{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"A AHSILEMSGGURCS ","gend":1,"add":"      ES EVA TRAWETS 8021                         ","city":"ROANOKE                  ","state":"VA","zip":"24013-9998","dob":"1981-10-20","age":"","mstatus":"","insh":"00117778","cliId":"","pno":"1504567989","cno":"","email":"","ename":"","eno":"","pphy":"DRAKE, CHANTELLE H","ppno":5409818621,"pcpadd":"1906 BELLEVIEW AVE SE,","pcpcity":"Roanoke","pcpstate":"VA","pcpzip":240141838,"pcpcounty":"","pcpid":"","pcpname":"CARILION MEDICAL CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"1208 STEWART AVE SE                               ","madd2":"                                                  ","madd3":"","mcity":"ROANOKE                  ","mstate":"VA","mzip":"24013-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F25.1","F43.10","K21.00","R19.7","R15.9","K50.10","K31.9","F41.9","F32.9","H54.7","K21.9","F20.9","Z79.899","K50.90","K64.8","D64.9","F17.200","K52.9","E66.9","K51.90","K50.919","R42","Z74.3","L02.214","K50.00","L02.31","R87.612","Z12.4","E66.1","Z68.35","F25.9","R56.9","G40.909","F17.210","K29.70","K62.6","R22.9","H50.10","H55.00","R29.891","R00.0","I51.7","R94.31","Z13.1","Z13.6","G40.919","F41.1","D57.3","R06.02","E87.6","E83.42","L65.9","Z23","Z01.812","K20.80","K63.3","K31.89","K29.00","K51.40","K51.80","K62.89","K50.80","Z01.818","K50.019","H54.61","Z97.3","N32.81","Z68.30","D75.839","D72.829","E87.1","Z09","E86.1","E87.8","E83.39","F60.3","R29.6","F44.5","D69.6","F41.8","Z72.0","K51.912","K56.691","E78.5","R73.09","Z13.220","K50.112","G47.30","R53.81","Z91.49","Z91.89","Z59.6","J06.9","R79.89","K51.919"," "],"date":["2022-11-03","2022-11-03","2021-03-16","2021-03-16","2021-03-16","2021-03-16","2021-03-16","2021-03-16","2021-11-08","2021-03-16","2022-09-27","2022-07-02","2021-03-16","2022-09-27","2019-11-04","2019-11-04","2019-11-04","2022-11-09","2020-12-20","2022-09-27","2022-11-09","2022-06-30","2022-06-30","2021-01-08","2021-03-23","2021-04-20","2019-11-15","2019-11-15","2019-12-17","2019-12-17","2022-10-05","2019-12-17","2019-12-17","2022-09-27","2021-03-16","2021-03-16","2020-11-04","2019-12-04","2019-12-04","2019-12-04","2021-05-25","2021-05-25","2021-05-25","2022-11-03","2022-11-03","2021-11-08","2022-07-01","2021-11-08","2021-05-25","2022-07-29","2021-05-25","2021-08-26","2021-10-05","2021-03-11","2021-03-16","2021-03-16","2021-03-16","2021-03-16","2019-11-04","2019-11-04","2019-11-04","2022-04-08","2021-03-11","2020-12-20","2022-09-27","2020-12-20","2020-12-20","2020-12-20","2022-07-29","2022-07-29","2022-07-29","2022-10-05","2022-07-01","2022-07-01","2022-07-01","2022-07-02","2022-07-01","2022-07-01","2022-07-02","2022-07-02","2022-07-02","2022-09-27","2022-09-27","2022-09-14","2022-09-14","2022-09-14","2022-09-27","2022-09-27","2022-06-30","2022-11-03","2022-11-03","2022-11-03","2022-10-05","2022-10-05","2022-10-05","2022-11-09"],"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":[["","65862069705","VENLAFAXINE","CAP 150MG ER","60","Select","Select",""],["","60505314008","OLANZAPINE","TAB 20MG","30","Select","Select",""],["","67877022305","GABAPENTIN","CAP 300MG","90","Select","Select",""],["","68382000905","LAMOTRIGINE","TAB 150MG","30","Select","Select",""],["","16729041401","DOXAZOSIN","TAB 2MG","30","Select","Select",""],["","00074055402","HUMIRA","INJ 40\/0.4ML","2","Select","Select",""],["","00378064110","PREDNISONE","TAB 10MG","100","Select","Select",""],["","68462030529","NORETHINDRON","TAB 0.35MG","28","Select","Select",""],["","62175061743","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","00591079601","SULFASALAZIN","TAB 500MG","360","Select","Select",""],["","43547034206","RISPERIDONE","TAB 2MG","30","Select","Select",""],["","49281042050","FLUZONE","INJ 2020-21","0.5","Select","Select",""],["","43386009019","GAVILYTE-G","SOL ","4,000.00","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":""}]}]}