{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"L EINNODNACNUD ","gend":0,"add":" 1201 TPA DR NOSPMIS 0061                         ","city":"CHRISTIANSBURG           ","state":"VA","zip":"24073-9998","dob":"1988-05-18","age":"","mstatus":"","insh":"00115418","cliId":"","pno":"9404519337","cno":5402396022,"email":"","ename":"","eno":"","pphy":"KIDD, JOSEPH H","ppno":5405625700,"pcpadd":"1314 PETERS CREEK RD,","pcpcity":"ROANOKE","pcpstate":"VA","pcpzip":240172500,"pcpcounty":"","pcpid":"","pcpname":"CARILION CLINIC FAMILY MEDICINE ROANOKE SALEM","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"N","ano":"","add2":"                                                  ","add3":"","madd1":"1600 SIMPSON RD APT 1021                          ","madd2":"                                                  ","madd3":"","mcity":"CHRISTIANSBURG           ","mstate":"VA","mzip":"24073-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F31.62","S69.82XD","R52","Z74.3","S61.021A","W39.XXXA","S68.022A","S68.125A","S68.123A","S68.121A","S68.127A","S68.522A","Z04.3","Y92.008","S68.623A","S68.625A","S61.411A","S69.91XA","T21.19XA","S20.91XA","S00.81XA","Z23","J45.20","K21.9","F17.220","S62.522A","S62.633A","S62.635A","T14.90XA","S62.631B","S68.622A","S62.635B","S69.82XA","S62.601A","S62.605A","S62.607A","G89.18","M79.642","S60.511A","X58.XXXA","S60.512A","F17.200","Z48.01","S65.902D","L98.9","Z89.022","F17.210","Z89.9","M25.642","L72.0","F41.9","F33.1","S69.80XD","G60.9","F31.61","Z72.0","R22.9","R51","S61.303A","Z20.822","U07.1","M79.10","R11.0","H10.9","F32.9","F43.10","L02.512","J40","R05","R11.2","R19.7","Z20.828","R06.02","Z68.29","E66.3","R03.0","L03.111","A41.9","L02.411","L02.91","R21","S41.101A","D72.829","J45.909","Z56.0","Z48.00","Z79.51","I51.7","R94.31","R07.9","Z53.29","Z79.899","S68.119A","S62.609A","F31.9","Z11.59","S90.811A","R23.8"," ","H66.92","J06.9"],"date":["2022-10-18","2022-08-16","2022-03-04","2020-07-15","2020-07-15","2020-07-15","2020-07-15","2020-07-16","2020-07-15","2020-07-16","2020-07-16","2020-07-15","2020-07-15","2020-07-15","2020-07-16","2020-07-15","2020-07-15","2020-07-15","2020-07-15","2020-07-15","2020-07-15","2022-09-30","2020-07-15","2020-07-15","2020-07-15","2020-07-15","2020-07-15","2020-07-15","2020-07-15","2020-07-16","2020-07-16","2020-07-16","2020-07-16","2020-07-16","2020-07-16","2020-07-16","2020-08-02","2020-08-02","2020-07-17","2020-07-17","2020-07-17","2022-03-19","2020-07-17","2020-07-19","2020-07-19","2020-08-02","2022-03-25","2020-08-02","2020-09-02","2021-08-11","2022-10-31","2021-08-24","2021-08-24","2021-08-24","2019-09-06","2019-09-06","2019-09-06","2019-10-18","2020-12-04","2022-09-21","2022-01-24","2022-01-24","2022-01-24","2021-03-22","2021-04-28","2021-05-26","2021-06-04","2020-06-06","2020-06-06","2020-06-06","2020-06-06","2020-06-06","2022-03-25","2022-03-04","2022-03-04","2022-03-04","2022-03-20","2022-03-19","2022-03-20","2022-03-19","2022-03-19","2022-03-19","2022-03-19","2022-03-20","2022-03-19","2022-03-20","2022-03-20","2022-03-25","2022-03-25","2022-03-25","2022-03-25","2022-03-25","2020-07-16","2020-07-16","2022-10-31","2022-08-18","2022-10-02","2022-10-02","2022-12-02","2022-12-02","2022-09-21"],"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":[["","00143980305","DOXYCYCL","CAP 100MG","14","Select","Select",""],["","00527293537","PREDNISONE","TAB 50MG","5","Select","Select",""],["","00093317431","ALBUTEROL","FAT E","8.5","Select","Select",""],["","16571020210","DICLOFENAC","TAB 50MG DR","21.00","Select","Select",""],["","49884072703","DOXYCYC","CAP 100MG","20.00","Select","Select",""],["","42571025201","CLINDAMYCIN","CAP 300MG","21","Select","Select",""],["","00406012301","HYDROCO\/APAP","TAB 5-325MG","8","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","20","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","65862019405","FLUOXETINE","CAP 40MG","90","Select","Select",""],["","16729016917","ESCITALOPRAM","TAB 10MG","90","Select","Select",""],["","69097094312","GABAPENTIN","CAP 300MG","30","Select","Select",""],["","52817033200","CYCLOBENZAPR","TAB 10MG","21.00","Select","Select",""],["","29300012510","MELOXICAM","TAB 15MG","30","Select","Select",""],["","00832712411","DIVALPROEX","TAB 500MG DR","180","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":""}]}]}