{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KIA CARTER","gend":1,"add":"1015   MOREHEAD AVENUE SE","city":"ROANOKE","state":"VA","zip":24013,"dob":"1986-03-19","age":"","mstatus":"","insh":6808218,"cliId":"","pno":5406826384,"cno":"","email":"","ename":"","eno":"","pphy":"BEACH, BRIANA MARY","ppno":5406826384,"pcpadd":"4035 ELECTRIC RD ,STE A","pcpcity":"ROANOKE","pcpstate":"VA","pcpzip":24018,"pcpcounty":"","pcpid":"","pcpname":"VELOCITY CARE ROANOKE","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"ROANOKE\/ALLEGHANY","aligned":"","ano":"","add2":"1015   MOREHEAD AVENUE SE","add3":"","madd1":"1015 MOREHEAD AVENUE SE","madd2":"APARTMENT B","madd3":"","mcity":"ROANOKE","mstate":"VA","mzip":"24013-2801","pcpfaxno":"(540) 562-4278","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["O35.0XX0","O09.212","O10.912","O34.219","Z3A.21","O99.212","F33.1","O24.111","O34.12","D25.9","Z3A.25","O36.8320","O09.892","O10.012","O99.412","E66.9","O24.312","E11.9","D64.9","I44.0","O34.211","O99.342","F41.0","F32.9","K21.9","O99.012","O36.8930","O09.92","O24.913","O10.913","O99.213","Z3A.28","O24.112","Z3A.27","O16.3","O26.893","R04.0","O24.419","Z3A.30","Z79.82","Z39.1","Z34.82","Z34.83","O10.013","T14.90XA","Z79.4","Z79.899","O99.013","O99.343","Z88.1","O24.313","O10.919","Z33.1","I10","O24.113","O28.8","Z3A.31","N85.8","F41.9","O34.13","Z3A.32","Z34.90","O34.10","Z3A.36","O09.93","R94.31","O10.92","O99.02","O24.429","Z37.0","O24.414","Z3A.37","O24.12","E11.65","O10.02","O99.42","O99.214","O69.81X0","O76","O80","O10.03","O24.13","Z86.59","O11.5","O10.93","O24.33","O99.43","D50.9","I16.0","O99.345","O14.15","O14.90","Z68.39","F41.1","R32","E66.01","D50.1","E78.5","N89.8","B37.3","N76.0","Z11.3","B96.89"],"date":["2020-02-14","2020-02-14","2020-03-13","2020-06-08","2020-02-14","2020-03-13","2020-07-29","2020-03-27","2020-03-13","2020-05-28","2020-03-15","2020-03-13","2020-03-13","2020-03-13","2020-03-13","2020-06-05","2020-03-13","2021-11-17","2020-06-05","2020-06-08","2020-06-06","2020-03-13","2020-03-13","2020-06-08","2020-04-16","2020-03-13","2020-03-15","2020-03-30","2020-05-28","2020-05-28","2020-05-28","2020-04-02","2020-04-06","2020-04-06","2020-04-19","2020-04-27","2020-04-24","2020-04-16","2020-04-22","2020-04-16","2020-04-16","2020-04-16","2020-04-16","2020-06-06","2020-04-18","2020-06-08","2020-04-27","2020-04-19","2020-04-27","2020-04-19","2020-04-19","2020-06-03","2020-04-23","2021-11-17","2020-06-06","2020-04-21","2020-04-27","2020-04-27","2020-06-08","2020-04-30","2020-04-30","2020-06-01","2020-05-28","2020-05-28","2020-06-01","2020-06-04","2020-06-05","2020-06-05","2020-06-05","2020-06-06","2020-06-05","2020-06-06","2020-06-06","2020-06-05","2020-06-05","2020-06-05","2020-06-05","2020-06-05","2020-06-05","2020-06-06","2020-06-14","2020-06-14","2020-06-14","2020-06-14","2020-06-08","2020-06-08","2020-06-08","2020-06-08","2020-06-12","2020-06-08","2020-06-09","2020-06-12","2020-06-12","2020-06-18","2020-06-26","2021-05-18","2021-11-17","2021-11-17","2021-12-03","2021-12-03","2021-12-03","2021-12-03","2021-12-03"],"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":[["","00193731221","CONTOUR","00193731221 CONTOUR ","200","Select","Select",""],["","68180072103","AMLODIPINE","68180072103 AMLODIPINE ","30","Select","Select",""],["","69097083512","SERTRALINE","69097083512 SERTRALINE ","30","Select","Select",""],["","49884012401","LABETALOL","49884012401 LABETALOL ","180","Select","Select",""],["","67877032005","IBUPROFEN","TAB 600MG","30","Select","Select",""],["","00904671980","ACETAMINOPHEN","TA B 325","30","Select","Select",""],["","68462030529","NORETHINDRON","TAB 0.35MG","28","Select","Select",""],["","00002831501","HUMULIN","00002831501 HUMULIN ","10","Select","Select",""],["","23155000810","HYDROCHLOROT","23155000810 HYDROCHLOROT ","30","Select","Select",""],["","00193654621","BAYER","MIS LANCETS","200","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","8","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","60","Select","Select",""],["","38396030576","CVS","MIS 30G","100.00","Select","Select",""],["","00536250676","SALINE","SPR 0.0065","44","Select","Select",""],["","41100081123","AFRIN","SPR 0.0005","15","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","10","Select","Select",""],["","08290324912","INSULIN","MIS 1ML\/31G","120","Select","Select",""],["","70710113908","FLUCONAZOLE","70710113908 FLUCONAZOLE ","2","Select","Select",""],["","59762500901","CLINDAMYCIN","59762500901 CLINDAMYCIN ","40","Select","Select",""],["","45802048678","DOCUSATE","CAP 100MG","60","Select","Select",""],["","00536100901","FERROUS","TAB 325MG","60","Select","Select",""],["","65162036111","FOLIC","TAB 1MG","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":{"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":""}]}]}