{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LEWIS LAMBERT JR","gend":0,"add":"806   RORER AVENUE NW                                       ","city":"ROANOKE                       ","state":"VA","zip":"24016-9998","dob":"1961-03-05","age":"","mstatus":"","insh":3227821,"cliId":"","pno":5405372642,"cno":"","email":"","ename":"","eno":"","pphy":"WHITNEY, WILLIAM P                                          ","ppno":5407720555,"pcpadd":"3369 Colonial Ave SW,","pcpcity":"Roanoke                       ","pcpstate":"VA","pcpzip":240183739,"pcpcounty":"","pcpid":"","pcpname":"CARILION FAMILY MEDICINE COLONIAL AVENUE","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"                                                            ","add3":"","madd1":"806 RORER AVENUE NW","madd2":"                                                            ","madd3":"","mcity":"ROANOKE                       ","mstate":"VA","mzip":"24016-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.1","H10.33","F11.20","B18.2","R53.83","Z11.3","F34.1","E11.9","R63.4","Z01.818","K59.09","K59.03","T40.2X5A","K70.30","F10.99","K76.6","I85.10","K74.60","R10.31","Z86.19","D17.79","R10.9","M89.9","K76.0","N28.1","N28.89","K59.00","I70.0","N40.0","N42.89","D17.1"],"date":["2019-01-07","2019-02-04","2021-12-26","2021-12-15","2021-04-19","2021-04-19","2021-04-20","2021-05-13","2021-05-21","2021-06-02","2021-06-10","2021-06-10","2021-06-10","2021-07-07","2021-09-14","2021-08-23","2021-08-23","2021-10-14","2021-11-02","2021-10-06","2021-10-29","2021-10-29","2021-11-04","2021-10-29","2021-10-29","2021-10-29","2021-10-29","2021-10-29","2021-10-29","2021-10-29","2021-11-04"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"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":[["","72626270101","SOFOS\/VELPAT","TAB 400-100","28","Select","Select",""],["","00832105515","BACLOFEN","TAB 20MG","270","Select","Select",""],["","00456120230","LINZESS","CAP 290MCG","30","Select","Select",""],["","59779030603","CVS","POW ","510","Select","Select",""],["","00121087316","LACTULOSE","SOL 10GM\/15","2,700.00","Select","Select",""],["","70436005801","BUPROPION","TAB 100MG SR","60","Select","Select",""],["","24208091055","ERYTHROMYCIN","OIN OP","3.5","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","29300012810","HYDROCHLOROT","TAB 25MG","30","Select","Select",""],["","10370010150","BUPROPN","TAB 150MG XL","30","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":""}]}]}