{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SAIGE   N ANTHONY","gend":1,"add":"202 NOWHERE ROAD","city":"AXTON","state":"VA","zip":"24054-2044","dob":"2003-01-26","age":"","mstatus":"","insh":4120592,"cliId":"","pno":2762520359,"cno":"","email":"","ename":"","eno":"","pphy":"STAMBAUGH, MERRIS A","ppno":2766703300,"pcpadd":"1107 Brookdale St, ","pcpcity":"Martinsville","pcpstate":"VA","pcpzip":241124501,"pcpcounty":"","pcpid":"","pcpname":"CARILION MEDICAL ASSOCIATES MARTINSVILLE","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"202 NOWHERE ROAD","madd2":"","madd3":"","mcity":"AXTON","mstate":"VA","mzip":"24054-2044","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z00.129","Z68.52","N94.6","K59.00","Z23","D50.9","R55","E86.0","N93.9","R11.2","Z88.0","R56.9","Z20.9","R58","R50.9","R09.89","Z03.818","A41.9","Z20.828","S29.9XXD","N39.0","Z32.02","F90.9","Z79.899","F91.3","Z01.419","R60.9","Z30.011","I24.0","I50.1","I50.9","R57.0","D69.6","R00.0","R04.2","E87.2","I42.0","R00.8","D64.9","Z79.82","R06.02","Z88.1","Z13.6","I50.20","I50.21","F19.90","R32","I51.3","G43.109","I49.3","K76.1","R04.0","F17.200","Z20.822","Z86.711","Z45.2","I51.7","J81.1","R51.9","Z79.01","R74.8","I51.9","I45.9","I45.81","R00.2","R94.31","I50.22","I10","I42.8","H04.123","M54.5","I08.8","I42.9","R29.898","R93.1","I34.0","I51.89","Z95.810","I11.0","F43.10","B34.8","Z95.811","S30.861A","H05.222","W57.XXXA","R21","L03.213","F11.11","Z30.430","Z30.432","T83.32XA"],"date":["2021-01-13","2020-05-29","2020-05-29","2020-05-29","2020-05-29","2020-12-31","2020-06-11","2020-06-11","2020-06-11","2020-06-11","2020-09-04","2020-06-11","2020-06-11","2020-06-11","2020-09-04","2020-09-04","2020-09-04","2020-09-04","2020-12-30","2020-09-04","2021-12-23","2021-12-23","2020-12-30","2020-12-30","2021-03-18","2020-12-18","2020-12-18","2020-12-18","2020-12-30","2020-12-30","2021-09-10","2020-12-30","2020-12-30","2020-12-30","2020-12-30","2020-12-30","2021-10-01","2020-12-30","2020-12-31","2020-12-30","2021-04-13","2020-12-30","2020-12-30","2021-01-07","2021-01-04","2020-12-31","2020-12-31","2021-08-18","2021-01-03","2021-01-07","2020-12-31","2020-12-31","2020-12-31","2021-12-23","2020-12-31","2021-01-03","2021-04-13","2021-01-02","2021-01-04","2021-08-27","2021-01-03","2021-01-03","2021-01-07","2021-01-07","2021-01-27","2022-02-24","2022-02-24","2022-02-24","2021-08-27","2021-04-07","2021-04-10","2021-04-13","2022-02-24","2021-08-18","2021-08-18","2021-08-18","2021-08-18","2021-08-27","2021-09-10","2021-09-10","2021-12-23","2022-02-24","2019-05-10","2019-05-10","2019-05-10","2019-05-10","2019-05-10","2019-07-22","2019-11-07","2019-11-25","2019-11-25"],"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":[["","57664050658","METOPROL","TAB 25MG","15","Select","Select",""],["","67877032105","IBUPROFEN","TAB 800MG","20","Select","Select",""],["","68180051303","LISINOPRIL","TAB 5MG","30","Select","Select",""],["","00003089421","ELIQUIS","TAB 5MG","60","Select","Select",""],["","10006073038","MAG","TAB 400MG","30","Select","Select",""],["","64679092302","ENALAPRIL","TAB 2.5MG","90","Select","Select",""],["","53746051110","SPIRONOLACT","TAB 25MG","180","Select","Select",""],["","65162068090","PROMETHAZINE","SOL DM","200","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","28","Select","Select",""],["","00555901658","SPRINTEC","TAB 28 DAY","28","Select","Select",""],["","00254203080","TRI-PREVIFEM","TAB ","28","Select","Select",""],["","00472073556","ANTIFUNGAL","CRE 0.02","28","Select","Select",""],["","68180071160","CEFDINIR","CAP 300MG","20","Select","Select",""],["","07610022640","MELATONIN","TAB 3MG","180","Select","Select",""],["","57896048914","POLYETH","POW 3350 NF","238","Select","Select",""],["","24357070130","ANECREAM","CRE 0.04","120","Select","Select",""],["","00573287193","PREPARATION","OIN H","28","Select","Select",""],["","00955100610","ENOXAPARIN","INJ 60\/0.6ML","108","Select","Select",""],["","65862052205","NAPROXEN","TAB 500MG","20","Select","Select",""],["","55111012705","CIPROFLOXACN","TAB 500MG","20","Select","Select",""],["","65162068210","PHENAZOPYRID","TAB 200MG","6","Select","Select",""],["","50428613836","CVS","CHW 15MG","24","Select","Select",""],["","00132018582","FLEET","ENE GLYCERIN","7.5","Select","Select",""],["","50428693430","SPECTRAVITE","TAB ADVANCED","90","Select","Select",""],["","68180016013","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","67877057305","BENZONATATE","CAP 100MG","20","Select","Select",""],["","59762500801","MISOPROSTOL","TAB 200MCG","1","Select","Select",""],["","00904530660","BANOPHEN","CAP 25MG","30","Select","Select",""],["","00054001829","PREDNISONE","TAB 20MG","8","Select","Select",""],["","50419042401","KYLEENA","IUD 19.5MG","1","Select","Select",""],["","24658031205","DOXYCYCL","TAB 100MG","28","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":""}]}]}