{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MORGAN   T ALLMAN","gend":1,"add":"307  E AUGUSTA AVENUE                                       ","city":"VINTON                        ","state":"VA","zip":"24179-3410","dob":"1997-02-28","age":"","mstatus":"","insh":4169579,"cliId":"","pno":5403303681,"cno":"","email":"","ename":"","eno":"","pphy":"HARRIS, MARCIA A                                            ","ppno":5409858465,"pcpadd":"434 PEPPER FERRYS ROAD,","pcpcity":"CHRISTIANSBURG                ","pcpstate":"VA","pcpzip":240735780,"pcpcounty":"","pcpid":"","pcpname":"CARILION FAMILY MEDICINE PARKWAY PHYSICIANS VINTON","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"APT A8                                                      ","add3":"","madd1":"307 E AUGUSTA AVENUE","madd2":"APT A8","madd3":"","mcity":"VINTON                        ","mstate":"VA","mzip":"24179-3410","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z39.1","Z34.82","Z34.83","Z20.2","Z36.89","Z3A.32","Z36.85","Z3A.36","O36.8130","Z3A.38","O42.12","O99.52","O99.824","O77.0","O76","O69.81X0","J45.20","Z37.0","Z3A.39","Z87.891","O42.90","O42.113","F39","R68.89","F41.1","F41.0","Z87.898","F12.20","F15.21","R47.81","R45.89","T50.902A","T42.6X2A","R45.0","Y92.9","T43.592A","T42.4X2A","T51.0X2A","R45.851","F15.20"],"date":["2019-03-11","2019-03-11","2019-03-11","2019-03-14","2019-03-28","2019-03-28","2019-04-25","2019-04-25","2019-05-09","2019-05-09","2019-05-15","2019-05-15","2019-05-15","2019-05-15","2019-05-15","2019-05-15","2019-05-15","2019-05-16","2019-05-16","2021-12-11","2019-05-15","2019-05-16","2021-12-11","2021-11-08","2021-11-08","2021-11-08","2021-11-08","2021-11-08","2021-11-08","2021-12-11","2021-12-11","2021-12-11","2021-12-11","2021-12-11","2021-12-11","2021-12-11","2021-12-11","2021-12-11","2021-12-11","2021-12-11"],"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":[["","70436005801","BUPROPION","TAB 100MG SR","30","Select","Select",""],["","69097094312","GABAPENTIN","CAP 300MG","90","Select","Select",""],["","65862048901","QUETIAPINE","TAB 25MG","30","Select","Select",""],["","00186037020","SYMBICORT","AER 160-4.5","10.2","Select","Select",""],["","00093317431","ALBUTEROL","FAT E","8.5","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":""}]}]}