{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" SAMOHTENAK R","gend":0,"add":"          TS NANAHCUB 112                         ","city":"PEARISBURG               ","state":"VA","zip":"24134-9998","dob":"1962-03-13","age":"","mstatus":"","insh":"10114818","cliId":"","pno":"9504598609","cno":5405990689,"email":"","ename":"","eno":"","pphy":"TSUI, CAMILLA K","ppno":5409510352,"pcpadd":"901 PLANTATION RD STE 3,  ","pcpcity":"Blacksburg","pcpstate":"VA","pcpzip":240603821,"pcpcounty":"","pcpid":"","pcpname":"CARILION FAMILY MEDICINE BLACKSBURG","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"211 BUCHANAN ST                                   ","madd2":"                                                  ","madd3":"","mcity":"PEARISBURG               ","mstate":"VA","mzip":"24134-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G47.33","E78.5","J45.909","F32.9","F41.1","F25.9","E66.01","R09.02","J18.9","J96.90","E78.2","I10","M17.0","R39.9","N30.01","F31.62","F41.9","G47.09","M25.561","M17.11","M17.12","J45.40","Z12.11","Z23","Z83.71","F25.1","Z00.00","R35.1","Z11.4","Z11.59"],"date":["2022-02-08","2021-08-24","2021-08-24","2021-08-24","2021-08-24","2022-08-04","2022-01-14","2022-04-30","2022-04-30","2022-03-30","2022-06-20","2022-06-20","2022-07-22","2021-12-02","2021-12-02","2022-02-03","2022-08-04","2022-08-04","2022-03-09","2022-03-09","2022-03-09","2022-03-21","2022-03-21","2022-06-20","2022-03-21","2022-07-20","2022-06-20","2022-06-20","2022-06-20","2022-06-20"],"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":[["","65757065142","LYBALVI","TAB 5-10MG","30","Select","Select",""],["","58160088752","FLUARIX","INJ 2021-22","0.5","Select","Select",""],["","00093057610","LOVASTATIN","TAB 20MG","90","Select","Select",""],["","50111064801","FLUOXETINE","CAP 20MG","270","Select","Select",""],["","43547034450","RISPERIDONE","TAB 4MG","180","Select","Select",""],["","68462010905","TOPIRAMATE","TAB 100MG","180","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","15","Select","Select",""],["","00781106110","ALPRAZOLAM","TAB 0.25MG","90","Select","Select",""],["","00185111160","BUPROPION","TAB 200MG SR","180","Select","Select",""],["","00173072020","FLOVENT","AER 220MCG","36","Select","Select",""],["","42806031250","DOXYCYCL","TAB 100MG","20","Select","Select",""],["","69097015815","MELOXICAM","TAB 7.5MG","60","Select","Select",""],["","43547035211","LISINOPRIL","TAB 5MG","90.00","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18.00","Select","Select",""],["","13668021830","ARIPIPRAZOLE","TAB 10MG","30.00","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":""}]}]}