{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"L   LRACRABNUD ","gend":0,"add":"LKREB 1132EUNEVA YE","city":"ROANOKE","state":"VA","zip":"24015-5411","dob":"1986-05-20","age":"","mstatus":"","insh":"91015131","cliId":"","pno":"3604500320","cno":5405669665,"email":"","ename":"","eno":"","pphy":"AIKIN, CLAIRE K","ppno":5409498241,"pcpadd":"428 S Magnolia Ave Ste 1, ","pcpcity":"Waynesboro","pcpstate":"VA","pcpzip":229803629,"pcpcounty":"","pcpid":"","pcpname":"CARILION CLINIC FAMILY MEDICINE COLONIAL AVE","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"2311 BERKLEY AVENUE","madd2":"","madd3":"","mcity":"ROANOKE","mstate":"VA","mzip":"24015-5411","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["D01.3","B20","F31.9","F41.1","K62.82","Z79.899","R50.9","R05","M79.10","F15.20","F11.20","F31.81","F43.10","R53.82","R63.5","Z76.89","Z21","F19.10","H10.413","H16.403","H52.13","H52.223","R68.89","J01.90","R51","F17.210","Z20.828","U07.1","Z71.6","Z03.818","R11.2","R19.7","A63.0","R85.613","Z88.0","F17.290","F15.24","R45.851","E87.6","F15.23","F17.200","H66.91","K14.6","Z60.9","Z73.3","Z87.39","Z87.19","Z87.09","R79.89","F15.94","Z86.59","F15.10","F31.5","R10.32","M54.5","S39.011A","R10.9","X58.XXXA","Y93.H2","F60.3","D72.829","Z85.048","Z90.49","Z20.822","Z72.0","F39","F19.94","Z91.19","F12.10","Z91.5","K59.00","R74.01","R53.1","A53.9","F32.9","F41.9","F43.12","F15.229","F10.20","H92.01","J32.9","R09.81","Z56.0","C21.0","R10.30","R10.31","B37.0","R10.84","R85.619","J02.9","F31.62","Z11.59","Z20.2","Z01.818","F31.31","S99.921A","S86.001A","R45.1","F43.0","F43.9","Z87.891","Z04.89","Z11.3","Z11.51","R85.610"],"date":["2021-11-17","2021-11-17","2021-10-27","2021-12-13","2021-12-07","2021-10-08","2021-10-26","2021-09-15","2020-03-26","2021-10-13","2021-03-12","2022-02-07","2022-02-07","2020-08-17","2020-08-17","2020-08-17","2022-02-07","2021-11-09","2020-08-31","2020-08-31","2020-08-31","2020-08-31","2020-09-02","2020-09-06","2020-09-06","2021-01-25","2020-12-23","2020-09-06","2021-11-10","2020-10-29","2022-03-16","2022-03-16","2020-11-02","2020-11-02","2021-01-25","2020-11-02","2020-12-23","2021-03-22","2021-03-23","2021-03-22","2021-08-09","2021-05-15","2020-12-23","2020-12-23","2020-12-23","2020-12-23","2020-12-23","2020-12-23","2022-04-06","2020-12-27","2020-12-27","2021-03-23","2021-10-13","2021-08-09","2021-01-06","2021-01-06","2021-08-09","2021-01-06","2021-01-06","2021-01-28","2021-01-10","2021-03-22","2021-03-22","2021-03-22","2021-05-22","2021-01-28","2021-03-22","2021-01-25","2021-03-22","2021-01-25","2021-12-07","2021-01-26","2021-01-26","2021-01-27","2021-02-04","2021-02-04","2021-02-04","2021-03-22","2021-03-22","2021-05-22","2021-05-22","2021-05-22","2021-05-22","2021-08-09","2021-08-09","2021-08-09","2021-09-15","2021-09-15","2021-10-08","2021-10-26","2021-11-04","2021-11-06","2022-02-07","2021-11-12","2022-02-09","2019-07-27","2019-07-27","2019-08-09","2019-08-09","2019-08-09","2019-08-09","2019-08-09","2019-09-27","2019-09-27","2019-09-29"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"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":[["","43598044674","NICOTINE","DIS 7MG\/24HR","14","Select","Select",""],["","61958210101","ODEFSEY","TAB ","30","Select","Select",""],["","69097084805","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","33342007107","OLANZAPINE","TAB 15MG","30","Select","Select",""],["","35573041830","ATOMOXETINE","CAP 40MG","30","Select","Select",""],["","00093005401","BUSPIRONE","TAB 10MG","56","Select","Select",""],["","68462022301","LITHIUM","TAB 300MG ER","120","Select","Select",""],["","13107003134","MIRTAZAPINE","TAB 15MG","14","Select","Select",""],["","69238183107","LEVOTHYROXIN","TAB 50MCG","30.00","Select","Select",""],["","68462013701","OXCARBAZEPIN","TAB 150MG","90.00","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","00781185220","AMOX\/K","TAB 875-125","10","Select","Select",""],["","45802086802","POLYETH","POW 3350 NF","238","Select","Select",""],["","57237007710","ONDANSETRON","TAB 4MG ODT","12","Select","Select",""],["","29300011101","LAMOTRIGINE","TAB 25MG","14","Select","Select",""],["","65162062711","TRAMADOL","TAB 50MG","20","Select","Select",""],["","61874011530","VRAYLAR","CAP 1.5MG","60","Select","Select",""],["","53489012002","DOXYCYCL","TAB 100MG","26","Select","Select",""],["","65162010150","GABAPENTIN","CAP 100MG","90","Select","Select",""],["","66689000816","NYSTATIN","SUS 100000","112","Select","Select",""],["","29300013510","CLONIDINE","TAB 0.1MG","90","Select","Select",""],["","59267100002","PFIZER","INJ COVID-19","0.3","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","68180016013","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","69543025216","VIRTUSSIN","SOL 100-10\/5","120","Select","Select",""],["","11523716202","CLARITIN-D","TAB 5-120MG","20","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","59779044574","CVS","DIS 14MG\/24H","28","Select","Select",""],["","00378110101","PRAZOSIN","CAP 1MG","14","Select","Select",""],["","00093506201","HYDROXYZ","TAB 50MG","42","Select","Select",""],["","61958110101","COMPLERA","TAB ","30","Select","Select",""],["","49702023113","TRIUMEQ","TAB ","30","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":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"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":""}]}]}