{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" C AHTRAMRETNEPRAC","gend":1,"add":"ELAD 242EVIRD T","city":"BLACKSBURG               ","state":"VA","zip":"24060-0467","dob":"1956-07-27","age":"","mstatus":"","insh":"10117218","cliId":"","pno":"9504548118","cno":5402598896,"email":"","ename":"","eno":"","pphy":"BADILLO, LESLIE","ppno":5407317624,"pcpadd":"2900 LAMB CIR STE 301,STE 201","pcpcity":"Christiansburg","pcpstate":"VA","pcpzip":240736345,"pcpcounty":"","pcpid":"","pcpname":"CARILION CLINIC FAMILY MEDICINE NEW RIVER VALLEY","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"242 DALET DRIVE","madd2":"                                                  ","madd3":"","mcity":"BLACKSBURG               ","mstate":"VA","mzip":"24060-0467","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F11.20","F41.9","F43.10","F19.10","F32.A","R09.02","I10","F51.5","E55.9","F11.23","R11.2","R19.7","R50.9","E11.9","F17.200","Z79.01","Z79.82","Z85.028","R10.84","R52","R11.11","K21.9","M25.562","R11.0","X58.XXXA","S81.812A","D64.9","M17.12","F31.4","F31.81","F05","F15.10","R45.851","Z20.822","I82.402","F32.9","C73","E78.5","F29","G40.909","G89.29","I25.10","J44.9","K27.9","K59.00","G62.9","F33.3","R44.2","L29.9","R05","R21","E07.9","Z79.51","Z56.0","Z79.890","I49.3","Z79.899","F15.90","F19.94","M26.609","R10.9","R51.9","F31.9","Z86.718","M26.621","H66.92","H92.02","G45.9","I25.2","Z86.73","Z72.0","W01.10XA","S09.90XA","I67.2","N30.00","R10.13","R35.0","R94.31","F33.1","F33.2","G89.4","Z85.41","Z85.850","Z86.711","Z87.891","Z88.0","A41.9","I70.0","I77.1","M00.9","W18.2XXA","Y93.E1","Y92.009","M62.82","S63.392A","D72.823","F11.10","M65.9","Z96.651","M19.012","M25.512","M25.462","R10.2","M25.519","R00.0","S09.8XXA","I67.82","S19.80XA","M50.30","S69.82XA","M19.032","M00.262","S62.122A","N30.90","R79.89","M00.862","Z98.890","M00.869","W19.XXXA","D63.8","E87.6","F39","M19.90","Z53.29","Z90.49","Z90.710","S69.92XA","D72.819","R78.81","Z87.39","I08.3","I38","M54.2","M54.6","I26.09","R07.2","Z91.19","I26.99","B18.2","F17.210","F17.290","G47.30","M79.7","Z91.14","Z85.42","R07.89","F41.8","K58.9","I82.401","Z86.16","K58.0","I51.7","D63.0","Z85.038","R07.9","D50.9","K92.1","M62.81","R26.2","S63.391D","G40.89","F33.9","G47.00","S69.90XA","F41.1","R53.83","R53.1","F32.3","Z88.8","Z88.6","R79.1","R00.2","R63.0","R06.02","F15.20","B19.20","F14.90","R06.89","Z74.3","M01.X62","S62.92XA","R30.0","F19.959","D68.69","F43.11","I82.502","S40.811A","S40.812A","J02.9","R44.1","M79.601","R44.3","E53.8","R53.81","M81.0","C18.9","D70.9","T14.91XA","T45.0X2A","M17.10","W01.0XXA","C16.9","Z90.3","Z78.9","F15.250","D68.59","F19.24","E86.0","J06.9","T50.904A","S40.211A","M25.511","R20.0","R05.9","R09.81","F14.10","M79.602","F31.5","Z04.3","M77.31","M85.871","F31.2","F31.30","W57.XXXA","F10.20","K29.70"],"date":["2022-10-19","2022-07-25","2022-09-15","2022-09-15","2022-08-07","2022-09-15","2022-11-02","2022-09-15","2022-09-15","2022-03-03","2022-03-03","2022-04-26","2022-03-18","2022-11-02","2022-05-02","2022-11-02","2022-11-02","2022-07-25","2022-03-03","2022-03-03","2022-03-03","2022-11-02","2022-05-02","2022-05-02","2022-07-06","2022-03-18","2022-03-18","2022-04-23","2021-06-01","2021-12-29","2021-09-08","2022-05-08","2022-07-26","2022-11-02","2021-10-27","2022-05-11","2021-06-08","2022-06-29","2022-07-25","2022-07-06","2022-04-12","2022-07-25","2022-08-07","2021-06-08","2021-06-08","2021-11-02","2021-11-28","2022-05-10","2021-06-08","2021-06-08","2022-05-02","2021-06-08","2022-07-24","2021-06-08","2021-06-08","2022-08-10","2022-09-15","2021-06-29","2022-09-15","2021-08-11","2022-05-16","2022-07-24","2021-10-20","2022-05-08","2021-08-11","2021-08-18","2021-08-18","2021-08-18","2021-09-22","2021-08-18","2021-12-29","2021-08-18","2021-08-18","2021-08-18","2021-09-24","2021-09-07","2021-09-07","2021-09-27","2021-09-16","2021-09-08","2021-09-28","2021-09-08","2021-11-01","2022-11-02","2022-11-02","2021-11-21","2022-05-08","2021-09-22","2021-09-22","2021-10-14","2021-09-22","2021-09-22","2021-10-08","2021-11-01","2021-09-22","2021-09-22","2021-09-22","2021-09-22","2021-09-22","2021-09-22