{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"   YRREJNOTROH L","gend":0,"add":"XOB OP5801 ","city":"HILLSVILLE","state":"VA","zip":"24343-9998","dob":"1947-07-09","age":"","mstatus":"","insh":"05000910*356","cliId":"","pno":"27\/6722857-8","cno":"","email":"","ename":"","eno":"","pphy":"DUMS, ROBERT M MD","ppno":"540\/268-1400","pcpadd":"6920 ROANOKE RD","pcpcity":"SHAWSVILLE","pcpstate":"VA","pcpzip":24162,"pcpcounty":"","pcpid":"","pcpname":"Carilion Clinic Family Medicine Giles Rural Health","plan":"OHP","program":"MEDICARE","lob":"MA-Non DSNP","region":"SOUTHWEST","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":["R07.9","E78.5","I65.21","I10.","E88.81","R07.2","E55.9","R53.83","N18.2","D63.1","N25.81","Z98.890","N18.9","Z01.818","Z20.822","I25.110","R26.89","R42.","E53.8","J06.9","J95.89","J98.11","I25.10","E78.00","Z86.2","J90.","K44.9","Z95.1","I48.91","K21.9","N18.31","G45.9","I08.0","R94.39","I24.9","Z01.810","I25.118","I34.0","D62.","N40.0","I12.9","N18.30","Z86.73","Z82.3","Z82.49","Z79.82","Z79.899","Z79.02","R00.1","H91.90","Z96.641","I73.9","I65.23","H10.30","J01.00","R05.9","Z48.812","I45.81","R94.31","N18.32","I45.89","I25.84","D53.1"],"date":["2022-05-12","2022-08-31","2022-08-31","2022-10-04","2022-08-31","2022-04-18","2022-10-20","2022-04-18","2022-10-20","2022-10-20","2022-10-20","2022-08-31","2022-10-17","2022-07-16","2022-07-16","2022-07-18","2022-03-21","2022-03-21","2022-10-12","2022-06-14","2022-07-19","2022-07-19","2022-07-26","2022-10-04","2022-04-13","2022-07-21","2022-07-21","2022-08-31","2022-07-22","2022-07-18","2022-04-13","2022-04-13","2022-05-12","2022-06-16","2022-05-12","2022-07-15","2022-07-18","2022-07-18","2022-07-18","2022-07-18","2022-07-18","2022-07-18","2022-08-31","2022-07-18","2022-07-18","2022-07-18","2022-07-18","2022-07-18","2022-07-18","2022-07-18","2022-07-18","2022-07-18","2022-08-31","2022-06-14","2022-06-14","2022-06-14","2022-07-18","2022-07-26","2022-07-26","2022-08-31","2022-04-18","2022-06-16","2022-10-17"],"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":[]},{"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":[["","68180098003","LISINOPRIL","TAB 10MG","90","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","49884012201","LABETALOL","TAB 100MG","180","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","90","Select","Select",""],["","70377000712","ROSUVASTATIN","TAB 10MG","90","Select","Select",""],["","64980013301","DIPYRIDAMOLE","TAB 25MG","180","Select","Select",""],["","68180038809","FENOFIBRATE","TAB 48MG","90","Select","Select",""],["","65862014990","FINASTERIDE","TAB 5MG","90","Select","Select",""],["","57237001401","TAMSULOSIN","CAP 0.4MG","30","Select","Select",""],["","64380071207","BENZONATATE","CAP 100MG","5","Select","Select",""],["","13668010410","ISOSORB","TAB 30MG ER","90","Select","Select",""],["","65862035790","CLOPIDOGREL","TAB 75MG","90","Select","Select",""],["","23155000201","HYDRALAZINE","TAB 25MG","180","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","50428029821","CHEST","TAB 400MG","20","Select","Select",""],["","24208091055","ERYTHROMYCIN","OIN 5MG\/GM","4","Select","Select",""],["","57664050658","METOPROL","TAB 25MG","60","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","8","Select","Select",""],["","24658031205","DOXYCYCL","TAB 100MG","20","Select","Select",""],["","51862024160","AMIODARONE","TAB 200MG","21","Select","Select",""],["","68180016011","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","49281012265","FLUZONE","INJ 2022-23","1","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":""}]}]}