{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TESHA   C JOYCE","gend":1,"add":"1114 DALE AVENUE","city":"ROANOKE","state":"VA","zip":"24013-1520","dob":"1983-06-25","age":"","mstatus":"","insh":6810069,"cliId":"","pno":5405663515,"cno":5405663515,"email":"","ename":"","eno":"","pphy":"MERTEN, JOHN R","ppno":"               ","pcpadd":"1314 Peters Creek Rd Nw Ste 14, ","pcpcity":"Roanoke","pcpstate":"VA","pcpzip":240172500,"pcpcounty":"","pcpid":"","pcpname":"","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":5403948227,"add2":"APT A","add3":"","madd1":"1114 DALE AVENUE","madd2":"APT A","madd3":"","mcity":"ROANOKE","mstate":"VA","mzip":"24013-1520","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["S92.322A","M79.672","W18.30XA","S92.332A","S92.342A","W18.39XA","F31.5","S92.325D","S92.335D","S92.345D","F25.9","S92.325A","S92.335A","S92.345A","M21.612","S59.811A","N92.0","Z01.419","N76.0","N94.6","F99","B96.89"],"date":["2019-11-01","2019-11-01","2019-11-01","2019-11-01","2019-11-01","2019-11-01","2021-01-20","2020-01-02","2020-01-02","2020-01-02","2020-12-30","2019-11-08","2019-11-08","2019-11-08","2019-11-08","2019-11-01","2020-10-14","2020-10-14","2020-10-14","2020-10-14","2020-10-14","2020-10-14"],"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":[]},{"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":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","50111033402","METRONIDAZOL ","TAB 500MG","14","Select","Select",""],["","00406012305","HYDROCO\/APAP ","TAB 5-325MG","30","Select","Select",""],["","65862094088","AUROVELA ","TAB 44216","28","Select","Select",""],["","00115180301","HYDROXYZ ","CAP 25MG","30","Select","Select",""],["","63402030430","LATUDA ","TAB 40MG","30","Select","Select",""],["","43547034150","RISPERIDONE ","TAB 1MG","30","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","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["No","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":""}]}]}