{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"J EILLIBNHGUAV ","gend":1,"add":"EBHSREH 2533WN DAOR REGR","city":"ROANOKE","state":"VA","zip":"24017-1859","dob":"1963-05-17","age":"","mstatus":"","insh":"00116182","cliId":"","pno":"2504563425","cno":5409152631,"email":"","ename":"","eno":"","pphy":"SCHLEUPNER, MARK A","ppno":5402245170,"pcpadd":"3 RIVERSIDE CIR,","pcpcity":"Roanoke","pcpstate":"VA","pcpzip":240164955,"pcpcounty":"","pcpid":"","pcpname":"CARILION CLINIC INTERNAL MEDICINE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"APT 25","add3":"","madd1":"3352 HERSHBERGER ROAD NW","madd2":"APT 25","madd3":"","mcity":"ROANOKE","mstate":"VA","mzip":"24017-1859","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J06.9","F17.200","F10.239","J45.901","J44.9","I10","M32.9","F17.210","Z79.51","Z79.82","F10.20","F14.20","M79.671","M79.672","J44.1","R06.02","R53.83","K21.9","Z20.828","Z86.73","R53.81","R76.8","Z87.39","R07.9","A08.4","R10.84","R11.2","R06.2","R07.89","E78.00","F33.2","F14.24","F14.94","M79.7","G89.29","K58.9","E78.5","R25.1","R05","Z79.899","I51.7","R52","E78.2","H04.129","J45.909","K08.409","L20.9","M13.0","M47.812","M47.819","I49.3","R94.31","Z23","R45.851","F14.23","Z59.0","Z98.51","Z88.8","Z91.040","Z91.81","F19.94","F43.10","F10.230","F32.9","Z53.21","M32.19","G45.9","Z72.0","Z74.3","G89.4","F10.10","R06.89","M54.5","Z68.20","Z79.52","H40.023","H47.233","Z83.511","H25.13","H04.123","M32.10","Z20.822","F34.9","F41.9","F43.21","G47.00","H40.9","H43.393","M19.072","F11.20","R79.1","W57.XXXA","Y92.59","F14.10","F19.10","T14.8XXA","R00.0","M79.10","R19.7","I70.90","J30.9","K29.70","L29.9","M25.50","Z82.49","Z82.69","R11.0","M19.071","M79.18","R30.0","R50.9","Z87.898","D69.3","R42","F14.90","F41.1","F41.0","R89.9","F12.20","F14.21","F12.21","F43.9","F32.A"],"date":["2020-01-16","2019-01-15","2020-01-16","2020-01-16","2021-08-18","2021-08-18","2020-01-16","2021-08-18","2020-01-16","2021-08-18","2022-08-01","2022-08-01","2018-02-13","2018-02-13","2021-03-03","2021-08-18","2021-03-03","2021-07-26","2021-03-02","2021-08-18","2021-03-03","2019-04-29","2019-04-29","2021-07-26","2021-06-14","2021-06-14","2021-06-14","2021-06-14","2021-07-26","2021-07-26","2019-11-14","2019-11-14","2020-12-28","2021-06-14","2019-11-11","2019-11-11","2019-11-11","2020-01-16","2021-08-18","2021-08-18","2021-07-26","2021-06-14","2018-06-18","2019-09-13","2018-06-18","2018-06-18","2018-06-18","2018-06-18","2018-06-18","2018-06-18","2021-07-26","2021-07-26","2020-12-28","2019-11-09","2019-11-09","2019-11-09","2019-11-09","2019-11-09","2019-11-07","2019-09-13","2019-11-08","2019-11-08","2020-01-16","2020-08-18","2018-05-14","2020-12-28","2020-01-27","2020-12-28","2021-08-18","2020-12-28","2020-12-28","2021-03-03","2018-04-11","2018-06-18","2019-11-07","2021-07-26","2021-07-26","2021-07-26","2021-07-26","2021-07-26","2021-07-26","2021-08-18","2019-09-13","2019-09-13","2019-09-13","2019-09-13","2021-08-18","2020-11-25","2018-02-13","2019-04-09","2019-04-27","2019-11-07","2019-11-07","2019-11-07","2019-11-07","2019-11-07","2020-01-16","2021-08-18","2021-08-18","2019-09-13","2019-09-13","2019-09-13","2019-09-13","2019-09-13","2019-09-13","2019-09-13","2019-01-10","2018-02-13","2021-03-02","2021-03-02","2021-03-02","2018-03-05","2019-03-15","2019-04-27","2019-04-27","2019-04-27","2019-04-27","2018-07-27","2022-08-01","2022-07-12","2022-07-12","2022-07-12","2022-08-01"],"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":[["","16729008110","NALTREXONE","TAB 50MG","30","Select","Select",""],["","57664049983","MIRTAZAPINE","TAB 15MG","30","Select","Select",""],["","00173088210","BREO","INH 200-25","60","Select","Select",""],["","59310057922","PROAIR","AER ","8.5","Select","Select",""],["","68180071909","AMLODIPINE","TAB 2.5MG","90","Select","Select",""],["","55111018015","TIZANIDINE","TAB 4MG","270","Select","Select",""],["","70377002711","ATORVASTATIN","TAB 10MG","45","Select","Select",""],["","00093816201","QUETIAPINE","TAB 100MG","90","Select","Select",""],["","43598072101","HYDROXYCHLOR","TAB 200MG","90","Select","Select",""],["","14539067401","HYDROXYZ","CAP 25MG","90","Select","Select",""],["","00591079401","DICYCLOMINE","CAP 10MG","56","Select","Select",""],["","00069047103","CHANTIX","PAK 0.5& 1MG","53","Select","Select",""],["","69097094312","GABAPENTIN","CAP 300MG","90","Select","Select",""],["","00054472825","PREDNISONE","TAB 5MG","30","Select","Select",""],["","13107008405","LORAZEPAM","TAB 1MG","20","Select","Select",""],["","65162052110","PROMETHAZINE","TAB 25MG","20","Select","Select",""],["","68462013701","OXCARBAZEPIN","TAB 150MG","30","Select","Select",""],["","12496120203","SUBOXONE","MIS 2-0.5MG","2","Select","Select",""],["","65162046650","IBUPROFEN","TAB 800MG","24","Select","Select",""],["","00093317431","ALBUTEROL","FAT E","25.5","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":""}]}]}