{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" AHTNAMASSUOKNIL L","gend":1,"add":"        EVIRD REPOOC 0155                         ","city":"DUBLIN                   ","state":"VA","zip":"24084-9998","dob":"1977-09-20","age":"","mstatus":"","insh":"00113024","cliId":"","pno":"0304535657","cno":2764846571,"email":"","ename":"","eno":"","pphy":"KELLY, DANIEL R","ppno":5407313200,"pcpadd":"701 RANDOLPH ST STE 120,STE 120","pcpcity":"Radford","pcpstate":"VA","pcpzip":241413047,"pcpcounty":"","pcpid":"","pcpname":"CARILION FAMILY MEDICINE RADFORD","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"5510 COOPER DRIVE                                 ","madd2":"                                                  ","madd3":"","mcity":"DUBLIN                   ","mstate":"VA","mzip":"24084-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["L97.521","E11.42","B35.1","M79.675","M79.674","M51.36","E11.9","Z79.899","I10","Z23","J45.40","F41.9","Z72.0","I73.9","I77.89","M79.669","F17.210","M79.606","M79.604","M79.605","Z01.812","Z79.01","R26.2","R79.89","L97.511","L84","J11.1","R05","R09.81","J45.909","F17.200","K21.9","G47.62","Z00.00","F31.81","M20.41","M72.2","M20.42","R11.10","R10.9","R42","R11.2","R53.1","M79.672","Z79.84","L03.116","L97.522","L97.512","L60.3","Z12.31","E11.621","L97.529","M25.571","M79.671","S92.511A","S99.921A","W10.9XXA","Y93.01","G89.29","M54.9","S93.491A","S92.511D","S93.491D","J30.2","Z20.822","Z80.3","A41.9","R65.21","N39.0","L03.115","E11.41","Z88.1","Z88.3","Z88.0","X58.XXXS","L97.519","S91.302S","R65.20","R09.02","E87.2","S91.301D","S91.302D","X58.XXXD","Z79.4","E11.65"," "],"date":["2022-07-07","2022-10-17","2021-07-28","2021-07-28","2021-07-28","2022-10-17","2022-10-17","2022-10-17","2022-10-17","2022-10-17","2022-10-17","2022-10-17","2021-04-20","2022-10-17","2021-02-15","2021-02-15","2021-02-15","2021-02-15","2021-03-10","2021-03-10","2021-02-27","2021-02-24","2021-03-04","2021-03-08","2022-08-22","2021-03-09","2020-03-23","2020-03-23","2020-03-23","2022-08-14","2021-05-23","2022-08-14","2022-03-23","2022-10-17","2019-11-13","2019-05-15","2019-05-15","2019-05-29","2021-05-23","2021-05-23","2021-05-23","2022-08-14","2021-05-23","2020-07-28","2020-06-16","2020-08-26","2021-08-25","2021-08-25","2021-07-28","2021-12-24","2022-09-02","2022-08-14","2019-10-07","2019-10-07","2019-10-11","2019-10-07","2019-10-07","2019-10-07","2022-08-14","2022-08-14","2019-10-11","2019-11-13","2019-11-13","2022-03-23","2022-08-14","2021-12-24","2022-08-14","2022-08-14","2022-08-14","2022-08-14","2022-08-14","2022-08-14","2022-08-14","2022-08-14","2022-08-23","2022-08-23","2022-08-23","2022-08-14","2022-08-14","2022-08-14","2022-09-02","2022-09-02","2022-09-02","2022-08-22","2022-08-22","2022-10-17"],"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":[["","51991031290","DESVENLAFAX","TAB 100MG ER","90","Select","Select",""],["","16729011917","MONTELUKAST","TAB 10MG","90","Select","Select",""],["","31722095105","OXYCOD\/APAP","TAB 10-325MG","120","Select","Select",""],["","16729014701","QUETIAPINE","TAB 100MG","75","Select","Select",""],["","00093317431","ALBUTEROL","FAT E","17","Select","Select",""],["","00781542092","PIOGLITAZONE","TAB 15MG","90","Select","Select",""],["","55111039905","LANSOPRAZOLE","CAP 30MG DR","90","Select","Select",""],["","64980041410","PREGABALIN","CAP 150MG","90","Select","Select",""],["","68382013506","LOSARTAN","TAB 25MG","90","Select","Select",""],["","68180046807","LOVASTATIN","TAB 20MG","90","Select","Select",""],["","00002143380","TRULICITY","INJ 0.75\/0.5","2","Select","Select",""],["","51224022070","METFORMIN","TAB 1000MG","180","Select","Select",""],["","64380080707","IBUPROFEN","TAB 800MG","90","Select","Select",""],["","00069046956","CHANTIX","TAB 1MG","56","Select","Select",""],["","42571016242","AMOX\/K","TAB 875-125","20","Select","Select",""],["","70461032103","FLUCLVX","INJ 2021-22","0.5","Select","Select",""],["","42806031205","DOXYCYCL","TAB 100MG","14","Select","Select",""],["","00169430713","RYBELSUS","TAB 7MG","30","Select","Select",""],["","42571025201","CLINDAMYCIN","CAP 300MG","20","Select","Select",""],["","43598021040","SSD","CRE 0.01","400","Select","Select",""],["","33342006015","CLOPIDOGREL","TAB 75MG","90","Select","Select",""],["","57237023305","SMZ-TMP","TAB 800-160","28","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","12","Select","Select",""],["","59310057922","PROAIR","AER ","17","Select","Select",""],["","00071101568","LYRICA","CAP 100MG","60","Select","Select",""],["","00228255111","DICLOFENAC","TAB 75MG DR","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":["",""]}},{"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":""}]}]}