{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ALB YEWEDPIHSNEKN","gend":0,"add":"  EVIRD EDIS NIATNUOM 371                         ","city":"NARROWS                  ","state":"VA","zip":"24124-2358","dob":"1939-03-26","age":"","mstatus":"","insh":"00113374","cliId":"","pno":"9504512779","cno":5409229719,"email":"","ename":"","eno":"","pphy":"DEVEREAUX, ROBERT","ppno":5409216110,"pcpadd":"430 BOXWOOD LN,  ","pcpcity":"Pearisburg","pcpstate":"VA","pcpzip":241341168,"pcpcounty":"","pcpid":"","pcpname":"CARILION CLINIC FAMILY MEDICINE GILES RURAL HEALTH","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"173 MOUNTAIN SIDE DRIVE                           ","madd2":"                                                  ","madd3":"","mcity":"NARROWS                  ","mstate":"VA","mzip":"24124-2358","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N17.9","N26.1","N28.1","N40.0","J96.21","N18.3","J44.1","J09.X2","K21.9","I25.2","I10","M54.16","R09.02","R06.02","J44.9","I05.8","R60.0","I89.0","Z79.899","J18.9","D72.829","A41.9","Z23","J43.9","J12.3","J96.11","I12.9","Z99.81","F51.04","F41.1","M21.379","R97.20","Z87.891","Z79.82","Z66","R94.31","R91.8","I77.1","I70.0","J43.2","R06.00","J96.01","N18.30","J96.02","Z20.822","R06.01","N18.32","M21.372","R00.1","Z72.0","R06.9","I21.4","I25.10","I21.3","R79.89","J90","I65.29","F17.220","I50.23","I13.0","I42.9","N39.0","L03.116","M79.89","I44.0","I49.3","G47.00","Z87.01","R60.9","Z20.5","R00.0","R06.82","J20.8","E78.5","I21.A1","J44.0","Z87.442","Z98.42","J18.1","I50.20","J43.8","M19.90","J10.1","B96.89","G89.29","E78.2","L57.0","J80","A41.53","N40.1","R33.8","E87.2","R91.1","L30.9","A48.8","I27.20","I34.8","R93.1","G47.34","M62.830","R06.03","I08.0","J96.10","Z79.51","Z79.02","I08.3","I11.9","I50.31","I11.0","I50.9","Z95.5","I50.21","N18.9","R50.9","R05.9","I49.1"],"date":["2022-02-25","2022-02-25","2022-02-25","2022-02-25","2022-02-25","2020-07-01","2022-07-29","2020-03-09","2022-05-31","2022-02-22","2022-05-31","2022-05-31","2022-07-29","2022-07-29","2022-06-27","2021-05-07","2020-06-02","2021-04-26","2022-02-22","2020-01-21","2020-01-21","2019-09-11","2021-11-30","2022-02-23","2020-01-27","2021-05-21","2022-02-22","2022-03-29","2020-01-21","2020-01-21","2020-01-21","2020-01-21","2022-02-22","2022-02-22","2022-02-23","2022-07-31","2022-07-29","2022-02-23","2022-02-23","2022-02-25","2020-01-21","2022-02-26","2022-03-29","2022-02-22","2022-07-29","2021-04-26","2022-02-23","2020-07-24","2019-09-11","2021-02-25","2019-09-11","2022-02-25","2022-03-29","2019-09-30","2020-06-17","2019-09-30","2020-03-08","2019-10-29","2022-02-23","2022-03-29","2022-02-25","2022-02-23","2020-06-24","2020-06-24","2022-07-31","2022-07-29","2021-02-23","2020-03-08","2019-09-30","2019-11-13","2022-02-22","2022-02-22","2020-03-09","2022-02-25","2019-09-29","2020-03-08","2019-09-29","2019-09-29","2020-01-21","2021-02-25","2019-02-26","2019-02-26","2020-03-19","2020-03-08","2020-03-08","2020-06-17","2020-07-08","2019-09-28","2020-03-08","2019-03-12","2019-03-12","2019-09-11","2019-09-29","2020-10-19","2020-03-19","2021-05-07","2021-05-07","2021-05-07","2020-07-01","2021-08-27","2022-02-22","2022-07-29","2019-10-29","2022-02-22","2022-02-22","2022-02-23","2022-02-23","2022-02-23","2022-02-25","2022-03-29","2022-02-25","2022-02-26","2022-02-23","2022-07-29","2022-07-29","2022-07-29"],"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":[["","59310057922","PROAIR","AER ","8.5","Select","Select",""],["","00487020103","IPRATROPIUM\/","SOL ALBUTER","360","Select","Select",""],["","31722071390","PANTOPRAZOLE","TAB 40MG","90","Select","Select",""],["","00597007547","SPIRIVA","CAP HANDIHLR","90","Select","Select",""],["","00173068220","VENTOLIN","AER ","18","Select","Select",""],["","16714066202","GABAPENTIN","CAP 300MG","90","Select","Select",""],["","00713022580","TRIAMCINOLON","CRE 0.001","80","Select","Select",""],["","50742061510","METOPROL","TAB 25MG ER","90","Select","Select",""],["","55111028130","LEVOFLOXACIN","TAB 750MG","3","Select","Select",""],["","00173088210","BREO","INH 200-25","60","Select","Select",""],["","00310461612","BREZTRI","AER SPHERE","10.7","Select","Select",""],["","00781261305","AMOXICILLIN","CAP 500MG","10","Select","Select",""],["","59746017310","PREDNISONE","TAB 10MG","90","Select","Select",""],["","76204080025","LEVALBUTEROL","NEB 0.63MG","75","Select","Select",""],["","50111043401","TRAZODONE","TAB 100MG","135","Select","Select",""],["","68645051554","AMLODIPINE","TAB 5MG","90","Select","Select",""],["","16714081701","OSELTAMIVIR","CAP 30MG","2","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","21","Select","Select",""],["","00143980305","DOXYCYCL","CAP 100MG","8","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","59762372004","ALPRAZOLAM","TAB 0.5MG","30","Select","Select",""],["","43547040111","FUROSEMIDE","TAB 20MG","30","Select","Select",""],["","00093505798","ATORVASTATIN","TAB 80MG","30.00","Select","Select",""],["","68645059090","CLOPIDOGREL","TAB 75MG","30.00","Select","Select",""],["","67877021560","CEFUROXIME","TAB 250MG","14.00","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":""}]}]}