{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ALYSSA ADKINS","gend":1,"add":"1087 SAUNDERS HILL LN","city":"HUDDLESTON","state":"VA","zip":"24104-9998","dob":"2000-09-26","age":"","mstatus":"","insh":"2233818*01","cliId":"","pno":5407693100,"cno":5407693100,"email":"","ename":"","eno":"","pphy":"RHEA, RANDALL MD","ppno":5409836700,"pcpadd":"415 S POLLARD ST,","pcpcity":"VINTON","pcpstate":"VA","pcpzip":"24179-9998","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":5409826928,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.3","F41.1","F90.2","F31.81","F33.2","Z39.1","F43.10","O36.5930","Z3A.36","O36.8330","Z3A.38","Z3A.39","F33.1","F31.9","F31.12","O36.8930","F31.4","O36.5990","Z3A.00","Z37.0","F31.10","O76.","Z01.419","Z20.2","Z32.02","D62.","O48.0","O61.0","O62.1","Z3A.40","Z53.29","Z88.0","Z88.8","O82.","Z11.3","N93.9"],"date":["2021-05-23","2021-05-23","2022-04-03","2021-11-01","2022-11-02","2023-05-17","2023-09-04","2023-06-17","2023-05-25","2023-06-02","2023-06-06","2023-06-17","2021-09-20","2021-11-07","2022-09-13","2023-06-13","2022-10-01","2023-06-16","2023-06-16","2023-06-17","2022-09-23","2023-06-17","2022-07-20","2022-07-20","2022-07-20","2023-06-15","2023-06-15","2023-06-15","2023-06-15","2023-06-15","2023-06-15","2023-06-15","2023-06-15","2023-06-15","2022-07-20","2022-07-20"],"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":[["","69097083412","SERTRALINE","TAB 50MG","30","Select","Select",""],["","49483070110","FLUOXETINE","CAP 10MG","30","Select","Select",""],["","43547034050","RISPERIDONE","TAB 0.5MG","60","Select","Select",""],["","57664049983","MIRTAZAPINE","TAB 15MG","30","Select","Select",""],["","13668013601","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","10702001801","OXYCODONE HCL","5 MG","10","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":""}]}]}