{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ROBERT GARRETT","gend":0,"add":"402 4TH ST SE","city":"ROANOKE","state":"VA","zip":"24013-9998","dob":"1983-03-24","age":"","mstatus":"","insh":"2289742*01","cliId":"","pno":"765\/239-3893","cno":"765\/239-3893","email":"","ename":"","eno":"","pphy":"GADDAM, SHRAVAN KUMAR R MD","ppno":"540\/981-7653","pcpadd":"SUITE 302 2001 CRYSTAL SPRG AVE","pcpcity":"ROANOKE","pcpstate":"VA","pcpzip":24014,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"540\/981-7469","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R22.42","I82.492","F32.9","V62.84","F60.0","F99.","F33.3","F10.94","F10.20","F43.12","R11.2","R10.13","F10.920","R11.0","Z75.1","F31.4","F15.10","E78.1","R73.03","Z86.718","I10.","E78.5","F43.10","F31.9","D50.9","Z59.0","F33.2","F33.0","F60.9","F10.239","Z90.49","S82.892A","R74.0","M25.572","F10.10","I82.409","D64.9","S93.492A","I82.4Z2","V58.89","F10.99","F33.1","F15.20","R42.","R03.0"],"date":["2020-04-02","2020-04-03","2020-08-18","2020-08-15","2020-04-07","2020-04-07","2020-08-06","2020-04-20","2020-08-25","2020-04-20","2020-08-25","2020-07-30","2020-08-15","2020-08-15","2020-08-15","2020-08-25","2020-08-25","2020-08-25","2020-08-25","2020-08-25","2020-08-25","2020-08-25","2020-04-23","2020-04-07","2020-08-06","2020-04-10","2020-04-10","2020-04-23","2020-04-23","2020-08-06","2020-08-06","2020-08-06","2020-08-06","2020-08-18","2020-04-11","2020-04-11","2020-07-31","2020-04-09","2020-07-30","2020-04-22","2020-08-01","2020-08-15","2020-08-17","2020-08-15","2020-08-15"],"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":[]},{"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":{"comment":"","sub":[["","16729014901","QUETIAPINE","TAB 300MG","30","Select","Select",""],["","70954001910","PRAZOSIN","CAP 1MG","90","Select","Select",""],["","57896092110","ASPIRIN","TAB 325MG EC","30","Select","Select",""],["","51079073520","HALOPERIDOL","TAB 2MG","60","Select","Select",""],["","10370010250","BUPROPN","TAB 300MG XL","30","Select","Select",""],["","10702001250","HYDROXYZ","TAB 50MG","90","Select","Select",""],["","50111044101","TRAZODONE","TAB 150MG","30","Select","Select",""],["","68462013801","OXCARBAZEPIN","TAB 300MG","60","Select","Select",""],["","00904672051","ACETAMIN","TAB 500MG","30","Select","Select",""],["","23155019101","BUPROPION","TAB 75MG","30","Select","Select",""]]}},{"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":""}]}]}