{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"H ANIGERREMRAF ","gend":1,"add":"SNURB 103NL DLEIF","city":"NARROWS","state":"VA","zip":"24124-9998","dob":"1974-11-24","age":"","mstatus":"","insh":"10119734","cliId":"","pno":"5504542087","cno":2762459135,"email":"","ename":"","eno":"","pphy":"DUMS, ROBERT M","ppno":5407191815,"pcpadd":"35 MEDICAL CT","pcpcity":"Hardy","pcpstate":"VA","pcpzip":241013992,"pcpcounty":"","pcpid":"","pcpname":"CARILION URGENT CARE WESTLAKE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"","add3":"","madd1":"301 BRUNSFIELD LN","madd2":"","madd3":"","mcity":"NARROWS","mstate":"VA","mzip":"24124-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["C56.1","I82.402","F11.20","D64.9","F06.4","F41.8","G25.81","M79.7","N95.1","Z01.818","Z95.828","Z86.718","R59.0","C56.9","I82.412","Z45.2","Z51.11","Z01.812","Z45.89","F32.2","K21.00","L63.0","R19.00","R51.9","G43.909","L03.113","K21.9","I25.2","Z86.711","Z86.73","Z79.01","Z79.899","F17.210","R21","M79.10","M79.89","M79.641","B19.20","D72.819","T45.1X5A","G89.4","F32.9","F41.0","E78.5","F19.10","Z85.43","M79.631","M25.531","D70.9","R27.8","M62.81","M79.642","M79.645","R20.2","Z89.012","R11.2","Z00.00","Z13.1","Z13.220","Z02.4","Z13.6","D69.6","R82.6","N39.0","K05.213","K05.6","K08.9","E04.2","L03.211","D84.821","N17.9","D70.1","F41.9","D84.9","D89.9","E04.1","Z72.0","R22.0","R50.9","B96.89","M25.50","Z20.828","Z79.82","C56.2","K80.20","J47.9","R91.8","M54.5","N13.30","R19.03","N83.8","R10.31","R10.813","N83.9","R10.9","R35.0","R34","Z79.02","R10.30","R19.09","I82.422","I82.812","Z12.4","Z86.19","R87.613","Z01.810","R00.1","I45.89","R94.31","Z23","I82.401","J98.11","R18.8","D49.59","I82.409","N87.0","R87.612","R30.0","N85.8","D36.0","D20.1","R87.619","G89.29","R71.0","K59.00","I95.89","N80.1","N89.8","F11.90","Z71.6","Z78.9","K63.89","A41.89","R65.21","J18.9","F32.A","Z20.822","J96.01","R07.9","D73.9","Z51.89","Z79.2","R10.12","A41.9","R06.03","R11.10","M79.2","R09.02","R53.83","R06.02","D73.89","Z01.89","R11.0","I05.9","J80","J15.6","R16.1","D73.5","C78.89","C79.89","N18.2","D50.9","E87.6","C76.3","J15.9","I34.0","B18.9","Z71.89","Z87.898"],"date":["2022-06-06","2022-04-11","2022-05-27","2021-06-25","2022-05-23","2021-07-23","2022-04-14","2022-04-13","2022-04-11","2021-01-24","2021-01-29","2022-05-06","2021-12-13","2022-04-23","2021-01-14","2021-01-29","2021-06-03","2021-01-24","2021-01-29","2022-05-23","2022-05-23","2021-02-26","2022-04-26","2022-05-23","2022-04-11","2021-07-16","2022-04-13","2022-04-13","2021-07-23","2022-04-13","2022-05-06","2021-07-23","2022-04-14","2021-03-08","2021-03-08","2021-07-23","2021-03-08","2022-04-16","2021-03-08","2022-04-13","2022-04-14","2021-07-23","2022-04-14","2022-04-26","2022-04-13","2022-04-26","2021-03-08","2021-03-10","2021-07-23","2020-07-10","2020-07-10","2020-07-10","2020-07-10","2020-07-10","2022-04-13","2022-05-23","2020-07-14","2020-07-14","2020-07-14","2020-07-14","2020-07-14","2021-07-21","2021-07-16","2021-07-21","2021-07-23","2021-07-23","2021-07-23","2021-07-23","2021-07-24","2022-04-13","2022-04-14","2021-