{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ANTHONY D POINDEXTER","gend":0,"add":"1702 WESTVIEW AVE","city":"ROANOKE","state":"VA","zip":"24016-9998","dob":"1972-05-28","age":"","mstatus":"","insh":"2317519*01","cliId":"","pno":5402669200,"cno":5402669200,"email":"","ename":"","eno":"","pphy":"WIID, MICHAEL MD","ppno":5402245170,"pcpadd":"3 RIVERSIDE CIRCLE,","pcpcity":"ROANOKE","pcpstate":"VA","pcpzip":"24016-9998","pcpcounty":"","pcpid":"","pcpname":"Carilion Medical Center","plan":"OHP","program":"MEDICAID","lob":"M4","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":5409838229,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.65","I10.","F17.210","Z59.00","Z79.4","R53.83","R73.09","M54.9","R41.82","N17.9","NO DATA","F19.10","G93.41","E11.00","R50.9","F20.9","G47.00","R40.4","R40.2411","R47.81","R52.","R00.0","R53.81","R42.","R63.1","R35.8","R10.84","R11.2","Z03.818"],"date":["2022-03-09","2022-03-09","2022-03-09","2022-03-09","2022-03-09","2022-03-09","2022-03-09","2022-02-03","2022-02-07","2022-02-07","2022-02-07","2022-02-07","2022-02-07","2022-02-07","2022-02-04","2022-02-04","2022-02-04","2022-02-07","2022-02-07","2022-02-07","2022-02-07","2021-05-01","2021-05-01","2021-05-01","2021-05-01","2021-05-01","2022-03-09","2022-03-09","2022-02-03"],"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":[["","56151146001","TRUE METRIX TES GLUCOSE","","100","Select","Select",""],["","00002821501","HUMULIN R INJ U-","100","20","Select","Select",""],["","56151014260","TRUPLUS LANC MIS","28G","100","Select","Select",""],["","00002831501","HUMULIN N INJ U-","100","20","Select","Select",""],["","08290328438","INSULIN SYRG MIS","0.3\/31G","100","Select","Select",""],["","13107003105","MIRTAZAPINE TAB","15MG","30","Select","Select",""],["","68382007901","HALOPERIDOL TAB","5MG","30","Select","Select",""],["","00169368712","LEVEMIR INJ","","10","Select","Select",""],["","75826011410","PHENAZOPYRID TAB","100MG","9","Select","Select",""],["","00002831501","HUMULIN N","INJ U-100","20","Select","Select",""],["","00002821501","HUMULIN R","INJ U-100","20","Select","Select",""],["","08290328438","INSULIN SYRG","MIS 0.3\/31G","100","Select","Select",""],["","56151014260","TRUPLUS LANC","MIS 28G","100","Select","Select",""],["","13107003105","MIRTAZAPINE","TAB 15MG","30","Select","Select",""],["","68382007901","HALOPERIDOL","TAB 5MG","30","Select","Select",""],["","56151146001","TRUE METRIX","TES GLUCOSE","100","Select","Select",""],["","00169368712","LEVEMIR","INJ ","10","Select","Select",""],["","75826011410","PHENAZOPYRID","TAB 100MG","9","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":""}]}]}