{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" ETTENAEJSNIKDA D","gend":1,"add":"               749 XOB OP                         ","city":"MEADOWS OF DAN           ","state":"VA","zip":"24120-9998","dob":"1957-08-27","age":"","mstatus":"","insh":"00110485","cliId":"","pno":"6204501867","cno":2769526452,"email":"","ename":"","eno":"","pphy":"HULLETT, JOEL","ppno":5407455700,"pcpadd":"249 FRANKLIN PIKE SE,","pcpcity":"Floyd","pcpstate":"VA","pcpzip":240912893,"pcpcounty":"","pcpid":"","pcpname":"CARILION CLINIC PRIMARY CARE ASSOCIATES FLOYD","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"PO BOX 947                                        ","madd2":"                                                  ","madd3":"","mcity":"MEADOWS OF DAN           ","mstate":"VA","mzip":"24120-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.42","E11.59","I10","R53.83","M51.36","F17.200","E78.2","T23.192A","E88.81","E11.9","R79.89","L72.0","Z13.820","M85.852","M54.6","R73.9","R21","R30.0","N39.0","R35.0","B37.9","R31.9","I80.9","M79.661","I83.91","R60.0","I15.2","R07.81","L98.9","M54.42","M54.5","M62.81","R26.2","L30.9","B37.2","Z23","L72.9","M79.604","I83.811","G47.9","H40.1131","R06.2","R25.1","M47.814","M47.816","M41.84","Z00.00","Z96.1","H16.223","B02.9","R22.1","F41.9","K75.2","Z13.31","I80.291","J98.4","Z78.0","I80.01","Z12.31","Z91.89","G25.81"," "],"date":["2022-10-13","2022-10-13","2021-07-09","2020-02-11","2020-03-02","2021-10-13","2022-10-13","2020-02-11","2019-04-16","2019-04-16","2019-04-16","2019-05-20","2019-08-21","2019-08-21","2020-01-02","2019-01-07","2019-01-07","2021-09-13","2021-08-16","2021-08-16","2021-08-16","2021-08-16","2022-07-26","2022-07-26","2022-07-26","2022-07-26","2022-10-13","2020-01-15","2019-05-23","2020-03-02","2020-03-02","2020-03-02","2020-03-02","2021-03-08","2021-03-08","2022-10-13","2019-06-11","2022-07-25","2022-06-15","2019-05-20","2021-06-17","2020-07-22","2021-10-13","2020-01-02","2020-01-02","2020-01-02","2019-04-16","2021-06-17","2021-06-17","2021-07-29","2019-05-23","2022-10-13","2019-05-01","2019-05-01","2022-07-26","2019-08-07","2019-08-07","2022-07-28","2022-10-13","2022-10-13","2022-10-13","2022-10-13"],"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":[["","43598075201","BUPROPION","TAB 150MG SR","60","Select","Select",""],["","80777028299","MODERNA","INJ BA4\/BA5","0.5","Select","Select",""],["","60505258009","ATORVASTATIN","TAB 40MG","90","Select","Select",""],["","69238131109","PREGABALIN","CAP 50MG","90","Select","Select",""],["","60505014201","GLIPIZIDE","TAB 10MG","60","Select","Select",""],["","00597015230","JARDIANCE","TAB 10MG","90","Select","Select",""],["","43547026810","ROPINIROLE","TAB 0.25MG","30","Select","Select",""],["","60505025103","TIZANIDINE","TAB 2MG","30","Select","Select",""],["","70710113908","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","69315030805","CIPROFLOXACN","SOL 0.3% OP","5","Select","Select",""],["","50111064701","FLUOXETINE","CAP 10MG","30","Select","Select",""],["","47781030801","NITROFUR","CAP 100MG","7","Select","Select",""],["","60432053716","NYSTATIN","SUS 100000","300","Select","Select",""],["","67877025130","TRIAMCINOLON","CRE 0.001","30","Select","Select",""],["","33332032001","AFLURIA","INJ 2020-21","0.5","Select","Select",""],["","64380074705","PRAMIPEXOLE","TAB 0.25MG","30","Select","Select",""],["","57599000101","FREESTYLE    KIT SENSOR","KIT SENSOR","1","Select","Select",""],["","57599000200","FREESTYLE    MIS READER","MIS READER","1","Select","Select",""],["","33342005407","PIOGLITAZONE","TAB 15MG","30","Select","Select",""],["","23155022801","ACYCLOVIR","TAB 800MG","35","Select","Select",""],["","00071101268","LYRICA","CAP 25MG","90","Select","Select",""],["","68462024805","RANITIDINE","TAB 150MG","60","Select","Select",""],["","60758018805","GENTAMICIN","SOL 0.3% OP","15","Select","Select",""],["","00093221001","SUCRALFATE","TAB 1GM","90","Select","Select",""],["","24208044335","LOTEMAX","OIN 0.005","3.5","Select","Select",""],["","53885065701","ONETOUCH","KIT VERIO","1","Select","Select",""],["","50111043301","TRAZODONE","TAB 50MG","30","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":["",""],"sub":{"indx":[["","",""],[""],[""],[""],[""]],"comment":[["","",""],[""],[""],[""],[""]],"sub":[]}}},{"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":""}]}]}