{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ASHLEY   L REEVES","gend":1,"add":"503 VIRGINIAN DRIVE","city":"CHRISTIANSBURG                ","state":"VA","zip":"24073-6590","dob":"1984-08-04","age":"","mstatus":"","insh":4225199,"cliId":"","pno":5405058537,"cno":5406412010,"email":"","ename":"","eno":"","pphy":"TSUI, CAMILLA K","ppno":5409510352,"pcpadd":"901 Plantation Rd Ste 3,","pcpcity":"Blacksburg                    ","pcpstate":"VA","pcpzip":240603821,"pcpcounty":"","pcpid":"","pcpname":"CARILION FAMILY MEDICINE BLACKSBURG","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"503 VIRGINIAN DRIVE","add3":"","madd1":"503 VIRGINIAN DRIVE","madd2":"","madd3":"","mcity":"CHRISTIANSBURG                ","mstate":"VA","mzip":"24073-6590","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z00.00","Z13.31","Z11.1","Z76.89","L02.91","L73.2","F41.1","J45.909","E78.00","Z23","K59.00","R10.9","F32.9","F41.9","Z86.73","N20.0","R10.11","R10.13","J22","J06.9","R05","R11.10","B34.9","R11.2","R19.7","N64.52","Z80.3","Z51.81","K50.00","M94.0","J20.9","R10.12","R07.89","R07.9","R06.00","Z79.899","D89.9","R40.4","G56.41","G44.52","G37.9","H92.09","K50.90","Z01.419","R87.610","T83.32XA","H92.02","H69.83","H91.8X2","H92.12","Z11.3","Z30.433","T83.32XD","F33.1","H66.92","H93.92","Z20.828","G40.909","Z88.0","Z88.1","Z13.228","R51","E87.1","R42","R32","R29.6","R56.9","G43.009","G96.00","K21.9","F17.200","R07.81","R43.9","Z20.822","R94.31","R10.10","K92.1","K50.018","K58.1","K31.7","K29.50","K21.00","K22.8","K64.8","K31.89","K63.89","K50.10","G43.909","Z79.51","E66.01","K62.89","R63.4","K50.818","Z80.0","Z87.19","Z71.83","B37.9","I82.90","M25.572","S93.492A","R06.02","R11.0","R53.83","I10","N83.291","R14.0","N83.201","Z79.82","I63.9","R53.1","I95.9","L40.9","R29.704","G81.91","R29.810","I20.0","R29.818","Z98.890","S02.82XA","G46.3","X58.XXXA","G40.89","I20.8","R55","Z86.69","F33.9","M19.011","E55.9","B02.9","K50.012","R10.84","R19.07","L40.0","D48.5","L40.8","S63.501A","M79.605"],"date":["2020-01-06","2020-01-06","2020-01-06","2020-01-06","2020-01-06","2020-01-06","2021-05-10","2021-12-08","2020-01-21","2020-01-21","2020-01-27","2020-01-27","2021-05-10","2022-01-13","2021-12-05","2020-01-27","2020-02-26","2021-12-05","2020-02-01","2020-02-02","2021-01-15","2021-01-12","2020-02-05","2020-09-21","2021-01-19","2021-02-17","2021-02-26","2020-03-31","2021-11-15","2020-02-26","2020-02-26","2020-02-26","2021-09-30","2022-01-13","2020-02-26","2020-03-31","2020-03-31","2022-01-11","2022-01-11","2022-01-11","2022-01-11","2020-04-29","2021-12-08","2020-05-04","2020-05-04","2020-05-04","2020-09-28","2020-09-18","2020-05-08","2020-11-02","2020-05-13","2020-05-13","2020-05-13","2020-08-18","2020-08-23","2020-08-23","2021-09-23","2022-01-11","2020-08-23","2020-08-23","2020-09-15","2020-09-21","2020-09-15","2021-12-05","2020-12-07","2020-11-02","2021-11-30","2020-12-07","2020-12-07","2021-01-12","2021-01-12","2021-01-15","2021-01-15","2021-12-08","2021-01-15","2021-01-19","2021-01-19","2021-01-25","2021-01-25","2021-01-27","2021-01-27","2021-01-27","2021-01-27","2021-01-27","2021-01-27","2021-01-27","2021-01-27","2021-01-25","2021-12-08","2021-01-25","2021-03-01","2021-01-27","2021-03-05","2021-02-26","2021-02-10","2021-02-26","2021-03-06","2021-07-27","2021-07-30","2021-07-30","2021-09-30","2021-11-15","2021-11-30","2021-11-30","2021-12-05","2021-12-05","2021-12-05","2021-12-08","2021-12-28","2021-12-28","2021-12-28","2021-12-28","2021-12-08","2021-12-28","2021-12-28","2021-12-28","2021-12-28","2021-12-28","2021-12-28","2021-12-28","2021-12-28","2022-01-11","2021-12-29","2022-01-13","2022-01-13","2022-01-13","2019-01-07","2019-03-11","2019-05-08","2019-06-11","2019-06-17","2019-06-17","2019-10-01","2019-09-17","2019-10-17","2019-11-04","2021-07-27"],"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":[["","65862052830","VENLAFAXINE","CAP 