{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BETHANEE   L RIDGEWAY","gend":1,"add":"PO BOX 737                                                  ","city":"VINTON                        ","state":"VA","zip":"24179-0737","dob":"1978-11-12","age":"","mstatus":"","insh":4310845,"cliId":"","pno":5402431455,"cno":5405105015,"email":"","ename":"","eno":"","pphy":"BEACH, BRIANA MARY                                          ","ppno":5405625700,"pcpadd":"1906 Belleview Ave SE                                       ,                                                            ","pcpcity":"Roanoke                       ","pcpstate":"VA","pcpzip":240141838,"pcpcounty":"","pcpid":"","pcpname":"CARILION CLINIC FAMILY MEDICINE SOUTHEAST","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"PO BOX 737                                                  ","add3":"","madd1":"PO Box 737                                                  ","madd2":"                                                            ","madd3":"","mcity":"Vinton                        ","mstate":"VA","mzip":"24179-0737","pcpfaxno":"(540) 562-4278","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I49.9","I49.3","R94.31","M25.561","R22.41","M79.604","E11.40","I10","Z87.891","M79.89","R06.02","R07.9","R06.09","R05","M17.11","E11.29","E11.65","R80.9","J45.20","M47.816","F41.1","E11.42","M47.814","E78.5","E11.9","M54.9","M47.815","M40.209","M54.5","M54.6","M62.81","L60.0","M79.675","H40.023","J06.9","E11.22","V89.2XXA","R26.89","M79.18","M47.817","M51.37","F41.9","R07.89","H91.90","H93.12","Z03.818","Z20.828","Z01.818","Z20.822","J30.2","J30.89","Z53.20","Z02.71","M17.12","M42.00","M25.562","E66.9","F90.9","J11.1","U07.1","Z23","S89.91XA"],"date":["2020-01-18","2020-01-18","2020-01-18","2020-04-08","2020-01-18","2020-01-18","2021-12-16","2021-04-28","2020-04-14","2020-01-18","2021-06-02","2020-01-18","2020-01-18","2020-01-18","2020-04-08","2020-04-14","2020-04-14","2020-04-14","2021-07-22","2020-10-21","2021-12-14","2020-07-21","2021-11-01","2020-07-22","2021-04-05","2020-11-09","2020-07-22","2020-07-22","2020-11-09","2020-11-09","2020-10-12","2020-08-24","2020-08-24","2021-04-05","2020-10-21","2020-10-21","2020-11-09","2020-11-09","2021-11-01","2021-11-01","2021-11-01","2021-12-01","2021-06-02","2021-04-28","2021-05-20","2021-06-11","2021-05-22","2021-05-28","2021-06-11","2021-07-22","2021-07-22","2021-07-29","2021-08-27","2021-08-27","2021-08-27","2021-09-22","2021-09-22","2021-12-01","2021-12-28","2021-12-31","2021-12-31","2022-05-25"],"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":[]},{"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":[["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","00597015330","JARDIANCE","TAB 25MG","90","Select","Select",""],["","00310653004","BYDUREON","INJ 2MG","4","Select","Select",""],["","","FREESTYLE    KIT SENSOR","KIT SENSOR","2","Select","Select",""],["","00093354756","ATOMOXETINE","CAP 80MG","14","Select","Select",""],["","64380080707","IBUPROFEN","TAB 800MG","60","Select","Select",""],["","69097083512","SERTRALINE","TAB 100MG","135","Select","Select",""],["","00088221905","LANTUS","INJ 100\/ML","27","Select","Select",""],["","68180051802","LISINOP\/HCTZ","TAB 10-12.5","90","Select","Select",""],["","08290320119","BD  PEN NEEDL","MIS 31GX5MM","100","Select","Select",""],["","00002771559","BASAGLAR","INJ 100UNIT","15","Select","Select",""],["","68180098003","LISINOPRIL","TAB 10MG","30","Select","Select",""],["","68382013805","TOPIRAMATE","TAB 25MG","60","Select","Select",""],["","16571040250","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","00310652401","BYETTA","INJ 10MCG","2.4","Select","Select",""],["","55111015810","OMEPRAZOLE","CAP 20MG","90","Select","Select",""],["","31722053301","METHOCARBAM","TAB 500MG","15","Select","Select",""],["","99073013001","FREESTYLE    MIS LANCETS","MIS LANCETS","100","Select","Select",""],["","99073070827","FREESTYLE    TES LITE","TES LITE","100","Select","Select",""],["","99073070914","FREESTYLE    KIT FREEDOM","KIT FREEDOM","1","Select","Select",""],["","61442010305","DICLOFENAC","TAB 75MG DR","60","Select","Select",""],["","08214055080","PEN  NEEDLES","MIS 31GX3\/16","200","Select","Select",""],["","57599000200","FREESTYLE    MIS READER","MIS READER","1","Select","Select",""],["","33342002208","LEVOFLOXACIN","TAB 500MG","7","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":{"indx":[["","",""],[""],[""],[""],[""]],"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":""}]}]}