{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"  ENELRADRENGAW J ","gend":1,"add":"YPPAH 9521RD SERCA ","city":"MONETA","state":"VA","zip":"24121-9998","dob":"1949-05-27","age":"","mstatus":"","insh":"04000910*028","cliId":"","pno":"92\/0450455-6","cno":"","email":"","ename":"","eno":"","pphy":"STAMBAUGH, MERRIS A MD","ppno":"276\/670-3300","pcpadd":"1107A BROOKDALE ST","pcpcity":"MARTINSVILLE","pcpstate":"VA","pcpzip":24112,"pcpcounty":"","pcpid":"","pcpname":"Carilion Medical Associates Martinsville","plan":"OHP","program":"MEDICARE","lob":"MA-Non DSNP","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["S39.92XA","M47.816","S79.912A","R04.0","D62.","K92.1","R07.9","J44.9","U07.1","J96.01","E87.1","I25.10","I10.","R19.7","R06.02","R94.31","R07.89","D64.9","E11.9","E78.5","I50.21","D50.9","R06.09","Z98.61","Z95.5","I11.0","R50.9","R42.","R55.","Z20.822","R91.8","I95.9","Z79.84","I25.82","E11.69","E78.2","M62.838","I50.41","F32.1","I08.1","I21.4","J12.82","J15.211","N39.0","I50.22","E87.2","B96.1","E83.42","J43.8","I34.0","R00.0","I21.A1","T82.855A","Z23.","Z87.891","R07.2","R53.83","R53.1","R11.0","R09.02","F32.9","R79.89","I49.3","H26.491","H26.492","Z96.1"],"date":["2021-02-22","2021-02-22","2021-02-22","2021-09-02","2021-08-24","2021-08-24","2021-09-13","2022-01-31","2022-11-19","2021-09-27","2021-09-19","2022-01-31","2022-01-31","2021-09-14","2021-09-15","2021-09-13","2021-09-01","2021-09-07","2021-09-19","2021-09-13","2021-08-30","2021-08-30","2021-09-19","2021-08-30","2021-08-30","2021-09-19","2021-09-19","2021-09-13","2021-09-13","2021-09-13","2021-09-18","2021-09-01","2021-09-01","2021-09-01","2022-01-31","2022-01-31","2021-04-19","2021-10-27","2022-01-31","2021-08-24","2021-09-07","2021-09-13","2021-09-18","2021-09-19","2021-09-18","2021-09-19","2021-09-19","2021-10-27","2021-09-13","2021-09-13","2021-09-13","2021-08-23","2021-08-23","2021-08-23","2021-08-23","2021-09-13","2021-09-13","2021-09-13","2021-09-13","2021-09-13","2021-09-13","2021-09-19","2021-08-23","2022-01-28","2022-02-22","2022-02-22"],"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":[["","00186037020","SYMBICORT","AER 160-4.5","10","Select","Select",""],["","00781286810","OMEPRAZOLE","CAP 20MG","30","Select","Select",""],["","69315011610","FUROSEMIDE","TAB 20MG","90","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","13668008130","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","16729021815","CLOPIDOGREL","TAB 75MG","30","Select","Select",""],["","68180051202","LISINOPRIL","TAB 2.5MG","30","Select","Select",""],["","63402051001","XOPENEX","AER ","15","Select","Select",""],["","62332011130","ROPINIROLE","TAB 12MG ER","30","Select","Select",""],["","00173068220","VENTOLIN","AER ","18","Select","Select",""],["","70010006305","METFORMIN","TAB 500MG","30","Select","Select",""],["","43547028110","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","76204060030","IPRATROPIUM\/","SOL ALBUTER","360","Select","Select",""],["","68382065101","ISOSORB","TAB 60MG ER","30","Select","Select",""],["","68382013814","TOPIRAMATE","TAB 25MG","60","Select","Select",""],["","00591292754","LEVALBUTEROL","AER 45\/ACT","15","Select","Select",""],["","00310737020","BUDES\/FORMOT","AER 160-4.5","10","Select","Select",""],["","45963070996","METOPROL","TAB 25MG ER","45","Select","Select",""],["","70377000812","ROSUVASTATIN","TAB 20MG","30","Select","Select",""],["","65862018730","ONDANSETRON","TAB 4MG","30","Select","Select",""],["","59762330403","NITROGLYCERN","SUB 0.4MG","25","Select","Select",""],["","65862017760","CEFDINIR","CAP 300MG","4","Select","Select",""],["","00173085910","BREO","INH 100-25","60","Select","Select",""],["","00536100901","FERROUS","TAB 325MG","30","Select","Select",""],["","66993013597","FLUTIC\/VILAN","INH 100-25","180","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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}