07-23","2022-04-13","2021-07-23","2021-07-23","2021-07-23","2021-11-22","2021-07-23","2022-04-13","2020-07-24","2020-07-24","2020-07-24","2020-11-18","2021-07-26","2022-04-14","2021-09-11","2022-04-20","2020-10-13","2020-10-12","2020-10-12","2020-10-13","2020-10-12","2020-10-12","2020-10-13","2020-10-12","2020-10-12","2020-10-12","2020-10-12","2020-10-13","2022-04-26","2020-10-19","2020-10-19","2020-10-19","2020-10-19","2020-11-16","2020-10-21","2020-10-21","2020-10-21","2022-04-17","2020-10-21","2020-10-23","2020-10-23","2020-10-23","2020-10-23","2020-10-23","2020-11-16","2020-11-16","2021-11-22","2020-12-10","2020-12-10","2020-12-10","2020-12-10","2020-12-10","2020-12-13","2020-12-10","2020-12-10","2020-12-10","2020-12-21","2020-12-21","2020-12-21","2020-12-21","2022-04-22","2022-04-13","2022-04-26","2022-04-18","2022-04-14","2022-04-14","2022-04-25","2022-04-17","2022-04-25","2022-04-13","2022-04-13","2022-04-18","2022-04-26","2022-04-14","2022-04-14","2022-04-11","2022-04-20","2022-04-13","2022-04-13","2022-04-16","2022-04-13","2022-04-13","2022-04-14","2022-05-26","2022-04-26","2022-04-23","2022-04-21","2022-04-14","2022-04-26","2022-04-14","2022-05-23","2022-05-23","2022-04-26","2022-04-13","2022-06-02","2022-04-23","2022-05-06","2022-05-06"],"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","14","Select","Select",""],["","65862053750","LEVOFLOXACIN","TAB 500MG","14","Select","Select",""],["","00591207030","LIDO\/PRILOCN","CRE 2.5-2.5%","30","Select","Select",""],["","68180079901","POT  CHLORIDE","CAP 10MEQ ER","90","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","00003089421","ELIQUIS","TAB 5MG","60","Select","Select",""],["","64380078706","BUSPIRONE","TAB 7.5MG","60","Select","Select",""],["","00093719801","FLUOXETINE","CAP 40MG","30","Select","Select",""],["","00406055201","OXYCODONE","TAB 5MG","25","Select","Select",""],["","59746011506","PROCHLORPER","TAB 10MG","30","Select","Select",""],["","69097094312","GABAPENTIN","CAP 300MG","90","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","14","Select","Select",""],["","68462039710","OMEPRAZOLE","CAP 40MG","90","Select","Select",""],["","65862018830","ONDANSETRON","TAB 8MG","60","Select","Select",""],["","27808003502","HYDROCO\/APAP","TAB 5-325MG","10","Select","Select",""],["","64380080807","IBUPROFEN","TAB 600MG","30","Select","Select",""],["","43598058230","BUPREN\/NALOX","MIS 8-2MG","56","Select","Select",""],["","60505079304","ENOXAPARIN","INJ 60\/0.6ML","30","Select","Select",""],["","00591264101","BUT\/APAP\/CAF","CAP CODEINE","30","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","21","Select","Select",""],["","57237002801","AMOXICILLIN","TAB 500MG","21","Select","Select",""],["","65162062711","TRAMADOL","TAB 50MG","15","Select","Select",""],["","29300012510","MELOXICAM","TAB 15MG","30","Select","Select",""],["","00172572860","FAMOTIDINE","TAB 20MG","60","Select","Select",""],["","00143980305","DOXYCYCL","CAP 100MG","28","Select","Select",""],["","63304069201","CLINDAMYCIN","CAP 150MG","63","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":""}]}]}