30.9","I81","F31.12","F41.1","N40.0","N43.3","N20.0","K63.89","K82.8","J43.2","I25.10","R26.2","R27.9","H90.3","L89.152","T43.595A","F31.60","D63.8","L02.511","E86.0","R53.83","R26.81","M54.59","G90.09"],"date":["2022-01-24","2022-09-22","2022-09-20","2022-09-06","2022-05-04","2022-05-04","2022-05-04","2022-09-20","2022-05-04","2022-09-20","2022-08-29","2022-08-29","2022-08-29","2022-08-22","2022-02-24","2022-09-06","2022-05-04","2022-09-20","2022-04-06","2022-08-10","2022-05-19","2022-07-25","2022-07-03","2022-07-03","2022-07-04","2022-07-04","2022-07-03","2022-07-03","2022-07-04","2022-07-04","2022-07-04","2022-07-04","2022-08-10","2022-08-02","2022-08-02","2022-08-02","2022-07-30","2022-07-26","2022-08-22","2022-08-29","2022-06-17","2022-06-17","2022-09-06","2022-08-02","2022-07-25","2022-07-25","2022-07-25","2022-08-02","2022-08-02","2022-08-12","2022-08-24","2022-08-02","2022-07-27","2022-07-03","2022-07-03","2022-08-29","2022-08-09","2022-08-09","2022-08-29","2022-08-29","2022-08-29","2022-08-29","2022-08-29","2022-08-29","2022-08-29","2022-08-12","2022-08-12","2022-08-26","2022-08-09","2022-07-25","2022-08-09","2022-08-10","2022-08-03","2022-07-25","2022-08-22","2022-08-02","2022-08-02","2022-08-02"],"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":[["","65862052305","GABAPENTIN","TAB 600MG","120","Select","Select",""],["","00054002025","LITHIUM","TAB 450MG ER","60","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","48.00","Select","Select",""],["","68462010630","ONDANSETRON","TAB 8MG","30.00","Select","Select",""],["","59746011506","PROCHLORPER","TAB 10MG","30.00","Select","Select",""],["","00116200116","CHLORHEX","SOL 0.0012","473.00","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":""}]}]}