75MG ER","30","Select","Select",""],["","00456120230","LINZESS","CAP 290MCG","30","Select","Select",""],["","68462012901","ZONISAMIDE","CAP 50MG","60","Select","Select",""],["","29300012510","MELOXICAM","TAB 15MG","28","Select","Select",""],["","00115166001","PROPRANOLOL","TAB 20MG","60","Select","Select",""],["","11534016503","FOLIC","TAB 1MG","120","Select","Select",""],["","65862018501","CLINDAMYCIN","CAP 150MG","63","Select","Select",""],["","58160082311","SHINGRIX","INJ 50\/0.5ML","1","Select","Select",""],["","31722071390","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","00555057202","METHOTREXATE","TAB 2.5MG","20","Select","Select",""],["","33342009441","RIZATRIPTAN","TAB 10MG ODT","9","Select","Select",""],["","00363022714","ASPIRIN","TAB 325MG EC","30","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","20","Select","Select",""],["","57894006103","STELARA","INJ 90MG\/ML","1","Select","Select",""],["","80777027310","MODERNA","INJ COVID-19","0.25","Select","Select",""],["","00574985510","BUDESONIDE","CAP 3MG DR","90","Select","Select",""],["","00378113401","KETOROLAC","TAB 10MG","10","Select","Select",""],["","55111017915","TIZANIDINE","TAB 2MG","30","Select","Select",""],["","00472037915","CLOTRIM\/BETA","CRE DIPROP","45","Select","Select",""],["","69238161503","OFLOXACIN","DRO 0.3%OTIC","5","Select","Select",""],["","57237000511","FLUCONAZOLE","TAB 150MG","7","Select","Select",""],["","68462010630","ONDANSETRON","TAB 8MG","15","Select","Select",""],["","00406051205","OXYCOD\/APAP","TAB 5-325MG","20","Select","Select",""],["","00781316907","SUMATRIPTAN","INJ 4MG\/0.5","1","Select","Select",""],["","68462034690","LEVOCETIRIZI","TAB 5MG","30","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","52817033200","CYCLOBENZAPR","TAB 10MG","30","Select","Select",""],["","00093317431","ALBUTEROL","FAT E","8.5","Select","Select",""],["","00591544210","PREDNISONE","TAB 10MG","32","Select","Select",""],["","81421002204","DULCOLAX","CAP 100MG","10","Select","Select",""],["","00781808926","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","00574110404","BROM\/PSE\/DM","SYP ","120","Select","Select",""],["","69543025216","VIRTUSSIN","SOL 100-10\/5","120","Select","Select",""],["","60432060416","PROMETHAZINE","SYP DM","120","Select","Select",""],["","00074055402","HUMIRA","INJ 40\/0.4ML","2","Select","Select",""],["","74312052805","VITAMIN","TAB 1000MCG","60","Select","Select",""],["","43547028910","BUPROPION","TAB 150MG SR","60","Select","Select",""],["","65862001905","CEPHALEXIN","CAP 500MG","28","Select","Select",""],["","00406012305","HYDROCO\/APAP","TAB 5-325MG","10","Select","Select",""],["","59746011506","PROCHLORPER","TAB 10MG","21","Select","Select",""],["","11917013941","D3","CAP 2000UNIT","30","Select","Select",""],["","68382079201","ACYCLOVIR","TAB 800MG","35","Select","Select",""],["","51672129303","CLOBETASOL","SOL 0.0005","50","Select","Select",""],["","45802048526","FLUOCIN","OIL 0.01% SC","118.28","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":""}]}]}