{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"W DLANORRUHTRA ","gend":0,"add":"OWEGDE 37EVIRD DO","city":"TROUTVILLE","state":"VA","zip":"24175-6403","dob":"1945-04-29","age":"","mstatus":"","insh":"00111902","cliId":"","pno":"0443469911","cno":"","email":"","ename":"","eno":"","pphy":"MISICKO, NANCY","ppno":5409660400,"pcpadd":"150 MARKET RIDGE LN,","pcpcity":"Daleville","pcpstate":"VA","pcpzip":240833258,"pcpcounty":"","pcpid":"","pcpname":"CARILION CLINIC FAMILY MEDICINE DALEVILLE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"73 EDGEWOOD DRIVE","madd2":"                                                  ","madd3":"","mcity":"TROUTVILLE","mstate":"VA","mzip":"24175-6403","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I70.0","R77.8","Z45.2","Z46.82","Z98.890","Z48.812","R91.8","I07.1","I51.89","E11.65","I10","R60.0","I08.1","Z03.89","I48.92","R06.02","Z98.61","I49.9","I49.8","I25.10","E11.9","Z85.828","Z79.01","Z79.82","Z79.84","R45.7","R53.81","R40.4","J84.10","E11.40","M62.81","R26.89","I35.0","D62","I48.20","N17.2","I21.4","Z95.1","E78.5","D69.6","M79.7","I50.20","E78.2","M48.061","M51.36","F41.1","B35.1","I48.91","N18.2","M25.512","G89.29","K21.9","I50.810","R00.2","R07.9","F41.9","K21.0","G47.00","M54.16","M54.17","M15.9","F41.0","M99.03","M54.42","M99.01","M50.322","M99.02","E78.49","K21.00","Z95.5","I25.2","E87.5","M79.10","Z79.899","R21","W57.XXXA","I08.0","I51.9","M47.896","M47.892","H25.13","M54.2","Z79.891","M62.830","Z23","I24.9","I25.84","R07.2","R07.89","Z88.8","Z79.02","R94.39","R94.31","I20.9","R06.09","R53.1","M79.606","I25.119","M19.90","E53.8","R00.1","R06.00","I11.0","I50.9","R09.02","R74.8","Y83.1","I49.01","I46.2","I13.0","T82.855A","I50.42","J98.11","N17.9","E87.1","Z20.822","E11.22","I08.3","I35.8","I50.30","N18.9","N28.9","Z01.810","I65.23","Z86.79","L53.9","R26.9","E13.621","L97.509","L97.512","R01.1","E11.21","M54.9"],"date":["2021-12-02","2021-12-17","2021-12-06","2021-12-02","2021-12-09","2022-02-01","2021-12-17","2021-12-05","2021-12-05","2021-12-17","2022-05-02","2022-04-07","2021-12-10","2021-12-13","2019-12-14","2021-11-18","2019-12-14","2021-11-18","2021-12-02","2022-08-18","2022-08-04","2019-12-14","2022-01-20","2021-11-18","2021-11-18","2021-11-29","2021-12-17","2021-12-17","2022-05-19","2022-04-07","2022-04-15","2022-02-01","2022-08-18","2022-04-14","2022-04-14","2022-04-14","2022-02-01","2022-08-18","2022-05-19","2022-04-15","2022-02-01","2022-02-01","2022-05-02","2022-08-04","2019-12-20","2022-08-04","2022-06-29","2022-05-19","2021-12-20","2022-05-02","2022-05-02","2022-04-15","2022-05-19","2019-01-14","2021-11-29","2019-10-10","2019-01-14","2019-10-03","2019-01-14","2019-01-14","2019-01-14","2019-10-10","2021-04-22","2021-04-22","2021-04-22","2021-04-22","2021-04-22","2022-01-20","2022-01-20","2021-11-29","2020-02-13","2019-04-09","2019-04-10","2022-08-04","2019-04-30","2019-04-30","2022-08-18","2019-05-30","2019-07-04","2019-07-04","2022-07-12","2018-07-20","2018-07-20","2018-08-13","2019-09-20","2019-10-03","2019-10-03","2019-10-03","2021-11-29","2019-10-03","2021-11-18","2019-10-04","2022-05-19","2019-10-04","2020-10-08","2021-11-18","2020-10-08","2021-12-02","2019-10-10","2019-10-10","2021-11-18","2021-11-18","2021-11-18","2021-11-18","2021-11-29","2021-11-29","2021-11-29","2022-05-19","2021-11-29","2021-12-01","2021-11-30","2021-11-29","2021-11-29","2021-11-29","2021-11-29","2021-11-29","2021-11-29","2021-11-30","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2022-02-17","2022-04-14","2022-04-14","2022-05-02","2022-05-02","2022-06-29","2022-05-19","2022-04-07","2022-08-18"],"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":[["","24208091019","ERYTHROMYCIN","OIN OP","4","Select","Select",""],["","68645019059","METOPROL","TAB 50MG","60","Select","Select",""],["","67877022310","GABAPENTIN","CAP 300MG","180","Select","Select",""],["","68645054659","METFORMIN","TAB 1000MG","180","Select","Select",""],["","31722059690","FENOFIBRATE","TAB 145MG","90","Select","Select",""],["","00378004001","CLORAZ","TAB 7.5MG","60","Select","Select",""],["","00193737701","CONTOUR","KIT NEXT","1","Select","Select",""],["","00093005405","BUSPIRONE","TAB 10MG","270","Select","Select",""],["","68462063945","NITROGLYCERN","SUB 0.4MG","25","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","90","Select","Select",""],["","43547040111","FUROSEMIDE","TAB 20MG","90","Select","Select",""],["","00186504054","NEXIUM","CAP 40MG","90","Select","Select",""],["","69238115403","EZETIMIBE","TAB 10MG","90","Select","Select",""],["","68462043318","COLESEVELAM","TAB 625MG","540","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","68645055254","LISINOPRIL","TAB 10MG","180","Select","Select",""],["","68645059090","CLOPIDOGREL","TAB 75MG","90","Select","Select",""],["","00193658621","MICROLET","MIS LANCETS","100","Select","Select",""],["","53885004601","ONETOUCH","KIT ULTRA 2","1","Select","Select",""],["","00143973805","PREDNISONE","TAB 20MG","5","Select","Select",""],["","00193654621","BAYER","MIS LANCETS","100","Select","Select",""],["","69238148901","BUMETANIDE","TAB 0.5MG","30.00","Select","Select",""],["","31722066510","ESOMEPRA","CAP 40MG DR","30.00","Select","Select",""],["","68382066010","SPIRONOLACT","TAB 25MG","30.00","Select","Select",""],["","65162035109","SILDENAFIL","TAB 20MG","90.00","Select","Select",""],["","00088221905","LANTUS","INJ 100\/ML","3.00","Select","Select",""],["","10702005650","OXYCODONE","TAB 10MG","30.00","Select","Select",""],["","73070010315","INSULIN","INJ FLEXPEN","3.00","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":["",""]}},{"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":""}]}]}