{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"   HANNAHNOTYAH L","gend":1,"add":"LLEWDEB 82142 TPA TS ","city":"INDEPENDENCE","state":"VA","zip":"24348-9998","dob":"2001-02-28","age":"","mstatus":"","insh":"4589110*65","cliId":"","pno":"22\/6729487-3","cno":"","email":"","ename":"","eno":"","pphy":"SULLIVAN, CHRISTOPHER M MD","ppno":"540\/389-5174","pcpadd":"150 SPARTAN DR","pcpcity":"SALEM","pcpstate":"VA","pcpzip":24153,"pcpcounty":"","pcpid":"","pcpname":"Carilion Clinic Family Medicine Southeast","plan":"OHP","program":"MEDICAID","lob":"M4","region":"SOUTHWEST","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R55.","R11.2","D68.0","O99.12","O99.344","Z3A.40","Z37.0","O69.81X0","NO DATA","Z20.822","O99.334","F17.200","F41.8","R56.9","F17.210","Z3A.12","R42.","I95.1","O28.3","Z82.79","Z31.5","V23.5","O35.9XX0","O99.332","Z3A.19","M54.89","O99.113","O26.893","Z3A.39","Z82.49","N92.6","E66.9","R23.8","F41.9","R04.0","A08.4","R19.7","S49.91XA","O36.8330","Z3A.36","Z79.899","O35.8XX0","O99.112","Z39.1","Z34.82","Z34.83","O23.41","E86.0","Z3A.08","Z3A.20","V89.2XXA","Z34.90","O36.8130","R41.3","G43.119","H51.11","F32.9","O70.1","O99.824","N93.9","Z63.79","O80.","G40.89","R58.","R53.81","Z76.89","R79.9","V23.89","Z39.2","O61.0","O99.820","O36.63X0","Z83.3","Z84.89","O9A.213","S40.021A","Z3A.29","V49.50XA"],"date":["2021-02-28","2021-02-28","2021-10-13","2021-10-12","2021-10-12","2021-10-12","2021-10-12","2021-10-12","2021-10-12","2021-10-12","2021-10-12","2021-10-12","2021-05-12","2021-10-06","2021-05-12","2021-03-26","2021-03-26","2021-03-26","2021-06-09","2021-06-09","2021-05-20","2021-06-09","2021-06-09","2021-05-20","2021-05-20","2021-06-28","2021-10-06","2021-10-06","2021-10-06","2021-10-06","2021-02-08","2021-05-12","2021-02-08","2021-02-08","2021-02-08","2020-10-06","2020-10-06","2021-07-20","2021-09-15","2021-09-15","2021-09-15","2021-05-20","2021-05-20","2021-08-18","2021-08-18","2021-08-18","2021-02-28","2021-02-28","2021-02-28","2021-05-12","2021-07-21","2021-09-15","2021-09-15","2019-12-17","2019-12-17","2019-12-18","2019-05-22","2019-02-27","2019-02-27","2019-04-11","2019-05-22","2019-02-28","2019-03-28","2019-04-11","2019-04-11","2019-05-22","2019-02-22","2019-02-22","2019-03-20","2019-02-18","2019-02-18","2019-02-18","2019-02-18","2019-02-18","2021-07-21","2021-07-21","2021-07-21","2021-07-21"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"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":[["","16729021616","SERTRALINE","TAB 50MG","30","Select","Select",""],["","50111078810","AZITHROMYCIN","TAB 500MG","2","Select","Select",""],["","12843003520","STOOL","CAP 100MG","30","Select","Select",""],["","61783000012","FC2","MIS CONDOM","24","Select","Select",""],["","70700016406","LEVONORGESTR","TAB 1.5MG","8","Select","Select",""],["","00378727253","NORETHINDRON","TAB 0.35MG","28","Select","Select",""],["","00093916301","VENLAFAXINE","TAB 100MG","30","Select","Select",""],["","00555032302","HYDROXYZ","CAP 25MG","30","Select","Select",""],["","68645056259","IBUPROFEN","TAB 600MG","30","Select","Select",""],["","52544089228","JOLIVETTE","TAB 0.35MG","28","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":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"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":""}]}]}