{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"STORMEE   L CHITWOOD","gend":1,"add":"208 TROY AVENUE NE","city":"ROANOKE                       ","state":"VA","zip":"24012-3142","dob":"2002-03-06","age":"","mstatus":"","insh":6849563,"cliId":"","pno":5405203872,"cno":5403203872,"email":"","ename":"","eno":"","pphy":"GREENAWALD, MARK H","ppno":5405625700,"pcpadd":"1314 Peters Creek Rd Nw Ste 14,","pcpcity":"Roanoke                       ","pcpstate":"VA","pcpzip":240172500,"pcpcounty":"","pcpid":"","pcpname":"CARILION FAMILY MEDICINE ROANOKE SALEM","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"208 TROY AVENUE NE","madd2":"","madd3":"","mcity":"ROANOKE                       ","mstate":"VA","mzip":"24012-3142","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["O36.8130","O26.893","M54.9","Z3A.36","O47.03","O99.89","M25.9","O99.02","O09.623","E66.9","O99.344","D64.9","Z37.0","Z3A.37","O70.0","O99.214","F39","Z86.19","O80","Z30.430","B34.9","R05","R06.02","R51","Z20.828","R00.0","R06.2","Z86.32","F33.2","X78.9XXA","F15.20","D72.829","F41.9","S51.812A","F12.20","Z20.822","Z91.5","Z23","Z56.0","R58","R45.851","F32.9","W26.9XXA","F12.10","F15.10","F41.8","F33.1","N94.9","Z11.3","Z30.431"],"date":["2020-01-07","2020-01-07","2020-01-07","2020-01-07","2020-01-07","2020-01-07","2020-01-07","2020-01-12","2020-01-12","2020-01-12","2020-01-12","2020-01-12","2020-01-13","2020-01-13","2020-01-12","2020-01-12","2020-01-12","2020-01-12","2020-01-13","2020-03-04","2020-06-26","2020-06-26","2020-06-26","2020-06-26","2020-06-26","2020-06-26","2020-07-13","2020-07-13","2021-01-09","2021-01-05","2021-01-05","2021-01-06","2021-05-17","2021-01-05","2021-01-05","2021-01-05","2021-01-05","2021-01-05","2021-01-05","2021-01-05","2021-01-06","2021-01-05","2021-01-05","2021-01-09","2021-01-09","2021-01-06","2021-05-26","2021-08-26","2021-07-20","2021-08-26"],"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":[["","68682045570","METRONIDAZOL","GEL 0.75%VAG","70","Select","Select",""],["","80777027398","MODERNA","INJ COVID-19","0.5","Select","Select",""],["","70710113908","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","13668013601","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","50111056001","TRAZODONE","TAB 50MG","30","Select","Select",""],["","00093742698","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","69097014260","ALBUTEROL","AER HFA","6.7","Select","Select",""],["","00173071820","FLOVENT","AER 44MCG","10.6","Select","Select",""],["","67877057505","BENZONATATE","CAP 200MG","30","Select","Select",""],["","00555901658","SPRINTEC","TAB 28 DAY","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":""}]}]}