{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"APRIL D REVELS","gend":1,"add":"1152 MARIGOLD DR","city":"GOODVIEW","state":"VA","zip":"24095-9998","dob":"1988-10-16","age":"","mstatus":"","insh":"2184577*01","cliId":"","pno":5408906278,"cno":5408906278,"email":"","ename":"","eno":"","pphy":"COUTURE, STEPHEN MD","ppno":5402832570,"pcpadd":"5304 INDIAN GRAVE RD,","pcpcity":"ROANOKE","pcpstate":"VA","pcpzip":"24018-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":5407254554,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["U07.1","NO DATA","A41.9","R50.9","F19.10","Z72.0","R00.0","R94.31","R07.9","I38.","F15.10","R21.","I07.9","A41.01","B18.2","I33.0","I76.","I26.90","B95.61","R78.81","B19.20","R22.31","D53.9","K08.89","I07.1","F11.20","M54.9","R40.20","R06.89","R07.81","R10.9","A49.01","J18.9","E87.6","B33.21","K52.9","Z09.","K59.03","R10.31","D72.820","K59.00","N93.9","R39.198","E87.1","F15.20","K50.112","K56.7","F11.21","Z86.16","Z91.19","F91.9","Z91.14","F17.210","Z88.1","R47.81","E87.8","R60.0","L27.1","T36.1X5A","R51.9","G47.00","R45.6","T40.1X1A","F11.10","Z65.1","Z87.891","T50.905A","L27.0","M25.571","M25.572","R93.5","F19.20","R52.","L71.0","E87.2","E22.2","E83.39","E83.42","E03.9","E86.0","F11.23","G43.909","Z79.899","T40.2X1A","J02.0","Z20.822","J02.9","Z20.818","F17.200","R10.30","K50.10","J34.89","R42.","R06.02","R07.89","R05.","B95.62","R65.10","K35.80","R41.0","J06.9","R05.9","N73.9","F05.","F15.23","K50.90","Z86.19","D72.829","Z28.310","I05.8","A41.89","Z66.","E44.1","F11.90","F15.90","I49.3","M43.6","R65.20","D64.9","M79.89","R35.0","E55.9","M77.9","M25.522","M25.722"],"date":["2021-03-01","2022-10-24","2021-09-12","2021-01-25","2021-09-15","2021-10-01","2022-10-24","2021-01-28","2021-03-01","2021-03-01","2021-09-15","2021-02-10","2021-02-20","2021-02-10","2021-09-15","2021-03-29","2021-03-15","2021-03-15","2021-03-15","2021-03-15","2022-10-24","2021-03-15","2021-09-12","2021-03-15","2021-03-12","2021-10-21","2022-03-10","2022-03-10","2022-03-10","2022-10-27","2022-10-27","2021-02-03","2021-02-03","2021-09-15","2021-02-22","2021-03-29","2021-03-29","2021-03-29","2021-09-11","2021-09-11","2022-10-24","2021-09-11","2021-09-11","2022-10-24","2021-09-12","2021-09-12","2021-09-12","2021-09-15","2021-09-12","2021-09-15","2021-09-15","2021-09-12","2022-10-24","2021-09-12","2021-09-12","2021-02-01","2021-03-05","2021-02-10","2021-02-10","2023-04-26","2021-02-10","2021-03-01","2022-03-10","2022-03-10","2022-03-10","2022-03-10","2021-02-20","2021-02-20","2021-02-20","2021-02-20","2021-09-12","2021-09-12","2021-09-12","2023-04-25","2021-01-26","2021-01-28","2021-01-28","2021-01-28","2022-10-24","2021-01-28","2021-01-28","2022-10-24","2021-04-09","2022-03-10","2023-04-26","2023-04-26","2023-04-26","2023-04-26","2023-04-26","2021-09-13","2021-09-15","2022-10-24","2022-10-24","2022-10-24","2021-01-28","2021-01-28","2021-02-09","2021-09-15","2021-09-15","2021-09-15","2021-10-01","2021-10-01","2022-10-27","2022-10-24","2022-10-24","2022-10-24","2022-10-24","2022-10-24","2022-10-24","2022-10-25","2021-01-25","2021-01-25","2021-01-25","2021-01-25","2021-01-25","2021-01-25","2021-01-25","2021-01-25","2021-01-25","2021-02-04","2021-03-17","2021-03-17","2023-06-29","2023-06-29","2023-06-29"],"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":[["","00781261305","AMOXICILLIN CAP","500MG","21","Select","Select",""],["","23155065205","METRONIDAZOL TAB","500MG","26","Select","Select",""],["","69618004410","DOCUSATE SOD CAP","100MG","14","Select","Select",""],["","57896010410","ACETAMINOPHE TAB","325MG","56","Select","Select",""],["","00143980305","DOXYCYCL HYC CAP","100MG","26","Select","Select",""],["","00378064205","PREDNISONE","20 MG","7","Select","Select",""],["","66993096045","METRONIDAZOLE","0.75 %","45","Select","Select",""],["","00093310905","AMOXICILLIN","500 MG","14","Select","Select",""],["","00143980305","DOXYCYCL HYC","CAP 100MG","26","Select","Select",""],["","23155065205","METRONIDAZOL","TAB 500MG","26","Select","Select",""],["","69618004410","DOCUSATE SOD","CAP 100MG","14","Select","Select",""],["","57896010410","ACETAMINOPHE","TAB 325MG","56","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":""}]}]}