{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MELISSA J LOHRMANN","gend":1,"add":"190  LARKIN BRANCH RD","city":"HENRY ","state":"VA","zip":"24102-9998","dob":"1980-08-23","age":"","mstatus":"","insh":11007286,"cliId":"3YM6WH6CA40","pno":5402381942,"cno":2762638754,"email":"","ename":"","eno":"","pphy":"BOHON, SONYA N ","ppno":5404844800,"pcpadd":"390 S Main St Ste 101","pcpcity":"Rocky Mount ","pcpstate":"VA","pcpzip":241511767,"pcpcounty":"","pcpid":"P0117675","pcpname":"CARILION MEDICAL ASSOCIATES ROCKY MOUNT","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"","add3":"","madd1":"75 BIRCH LEAF CIR ","madd2":"","madd3":"","mcity":"BASSETT  ","mstate":"VA","mzip":"24055-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["J22","F31.32","Z20.828","J01.90","K08.89","Z01.31","F11.20","Z79.899","Z51.81","J20.9","Z03.818","R05"],"date":["2020-03-13","2019-07-08","2020-12-09","2019-07-11","2019-07-11","2019-07-11","2019-09-03","2019-08-29","2019-08-29","2020-12-09","2020-12-09","2020-12-09"],"priorHcc":["","","","","","","","","","","",""]}},{"a":[]}]},{"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":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}}]},{"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":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","143980305","DOXYCYCL HYC","CAP 100MG","","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","","Select","Select",""],["","93317431","ALBUTEROL SUL","FAT E","","Select","Select",""],["","591544305","PREDNISONE","TAB 20MG","","Select","Select",""],["","65862001501","AMOXICILLIN","TAB 875MG","","Select","Select",""],["","12496120803","SUBOXONE","MIS 8-2MG","","Select","Select",""],["","50111064801","FLUOXETINE","CAP 20MG","","Select","Select",""],["","65862050320","AMOX\/K CLAV","TAB 875-125","","Select","Select",""],["","93317431","ALBUTEROL ","FAT E","8.5","Select","Select",""],["","68462019005","NAPROXEN ","TAB 500MG","30","Select","Select",""],["","591544305","PREDNISONE ","TAB 20MG","10","Select","Select",""],["","143980305","DOXYCYCL ","CAP 100MG","20","Select","Select",""],["","65862050320","AMOX\/K ","TAB 875-125","20","Select","Select",""],["","65862001501","AMOXICILLIN ","TAB 875MG","20","Select","Select",""],["","12496120803","SUBOXONE ","MIS 8-2MG","7","Select","Select",""],["","50111064801","FLUOXETINE ","20MG","30","Select","Select",""],["","00093317431","ALBUTEROL","E","8.5","Select","Select",""],["","00143980305","DOXYCYCL","100MG","20","Select","Select",""],["","65862050320","AMOX\/K","875-125","20","Select","Select",""]]}},{"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":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[[["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""]]]},{"t":"Mini-Cog","q":[{"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":""}]}]}