{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SEQUOIA THOMASON","gend":1,"add":"104 OAKLAND CT","city":"THAXTON","state":"VA","zip":"24174-9998","dob":"2004-08-20","age":"","mstatus":"","insh":"1541397*01","cliId":"","pno":5405814979,"cno":5405814979,"email":"","ename":"","eno":"","pphy":"LINICK, KELLI L MD","ppno":5409771436,"pcpadd":"37 LAYMANTOWN RD,","pcpcity":"TROUTVILLE","pcpstate":"VA","pcpzip":"24175-9998","pcpcounty":"","pcpid":"","pcpname":"Carilion Healthcare Corp","plan":"OHP","program":"MEDICAID","lob":"M4","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":5409774230,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R52.","R11.2","K51.318","R63.4","S06.0X0A","R53.83","R53.81","R11.0","NO DATA","R42.","R51.9","R00.2","Z72.820","R55.","H53.9","R07.89","Z79.899","R10.31","Z87.11"],"date":["2023-01-07","2023-01-07","2022-12-19","2021-07-15","2022-08-29","2022-08-29","2022-08-29","2022-10-16","2022-08-29","2022-08-29","2022-08-29","2021-02-20","2021-02-20","2021-02-20","2021-02-20","2022-04-11","2022-08-29","2022-10-16","2022-10-16"],"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":[["","60219107601","AZATHIOPRINE TAB","50MG","60","Select","Select",""],["","00555906458","KELNOR TAB","1\/35","28","Select","Select",""],["","59746000103","METHYLPRED TAB","4MG","21","Select","Select",""],["","00378001401","METHOTREXATE TAB","2.5MG","40","Select","Select",""],["","69315012710","FOLIC ACID TAB","1000MCG","30","Select","Select",""],["","68382071119","MESALAMINE TAB","1.2GM","60","Select","Select",""],["","68382071119","MESALAMINE","1.2 G","60","Select","Select",""],["","60219107601","AZATHIOPRINE","50 MG","60","Select","Select",""],["","68462015713","ONDANSETRON ODT","4 MG","20","Select","Select",""],["","00555906458","KELNOR","TAB 12785","28","Select","Select",""],["","00378001401","METHOTREXATE","TAB 2.5MG","40","Select","Select",""],["","69315012710","FOLIC ACID","TAB 1000MCG","30","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","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":""}]}]}