{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ISIAH ATKINSON","gend":0,"add":"4319 GARST MILL ROAD ","city":"ROANOKE  ","state":"VA","zip":"24018-6222","dob":"1999-03-22","age":"","mstatus":"","insh":11015475,"cliId":"3CY6NF4DM57","pno":5408197116,"cno":5408197116,"email":"","ename":"","eno":"","pphy":"ARTHUR, CHRISTY L ","ppno":5407257800,"pcpadd":"3707 Brambleton Ave Ste 2","pcpcity":"Roanoke  ","pcpstate":"VA","pcpzip":240183658,"pcpcounty":"","pcpid":"P0117359","pcpname":"CARILION FAMILY MEDICINE BRAMBLETON","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"APARTMENT G ","add3":"","madd1":"4319 GARST MILL ROAD ","madd2":"APARTMENT G ","madd3":"","mcity":"ROANOKE  ","mstate":"VA","mzip":"24018-6222","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["Z00.00","E55.9","R32","Z13.220","J45.20","F84.0","F41.9","H57.89","H10.89","Z20.822","R50.9","M79.10","J02.9","R51.9"],"date":["2021-06-15","2021-06-15","2021-06-15","2021-06-15","2021-06-15","2021-06-15","2021-06-15","2021-06-23","2021-06-23","2021-09-29","2021-09-29","2021-09-29","2021-09-29","2021-09-29"],"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":[["","62332000131","FAMOTIDINE","TAB 20MG","","Select","Select",""],["","65862001205","SERTRALINE","TAB 50MG","","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","","Select","Select",""],["","65862001205","SERTRALINE ","TAB 50MG","30","Select","Select",""],["","62332000131","FAMOTIDINE ","TAB 20MG","30","Select","Select",""],["","60505082901","FLUTICASONE ","SPR 50MCG","16","Select","Select",""],["","45802005535","TRIAMCINOLON ","0.10%","15","Select","Select",""],["","00781185220","AMOX\/K ","875-125","20","Select","Select",""],["","65862042005","SMZ\/TMP ","800-160","20","Select","Select",""],["","61314062810","POLYMYXIN ","TRIMETHP","10","Select","Select",""],["","45802005535","TRIAMCINOLON","0.001","15","Select","Select",""],["","00781185220","AMOX\/K","875-125","20","Select","Select",""],["","61314062810","POLYMYXIN","TRIMETHP","10","Select","Select",""],["","65862042005","SMZ\/TMP","800-160","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":""}]}]}