{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"S L YCNANYRUBSWERH","gend":1,"add":"TSUCOL 493DR EGDIR ","city":"WOODLAWN","state":"VA","zip":"24381-9998","dob":"1954-08-01","age":"","mstatus":"","insh":"00110249","cliId":"","pno":"3267287417","cno":"","email":"","ename":"","eno":"","pphy":"PRYOR, ROBERT E","ppno":2762365181,"pcpadd":"199 Hospital Dr, Ste 5","pcpcity":"Galax","pcpstate":"VA","pcpzip":243332453,"pcpcounty":"","pcpid":"","pcpname":"CARILION MEDICAL ASSOCIATES GALAX FAMILY","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"SOUTHWEST","aligned":"Y","ano":"","add2":"","add3":"","madd1":"394 LOCUST RIDGE RD","madd2":"","madd3":"","mcity":"WOODLAWN","mstate":"VA","mzip":"24381-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R07.2","K22.8","M43.22","R22.1","R06.02","R07.9","J44.9","I25.10","I10","F32.9","K21.9","M19.90","M79.7","F41.9","Z86.73","Z88.8","Z79.51","Z79.82","L03.119","L97.911","Z96.651","K22.9","R13.10","M50.30","M96.1","Z01.810","Z01.812","Z20.822","C15.3","K31.9","I12.9","N18.30","G89.29","M25.512","M25.511","B18.2","G60.9","M81.0","F33.42","K44.9","F17.210","N18.9","K29.50","M05.89","Z79.899","G89.4","F31.81","Z72.0","D00.1","Z51.0","C15.9","Z87.891","Z01.818","Z86.19","M06.9","Z51.11","H65.91","F17.200","R53.81","R73.02","I77.9","J41.0","M89.49","L03.90","H66.91","J40","R63.4","I95.9","R60.0","Z47.89","Z85.01","R10.9","S01.111A","W19.XXXA","Y93.89","Y92.009","Y99.9","S81.012A","R51","B19.9","Z79.891","S01.312A","W01.0XXA","S82.012A","R53.83","Z00.00","R11.0","J41.1","J98.4","Z12.31","Z80.3","S81.012D","M25.562","S01.111D","W19.XXXD","M25.462","S81.012S","S01.111S","S81.011A","Z96.652","Z08","Z92.21","Z92.3","H35.63","H25.13","H31.093","H43.393","R91.8","Z23","Z91.09","H61.23","Z28.3","F33.9","J06.9","J01.90","N89.8","R03.0","Z20.828","M25.561","G47.00","I63.9","Z99.89","M25.461","M25.861","R94.31","M17.11","M89.561","M66.0","M79.604","M79.605","M79.89","R09.81","R09.82","D16.31","M21.061","G89.18","Z47.1","N18.3","Z51.89","Z74.1"],"date":["2021-02-21","2021-03-08","2021-02-21","2021-02-21","2021-02-22","2021-02-21","2022-02-07","2021-02-21","2022-02-07","2021-04-16","2022-02-07","2021-02-21","2021-02-21","2021-04-16","2021-04-16","2021-02-21","2021-02-21","2021-02-21","2021-06-15","2020-02-24","2020-06-09","2021-04-16","2021-02-24","2021-04-08","2021-04-08","2021-03-03","2021-03-03","2021-03-03","2022-02-09","2021-03-08","2021-03-08","2021-03-08","2021-03-08","2021-03-08","2021-03-08","2022-02-07","2021-03-08","2021-04-16","2022-02-07","2021-04-16","2021-03-08","2021-03-08","2021-03-08","2021-04-08","2021-04-16","2021-04-08","2020-06-29","2021-03-19","2021-04-16","2021-05-27","2021-10-12","2021-04-06","2021-04-12","2021-04-16","2021-04-16","2021-05-19","2020-05-02","2021-02-02","2020-05-18","2022-02-07","2022-02-07","2021-01-07","2021-01-07","2020-11-20","2020-05-26","2021-06-15","2021-06-15","2021-06-15","2021-06-15","2020-06-09","2021-06-15","2021-06-15","2020-07-04","2020-07-04","2020-07-04","2020-07-04","2020-07-04","2020-07-04","2020-07-04","2020-07-04","2020-07-04","2020-07-04","2020-07-04","2020-07-04","2021-07-08","2021-07-08","2021-07-08","2022-02-07","2021-07-13","2021-07-13","2021-07-13","2020-07-16","2020-07-16","2020-07-16","2020-07-16","2020-07-16","2020-07-16","2020-07-16","2020-07-20","2020-07-20","2021-10-06","2021-10-06","2021-10-06","2020-10-09","2020-10-09","2020-10-09","2020-10-09","2