{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"E LUAPSDRAWD","gend":0,"add":"BSC SREGOR TMYRF EITSIRK ","city":"WYTHEVILLE","state":"VA","zip":"24382-4633","dob":"1979-03-14","age":"","mstatus":"","insh":"10119952","cliId":"","pno":"1667274893","cno":"","email":"","ename":"","eno":"","pphy":"MOSIER, GABRIEL L","ppno":"2762288686          ","pcpadd":"1375 W Ridge Rd, ","pcpcity":"Wytheville","pcpstate":"VA","pcpzip":"243825011","pcpcounty":"","pcpid":"","pcpname":"CARILION FAMILY MEDICINE WYTHEVILLE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"120 TREMOUGH DRIVE","add3":"","madd1":"MT ROGERS CSB KRISTIE FRY","madd2":"120 TREMOUGH DRIVE","madd3":"","mcity":"WYTHEVILLE","mstate":"VA","mzip":"24382-4633","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F20.9","R09.02","E04.2","E11.9","E04.1","M85.9","Z79.52","Z94.81","Z13.820","C92.Z0","D89.811","Z85.6","R74.01","E09.9","Z94.84","Z86.16","Z79.899","R07.9","I10","E78.5","Z82.49","J45.909","F17.200","E55.9","Z08","D50.9","D22.5","D89.813","L94.0","L72.0","L81.4","Z12.83","D48.9","F10.20","Z28.21"],"date":["2022-01-19","2022-01-20","2021-03-18","2021-08-17","2021-05-21","2021-03-18","2021-08-30","2021-03-18","2021-03-18","2021-05-21","2021-08-30","2021-08-30","2021-05-21","2021-08-30","2021-08-30","2021-05-21","2021-05-21","2021-05-21","2022-02-22","2021-05-21","2021-05-21","2021-06-01","2021-06-01","2021-08-17","2021-08-30","2020-09-25","2021-10-28","2021-10-28","2021-10-28","2021-10-28","2021-10-28","2021-10-28","2021-10-28","2020-11-13","2020-11-13"],"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":[["","27241000606","RISPERIDONE","TAB 4MG","30.00","Select","Select",""],["","62756018388","OXCARBAZEPIN","TAB 150MG","30.00","Select","Select",""],["","68180051802","LISINOP\/HCTZ","TAB 10-12.5","30.00","Select","Select",""],["","69315013601","BENZTROPINE","TAB 0.5MG","30.00","Select","Select",""],["","00597007541","SPIRIVA","CAP HANDIHLR","30.00","Select","Select",""],["","68462043518","ACAMPRO","TAB 333MG","180.00","Select","Select",""],["","00093317431","ALBUTEROL","FAT E","8.50","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":""}]}]}