{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JAMEY B SCOTT","gend":0,"add":"140 RIVERVIEW ST  ","city":"ROCKY MOUNT ","state":"VA","zip":"24151-9998","dob":"1978-01-11","age":"","mstatus":"","insh":11008591,"cliId":"5R30HR5XM11","pno":2767328054,"cno":5402431457,"email":"","ename":"","eno":"","pphy":"MAXEY, JAMES","ppno":5404835168,"pcpadd":"195 Maple Ave","pcpcity":"Rocky Mount ","pcpstate":"VA","pcpzip":241511506,"pcpcounty":"","pcpid":"P0117414","pcpname":"CARILION FAMILY MEDICINE ROCKY MOUNT","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"","add3":"","madd1":"140 RIVERVIEW ST  ","madd2":"","madd3":"","mcity":"ROCKY MOUNT ","mstate":"VA","mzip":"24151-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["F14.10","F43.20","Z86.19","F31.63","D69.6","F19.10","M50.30","M47.812","M54.2","M54.12","M54.5","K74.60","F17.210","G89.29","M47.816","M51.36","M47.817","M51.26","M48.061","M51.27","M48.07","M43.17","M51.46","M51.47","F41.9","F31.9","B19.20","Z87.820","Z79.899","F19.20","F25.9","F14.20","F14.221","E87.0","F17.200","F51.3","J31.2","R45.850","R45.4","R07.9","I49.8","F19.959","K70.30","Z23","Z11.4","S06.306S","Z68.21","M48.02"],"date":["2021-03-23","2021-03-23","2020-02-17","2020-04-10","2020-02-17","2020-04-10","2020-03-04","2021-11-26","2021-11-26","2021-11-01","2020-10-02","2020-04-10","2020-04-10","2020-08-10","2020-10-02","2020-09-23","2020-10-02","2020-10-02","2020-10-02","2020-10-02","2020-10-02","2020-10-02","2020-10-02","2020-10-02","2019-10-04","2019-10-04","2019-10-10","2019-10-05","2019-10-04","2019-10-10","2019-12-18","2019-12-18","2019-10-05","2019-10-07","2019-10-05","2019-10-05","2019-10-05","2019-10-05","2019-10-05","2019-10-06","2019-10-06","2019-10-10","2019-11-14","2019-11-14","2019-11-14","2019-12-18","2019-12-18","2021-11-26"],"priorHcc":["","","","","","","",null,null,null,"","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",null]}},{"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":[["","43547030403","ARIPIPRAZOLE","TAB 10MG","","Select","Select",""],["","172392670","DIAZEPAM","TAB 5MG","","Select","Select",""],["","43547030403","ARIPIPRAZOLE ","TAB 10MG","30","Select","Select",""],["","172392670","DIAZEPAM ","TAB 5MG","1","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":""}]}]}