","2021-09-22","2022-04-23","2021-09-22","2021-09-22","2021-10-21","2021-09-22","2021-09-22","2021-09-22","2021-09-22","2021-09-22","2021-09-22","2021-11-01","2021-09-23","2021-11-01","2021-09-23","2021-10-11","2021-09-26","2021-09-28","2021-10-08","2021-10-14","2022-04-12","2021-11-02","2021-10-08","2021-10-08","2022-04-12","2022-04-12","2021-10-08","2021-10-11","2021-10-11","2021-10-09","2021-10-13","2021-10-13","2021-10-13","2021-10-13","2021-11-01","2021-10-20","2021-10-21","2022-07-25","2022-05-23","2022-05-11","2022-05-11","2021-12-24","2021-12-24","2021-10-20","2021-10-20","2022-05-10","2021-12-24","2021-11-02","2021-10-21","2021-10-21","2021-10-21","2021-10-21","2021-10-21","2021-11-01","2022-11-02","2022-05-11","2021-10-26","2021-11-01","2021-11-01","2021-11-01","2021-11-01","2022-05-11","2021-11-02","2021-11-02","2021-11-02","2021-11-20","2021-11-20","2021-11-22","2021-11-21","2021-11-21","2021-11-23","2021-12-20","2021-12-20","2022-06-29","2021-12-24","2022-05-16","2021-12-24","2022-05-10","2022-05-02","2021-09-23","2021-09-23","2022-05-02","2022-05-18","2022-05-16","2022-05-16","2022-05-16","2022-07-06","2022-04-25","2022-04-25","2022-05-08","2022-07-06","2022-05-08","2022-04-23","2022-04-26","2022-04-26","2022-04-26","2022-04-15","2022-05-10","2022-05-10","2022-04-15","2022-04-12","2022-04-15","2022-04-12","2022-04-12","2022-05-11","2022-05-11","2022-05-11","2022-05-10","2022-11-02","2022-05-10","2022-07-06","2022-07-06","2022-07-06","2022-06-29","2022-06-29","2021-12-20","2022-04-12","2022-08-09","2022-04-20","2022-04-20","2022-04-20","2022-08-02","2022-07-25","2022-07-25","2022-07-25","2022-07-25"],"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":[["","12496120803","SUBOXONE","MIS 8-2MG","24","Select","Select",""],["","50111045001","TRAZODONE","TAB 150MG","30","Select","Select",""],["","65862052405","GABAPENTIN","TAB 800MG","90","Select","Select",""],["","51991074690","DULOXETINE","CAP 20MG","60","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","6","Select","Select",""],["","00378668910","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","70954001910","PRAZOSIN","CAP 1MG","30","Select","Select",""],["","65162052110","PROMETHAZINE","TAB 25MG","6","Select","Select",""],["","68180016011","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","53489011905","DOXYCYCL","CAP 100MG","10","Select","Select",""],["","50458057930","XARELTO","TAB 20MG","30","Select","Select",""],["","00378064205","PREDNISONE","TAB 20MG","10","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","12.00","Select","Select",""],["","47781035703","BUPREN\/NALOX","MIS 8-2MG","14","Select","Select",""],["","69097052444","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","00093317431","ALBUTEROL","FAT E","8.5","Select","Select",""],["","65862049301","QUETIAPINE","TAB 200MG","30","Select","Select",""],["","57664049983","MIRTAZAPINE","TAB 15MG","15","Select","Select",""],["","13668013601","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","23155013525","DOXYCYC","TAB 100MG","60","Select","Select",""],["","43547030303","ARIPIPRAZOLE","TAB 5MG","30","Select","Select",""],["","62756079888","DIVALPROEX","TAB 500MG DR","60","Select","Select",""],["","42806015905","HYDROXYZ","TAB 10MG","90","Select","Select",""],["","71930005552","APAP\/CODEINE","TAB 300-30MG","8","Select","Select",""],["","67877025130","TRIAMCINOLON","CRE 0.001","30","Select","Select",""],["","00173085910","BREO","INH 100-25","60","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","6","Select","Select",""],["","42806009430","POT  CHLORIDE","POW 20MEQ","4","Select","Select",""],["","63304069301","CLINDAMYCIN","CAP 300MG","60","Select","Select",""],["","00093216568","NALOXONE","SPR ","2","Select","Select",""],["","00143122701","DICYCLOMINE","TAB 20MG","120","Select","Select",""],["","00093221001","SUCRALFATE","TAB 1GM","120","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":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","",""],[""],[""],[""],[""]],"comment":[["","",""],[""],[""],[""],[""]],"sub":[]}}},{"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":""}]}]}