{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"L YCNANRABNUD ","gend":1,"add":"IRAED 019TEERTS GN","city":"LYNCHBURG","state":"VA","zip":"24503-3910","dob":"1942-07-15","age":"","mstatus":"","insh":"00116870","cliId":"","pno":"0304538129","cno":"","email":"","ename":"","eno":"","pphy":"SINGH, CHAND","ppno":5409858465,"pcpadd":"101 Elm Ave SE, ","pcpcity":"Roanoke","pcpstate":"VA","pcpzip":240132222,"pcpcounty":"","pcpid":"","pcpname":"CARILION CLINIC COMMUNITY CARE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"","add3":"","madd1":"910 DEARING STREET","madd2":"","madd3":"","mcity":"LYNCHBURG","mstate":"VA","mzip":"24503-3910","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["L22","N39.46","Z99.89","M13.80","H35.3231","D48.5","E11.9","I10","G47.33","E11.49","Z86.711","E66.01","R91.1","Z68.38","C67.9","D23.112","D23.122","L72.0","L82.1","K21.9","Z79.01","G40.909","Z86.718","H43.393","E66.9","Z68.34","K92.1","E03.9","E78.5","F33.9","G47.00","H35.30","I20.9","J44.9","K08.109","M17.0","N32.81","R01.1","R56.9","R60.0","Z79.51","Z79.84","Z79.899","Z76.89","Z13.0","H40.003","H31.012","Z00.01","Z13.89","Z71.89","Z12.11","Z23","H35.62","Z68.32","D12.6","K62.1","Z80.0","K64.8","K57.30","H35.3221","G44.209","Z85.51","Z71.3","I35.1","I26.09","H35.3132","H35.61","H35.3123","H35.3211","Z51.81","H35.3212","R06.02","D23.10"],"date":["2022-02-14","2022-02-14","2022-02-14","2022-02-14","2021-12-17","2021-04-21","2022-01-20","2022-01-24","2022-01-01","2021-08-09","2022-01-24","2022-01-20","2018-07-10","2018-07-10","2019-04-15","2021-04-21","2021-04-21","2021-04-21","2021-04-21","2021-04-26","2022-01-31","2021-11-04","2019-06-14","2019-11-14","2021-10-18","2019-06-06","2021-08-09","2021-11-04","2022-01-20","2018-06-18","2018-06-18","2018-06-18","2018-06-18","2021-10-18","2018-06-18","2018-06-18","2018-06-18","2018-06-18","2018-06-18","2018-06-18","2018-06-18","2018-06-18","2018-06-18","2019-06-20","2020-07-01","2021-11-19","2021-07-20","2021-07-26","2021-07-26","2021-07-26","2021-11-04","2021-10-22","2022-02-03","2021-10-18","2021-11-04","2021-11-04","2021-11-04","2021-11-04","2021-11-04","2022-02-03","2019-12-10","2021-01-05","2021-01-05","2018-01-11","2018-01-11","2018-01-19","2018-01-19","2018-01-22","2018-01-22","2022-01-31","2022-02-03","2018-02-09","2021-02-12"],"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":[["","70436000203","POT  CHLORIDE","TAB 10MEQ ER","360","Select","Select",""],["","00173069600","ADVAIR","AER 250\/50","180","Select","Select",""],["","57237016199","OMEPRAZOLE","CAP 20MG","90","Select","Select",""],["","65862024708","LEVETIRACETA","TAB 750MG","180","Select","Select",""],["","68180046907","LOVASTATIN","TAB 40MG","90","Select","Select",""],["","00378021610","FUROSEMIDE","TAB 40MG","90","Select","Select",""],["","00378180710","LEVOTHYROXIN","TAB 88MCG","90","Select","Select",""],["","65862019405","FLUOXETINE","CAP 40MG","90","Select","Select",""],["","00093172101","WARFARIN","TAB 5MG","87","Select","Select",""],["","68382025501","OXYBUTYNIN","TAB 5MG ER","90","Select","Select",""],["","00093317431","ALBUTEROL","FAT E","8.5","Select","Select",""],["","66758016005","KLOR-CON","TAB 10MEQ ER","180","Select","Select",""],["","68382076010","METFORMIN","TAB 1000MG","90","Select","Select",""],["","68180038909","FENOFIBRATE","TAB 145MG","90","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","180","Select","Select",""],["","24208091055","ERYTHROMYCIN","OIN 5MG\/GM","3.5","Select","Select",""],["","59310057922","PROAIR","AER ","25.5","Select","Select",""],["","66993058597","FLUTIC\/SALME","AER 250\/50","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":""}]}]}