{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MISTIE J PARKS","gend":1,"add":"11   LONGVIEW DRIVE","city":"WYTHEVILLE","state":"VA","zip":24382,"dob":"1996-05-06","age":"","mstatus":"","insh":4185702,"cliId":"","pno":2769208074,"cno":"","email":"","ename":"","eno":"","pphy":"THOMAS, KARI","ppno":2769208074,"pcpadd":"1375 W RIDGE RD,","pcpcity":"WYTHEVILLE","pcpstate":"VA","pcpzip":24382,"pcpcounty":"","pcpid":"","pcpname":"CARILION CLINIC FAMILY MEDICIN","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"ROANOKE\/ALLEGHANY","aligned":"","ano":"","add2":"11   LONGVIEW DRIVE","add3":"","madd1":"11 LONGVIEW DRIVE","madd2":"APT B","madd3":"","mcity":"WYTHEVILLE                    ","mstate":"VA","mzip":"24382-4046","pcpfaxno":"(276) 228-7933","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E10.9","E78.2","E03.9","K21.9","K58.0","E55.9","Z30.09","Z71.3","Z71.82","Z68.33","R10.84","R19.7","Z68.30","Z01.419","F43.10","E11.9","R53.83","M25.531","T14.90XA","S69.91XA","B34.9","R11.2","R42","E08.65","Z20.822","Z79.3","Z79.4","Z79.899","E11.65","R53.82","G56.01","G47.10","O20.9","Z3A.01","O24.911","O99.891","N93.9","Z3A.00","Z32.01","Z11.3","Z32.00","O03.9","O03.4","R10.2"],"date":["2021-12-20","2021-03-09","2021-12-20","2021-03-09","2021-03-09","2021-12-20","2020-05-14","2020-05-14","2020-05-14","2020-02-13","2020-05-18","2020-08-10","2020-05-14","2021-03-09","2021-12-27","2021-08-05","2021-09-12","2021-08-20","2021-08-20","2021-08-20","2021-09-12","2021-09-12","2021-09-12","2021-09-12","2021-09-12","2021-09-12","2021-12-05","2021-09-12","2021-09-12","2021-12-20","2021-10-05","2021-10-05","2021-12-05","2021-12-05","2021-12-05","2021-12-05","2021-12-05","2021-12-05","2021-12-06","2021-12-06","2021-12-07","2021-12-13","2021-12-16","2021-12-16"],"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":[["","00378180010","LEVOTHYROXIN","TAB 25MCG","30","Select","Select",""],["","00169750111","NOVOLOG","INJ 100\/ML","20","Select","Select",""],["","00193658621","MICROLET","MIS LANCETS","100","Select","Select",""],["","69452015120","VITAMIN","CAP 50000UNT","4","Select","Select",""],["","00088222033","LANTUS","INJ 100\/ML","20","Select","Select",""],["","68462030929","NORGEST\/ETHI","TAB 0.25\/35","28","Select","Select",""],["","00093220401","METOCLOPRAM","TAB 5MG","20","Select","Select",""],["","00169368712","LEVEMIR","INJ ","10","Select","Select",""],["","00193731150","CONTOUR","TES NEXT","100","Select","Select",""],["","62175061846","PANTOPRAZOLE","TAB 20MG","30","Select","Select",""],["","00555901658","SPRINTEC","TAB 28 DAY","28","Select","Select",""],["","70377000612","ROSUVASTATIN","TAB 5MG","30","Select","Select",""],["","65862077685","MILI","TAB 0.25\/35","28","Select","Select",""],["","43386009019","GAVILYTE-G","SOL ","4,000.00","Select","Select",""],["","08290328431","INSULIN","MIS 0.3\/30G","100","Select","Select",""],["","70700011985","ESTARYLLA","TAB 0.25-35","28","Select","Select",""],["","55111068405","IBU","TAB 800MG","30","Select","Select",""],["","00591544305","PREDNISONE","TAB 20MG","6","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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","",""],[""],[""],[""],[""]],"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":""}]}]}