{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CRISHAWNA  N HARRIS","gend":1,"add":"846 MARSHALL ST SE","city":"ROANOKE","state":"VA","zip":"24015-9998","dob":"1977-08-31","age":"","mstatus":"","insh":"1269696*01","cliId":"","pno":4344269147,"cno":4344269147,"email":"","ename":"","eno":"","pphy":"DEPRET-GUILLAUME, SERGE MD","ppno":5402651607,"pcpadd":"4910 VALLEY VIEW BLVD","pcpcity":"ROANOKE","pcpstate":"VA","pcpzip":"24012-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":5403667353,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E66.01","Z68.43","I10.","E11.9","H04.123","F41.9","NO DATA","H00.012","F41.8"],"date":["2021-07-29","2021-07-29","2023-03-08","2023-03-08","2021-10-29","2023-03-08","2023-03-08","2023-04-05","2023-04-05"],"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":[["","61958120101","STRIBILD","150-200 MG","30","Select","Select",""],["","73796027104","BLOOD PRESS","KIT 3 SERIES","1","Select","Select",""],["","70377002911","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","80681009900","FOLIC ACID","TAB 400MCG","30","Select","Select",""],["","70010049110","METFORMIN","TAB 500MG ER","120","Select","Select",""],["","58487003230","COENZYME Q10","TAB 50MG","30","Select","Select",""],["","53885027210","ONETOUCH","TES VERIO","100","Select","Select",""],["","69097083412","SERTRALINE","TAB 50MG","30","Select","Select",""],["","00093720298","PRAVASTATIN","TAB 40MG","30","Select","Select",""],["","68180097903","LISINOPRIL","40 MG","90","Select","Select",""],["","68382003516","VENLAFAXINE","CAP 75MG ER","30","Select","Select",""],["","70010049110","METFORMIN HCL ER","500 MG","60","Select","Select",""],["","16571020106","DICLOFENAC SODIUM","75 MG","14","Select","Select",""],["","69097015907","MELOXICAM","15 MG","30","Select","Select",""],["","10702001801","OXYCODONE HCL","5 MG","3","Select","Select",""],["","00591352530","LIDOCAINE","5 %","30","Select","Select",""],["","60505025203","TIZANIDINE HCL","4 MG","20","Select","Select",""],["","69097083412","SERTRALINE HCL","50 MG","30","Select","Select",""],["","00093720298","PRAVASTATIN SODIUM","40 MG","90","Select","Select",""],["","24208091055","ERYTHROMYCIN","5 MG\/GRAM","3.5","Select","Select",""],["","76385012350","METHOCARBAMOL","500 MG","30","Select","Select",""],["","53885027210","ONETOUCH VERIO TEST STRIP","","100","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":""}]}]}