{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" A YRAMSNIGGIH","gend":1,"add":"L TORT 02A TPA ENA","city":"LEXINGTON","state":"VA","zip":24450,"dob":"1948-04-21","age":"","mstatus":"","insh":"00112813","cliId":"","pno":"6404504513","cno":"","email":"","ename":"","eno":"","pphy":"HAMILTON, THOMAS F","ppno":5404631540,"pcpadd":"2252 MAGNOLIA AVE,","pcpcity":"BUENA VISTA","pcpstate":"VA","pcpzip":24416,"pcpcounty":"","pcpid":"","pcpname":"CARILION CLINIC FAMILY MEDICIN","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"Roanoke\/Alleghany","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"20 TROT LANE APT A                                ","madd2":"                                                  ","madd3":"","mcity":"LEXINGTON                ","mstate":"VA","mzip":"24450-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M25.551","E86.0","R55","M65.271","M21.6X1","M21.6X2","M72.2","L85.1","M79.671","M79.672","E11.9","M54.2","I49.3","M79.7","I10","N18.3","F41.8","E78.5","E03.9","R50.9","R53.83","I12.9","N18.30","I08.0","D64.9","I49.9","R68.83","N18.32","N81.2","R05.9","R06.02","R19.7","N28.1","E11.22","R74.8","Z20.822","Z79.51","Z79.82","Z79.899","Z12.31","I25.10","I25.84","R07.9","Z12.11","H25.13","Z13.820","Z78.0","Z03.818","R73.03","M79.605","R60.9","H52.4","H53.003","Z23","N39.46","N81.9","M54.50","K21.9","F32.9","G89.4","M25.511","M54.12","R35.0","R82.998","G89.29","R60.0","N30.00","R30.0","R89.9","R07.81","J01.00","R68.89","Q60.0","R06.00","R09.81","N18.9","R42","M79.606","H53.8","M79.604","I45.81","Z71.9","D50.9","H65.01","M75.41","W19.XXXA","N19","M16.11","H92.01","N18.31","I34.0"," "],"date":["2020-08-27","2022-04-22","2022-06-10","2019-04-24","2019-04-24","2019-04-24","2019-04-24","2019-04-24","2019-04-24","2019-04-24","2020-02-03","2019-09-03","2022-09-14","2022-09-21","2022-10-24","2020-09-03","2019-07-15","2022-10-24","2022-10-24","2020-11-23","2022-02-03","2022-05-21","2022-10-24","2022-05-24","2022-09-21","2022-02-03","2022-02-03","2022-06-02","2022-10-12","2022-01-25","2022-01-25","2022-05-21","2022-06-22","2022-05-21","2022-05-21","2022-05-21","2022-05-21","2022-05-21","2022-05-21","2022-02-01","2022-05-27","2022-05-27","2022-05-27","2021-12-21","2022-10-27","2021-08-03","2021-08-03","2020-11-24","2021-06-02","2020-11-23","2019-12-11","2018-07-09","2018-07-09","2022-09-14","2019-01-04","2019-01-04","2022-03-03","2022-09-21","2020-07-13","2021-12-02","2021-06-30","2019-09-03","2022-03-03","2022-03-03","2022-03-03","2019-12-11","2022-06-14","2022-06-14","2022-05-12","2022-01-27","2020-03-06","2018-03-28","2018-03-28","2021-12-30","2021-12-30","2022-09-14","2022-09-14","2019-12-11","2019-07-19","2020-11-23","2022-04-15","2019-09-16","2018-03-26","2018-03-26","2021-06-30","2020-08-27","2019-06-20","2020-09-03","2018-04-10","2022-09-21","2022-09-14","2022-10-27"],"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":[["","53746051101","SPIRONOLACT","TAB 25MG","90","Select","Select",""],["","00093005805","TRAMADOL","TAB 50MG","90","Select","Select",""],["","00378020810","FUROSEMIDE","TAB 20MG","360","Select","Select",""],["","69097081312","GABAPENTIN","CAP 100MG","30","Select","Select",""],["","70377000314","SIMVASTATIN","TAB 20MG","90","Select","Select",""],["","00093742698","MONTELUKAST","TAB 10MG","90","Select","Select",""],["","00378180510","LEVOTHYROXIN","TAB 75MCG","90","Select","Select",""],["","13668001005","CITALOPRAM","TAB 20MG","90","Select","Select",""],["","68180051303","LISINOPRIL","TAB 5MG","90","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","90","Select","Select",""],["","00093117210","PENICILLN","TAB 250MG","28","Select","Select",""],["","68180072003","AMLODIPINE","TAB 5MG","90","Select","Select",""],["","00378668910","PANTOPRAZOLE","TAB 40MG","90","Select","Select",""],["","00378064110","PREDNISONE","TAB 10MG","18","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","10","Select","Select",""],["","53489011905","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","59310057922","PROAIR","AER ","8.5","Select","Select",""],["","00093310905","AMOXICILLIN","CAP 500MG","21","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","70461001903","FLUAD","INJ 2019-20","0.5","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":""}]}]}