{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TERRI   L PHIPPS","gend":1,"add":"4728 ABBS VALLEY ROAD","city":"BLUEFIELD","state":"VA","zip":"24605-9998","dob":"1977-03-09","age":"","mstatus":"","insh":"2059031*01","cliId":"","pno":"276\/945-3197","cno":"","email":"","ename":"","eno":"","pphy":"CROUSE, NONA G NP","ppno":"276\/964-6771","pcpadd":"ONE CLINIC DR","pcpcity":"RICHLANDS","pcpstate":"VA","pcpzip":24641,"pcpcounty":"","pcpid":"","pcpname":"CLINCH VALLEY PHYSICIANS ASSOCIATES LLC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"SOUTHWEST","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"276\/964-1370","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F11.20","F15.10","NO DATA","F13.10","Z79.899","F17.210","F33.2","F10.10","R53.83","E78.2","E53.8","K21.9","G25.81","M25.50","F41.8","J01.00","F12.10","R74.8","R06.02","R06.2","E78.5","E55.9","Z23.","F19.21","F31.60","F41.1","F34.1","F11.10","Z00.00","Z13.1","Z13.220","R05.","H81.10","R11.0","R63.4","H04.123","D31.32"],"date":["2021-12-17","2019-11-14","2019-09-23","2019-06-27","2019-10-07","2019-08-05","2019-08-28","2019-10-07","2020-01-02","2019-02-20","2019-02-20","2020-01-08","2019-02-20","2019-02-20","2021-10-07","2019-02-20","2019-06-13","2021-10-07","2021-03-26","2021-03-26","2020-01-08","2020-01-08","2021-10-07","2020-01-08","2020-01-09","2019-11-21","2019-11-21","2019-07-15","2020-01-02","2020-01-02","2020-01-02","2020-01-02","2019-11-14","2019-11-14","2019-11-14","2020-11-03","2020-11-03"],"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":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"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":[]},{"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":""}]}]}