021-10-12","2022-02-07","2020-11-20","2020-11-23","2019-11-23","2019-12-05","2021-12-07","2021-12-07","2021-12-07","2021-12-07","2020-12-12","2020-02-13","2021-01-07","2021-02-02","2021-02-02","2020-02-03","2020-02-03","2020-02-03","2020-02-13","2020-02-03","2020-02-05","2020-02-05","2020-02-05","2020-02-05","2021-02-08","2021-02-08","2020-02-13","2020-02-13","2020-02-13","2020-02-18","2020-02-18","2020-02-18","2020-02-18"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"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":[["","27241009903","DULOXETINE","CAP 60MG","90","Select","Select",""],["","00173069600","ADVAIR","AER 250\/50","60","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8.5","Select","Select",""],["","68382080510","TRAZODONE","TAB 50MG","90","Select","Select",""],["","10702000801","OXYCODONE","TAB 15MG","150","Select","Select",""],["","59310057922","PROAIR","AER ","8.5","Select","Select",""],["","68462039710","OMEPRAZOLE","CAP 40MG","90","Select","Select",""],["","65862018830","ONDANSETRON","TAB 8MG","30","Select","Select",""],["","68462025601","ROPINIROLE","TAB 2MG","30","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","65862053750","LEVOFLOXACIN","TAB 500MG","10","Select","Select",""],["","52817033010","CYCLOBENZAPR","TAB 5MG","90","Select","Select",""],["","00054429731","FUROSEMIDE","TAB 20MG","180","Select","Select",""],["","68462012705","GABAPENTIN","TAB 800MG","45","Select","Select",""],["","47335030888","ZOLPIDEM","TAB 12.5MG","30","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","70710116801","ATENOL\/CHLOR","TAB 100-25MG","10","Select","Select",""],["","62332003731","LAMOTRIGINE","TAB 25MG","145","Select","Select",""],["","65862050320","AMOX\/K","TAB 875-125","20","Select","Select",""],["","00254101196","SUCRALFATE","SUS 1GM\/10ML","300","Select","Select",""],["","00406915076","FENTANYL","DIS 50MCG\/HR","10","Select","Select",""],["","43547040650","CLONAZEPAM","TAB 0.5MG","60","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","20","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","30","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","00093220401","METOCLOPRAM","TAB 5MG","54","Select","Select",""],["","51224002230","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","64380080707","IBUPROFEN","TAB 800MG","90","Select","Select",""],["","00000000000","LIDOCAINE","SOL 2% VISC","180","Select","Select",""],["","00378932132","WIXELA","AER 250\/50","60","Select","Select",""],["","00054418325","DEXAMETHASON","TAB 2MG","28","Select","Select",""],["","00143928501","AMOXICILLIN","TAB 875MG","20","Select","Select",""],["","57237000511","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","00143980305","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","59746011506","PROCHLORPER","TAB 10MG","30","Select","Select",""],["","57237005920","CEFUROXIME","TAB 500MG","20","Select","Select",""],["","00591505221","PREDNISONE","PAK 5MG","21","Select","Select",""],["","00069046956","CHANTIX","TAB 1MG","60","Select","Select",""],["","49281072010","FLUBLOK","INJ 2020-21","0.5","Select","Select",""],["","57237000730","MIRTAZAPINE","TAB 7.5MG","30","Select","Select",""],["","00054032756","FLUTIC\/SALME","AER 250\/50","60","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":["",""]}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"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":""}]}]}