{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"M ANITSDLIW ","gend":1,"add":"R  YELLAV TNASAELP S  611                      DAO","city":"WINCHESTER               ","state":"VA","zip":"22601-5236","dob":"1977-09-20","age":"","mstatus":"","insh":"10112564","cliId":"","pno":"1304500123","cno":5403980775,"email":"","ename":"","eno":"","pphy":"SUWAL, ANIL","ppno":5404844800,"pcpadd":"390 S MAIN ST STE 201,","pcpcity":"Rocky Mount","pcpstate":"VA","pcpzip":241511767,"pcpcounty":"","pcpid":"","pcpname":"CARILION MEDICAL ASSOCIATES ROCKY MOUNT","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"NORTHERN & WINCHESTER","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"116  S PLEASANT VALLEY  ROAD                      ","madd2":"                                                  ","madd3":"","mcity":"WINCHESTER               ","mstate":"VA","mzip":"22601-5236","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F19.20","F32.9","Z20.828","F11.20","R10.84","N83.291","K58.9","R11.2","F99","R19.7","Z20.822","B34.9","M54.5","R10.9","F41.0","I78.0","F41.1","F32.1","R06.02","R07.89","M54.30","J01.90","Z13.1","L02.91","E66.9","Z13.6","U07.1","Z11.59","E86.0","N64.59","G47.33","E66.01","R42","Z68.41","R07.9","Z79.899","M79.604","M79.605","R22.43","I78.1","M94.0","Z88.2","R10.30","Z03.89","R31.9","M54.9","J02.9","N39.0","J34.0","J06.9","H69.83","Z12.31","K80.20","R93.89","K76.0","R16.0","N85.8","Z01.419","Z12.4","N39.41","L25.9","R10.11","R12","R93.2","K80.10","F41.9","F32.A","Z87.442","Z87.891","Z80.3","Z01.818","N39.3","N20.0","M54.42"," ","M54.59"],"date":["2022-04-07","2022-05-19","2022-06-14","2021-10-28","2022-12-05","2022-02-13","2022-02-13","2022-02-13","2021-10-28","2021-04-01","2022-06-14","2021-04-19","2021-04-27","2022-02-13","2021-04-28","2021-04-28","2021-06-14","2021-06-14","2021-06-17","2021-06-17","2021-07-15","2021-07-15","2021-07-15","2020-08-19","2022-05-05","2021-08-30","2021-09-10","2021-10-13","2020-10-18","2020-10-22","2022-06-17","2020-10-24","2020-10-24","2020-10-24","2021-11-18","2021-10-29","2020-11-12","2020-11-12","2020-11-12","2020-11-12","2021-11-18","2022-06-17","2020-11-23","2020-11-23","2022-02-13","2022-02-13","2022-11-08","2022-03-04","2022-03-18","2022-03-18","2022-03-18","2022-03-22","2022-06-17","2022-05-25","2022-04-09","2022-04-09","2022-04-09","2022-04-27","2022-04-27","2022-04-27","2022-05-05","2022-05-05","2022-05-05","2022-05-05","2022-06-17","2022-06-17","2022-06-17","2022-06-17","2022-06-17","2022-06-17","2022-06-14","2022-06-21","2022-12-05","2021-08-25","2022-12-05","2022-12-05"],"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":[["","65862039010","ONDANSETRON","TAB 4MG ODT","10","Select","Select",""],["","00143312601","DICYCLOMINE","CAP 10MG","20.00","Select","Select",""],["","50111064801","FLUOXETINE","CAP 20MG","30","Select","Select",""],["","59651000305","OMEPRAZOLE","CAP 40MG","90","Select","Select",""],["","10702000710","CYCLOBENZAPR","TAB 10MG","10","Select","Select",""],["","70954006020","PREDNISONE","TAB 20MG","15","Select","Select",""],["","00168000415","TRIAMCINOLON","CRE 0.001","15","Select","Select",""],["","68180030260","CEFUROXIME","TAB 250MG","14.00","Select","Select",""],["","16729020201","BUSPIRONE","TAB 10MG","60","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","15","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":""}]}]}