{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MELINDA   W KEELING","gend":1,"add":"2802 COLONIAL AVENUE SW","city":"ROANOKE                       ","state":"VA","zip":"24015-3843","dob":"1992-01-20","age":"","mstatus":"","insh":4734981,"cliId":"","pno":5405897943,"cno":"","email":"","ename":"","eno":"","pphy":"DOOLAN, AMY W","ppno":5405625700,"pcpadd":"3700 S Main St,","pcpcity":"Blacksburg                    ","pcpstate":"VA","pcpzip":240607017,"pcpcounty":"","pcpid":"","pcpname":"CARILION FAMILY MEDICINE ROANOKE SALEM","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"2802 COLONIAL AVENUE SW","add3":"","madd1":"2802 COLONIAL AVENUE SW","madd2":"APT 11","madd3":"","mcity":"ROANOKE                       ","mstate":"VA","mzip":"24015-3843","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F11.20","F33.1","K59.03","T40.2X5A","R51","J01.00","Z30.9","Z72.0","F41.1","R35.0","N89.8","Z30.42","Z23","G43.709","N76.0","K21.9","B96.89","R87.610","Z01.419","I21.A1","I51.81","A41.9","R93.1","R07.9","Z99.89","F15.10","J18.1","R00.0","J18.9","E87.2","F15.90","R07.89","R11.2","R61","Z20.822","J98.8","R06.02","R11.0","R79.89","D72.829","R65.20","E87.6","J96.01","G93.41","I50.21","I20.1","J15.9","E07.81","B19.20","F17.210","I08.3","R94.6","R06.09","F19.10","F10.10","R91.8","J90","I42.8","B18.2","Z79.891","I34.0","Z09","Z11.59","I42.7","I08.1","F14.282","F14.10","F12.90","N30.00","N92.6","R30.0","Z32.02","F15.20","F11.11","F13.20","F10.20","F12.20"],"date":["2021-12-28","2021-10-04","2021-10-04","2021-10-04","2020-03-05","2020-03-05","2020-06-18","2021-05-17","2021-10-04","2020-08-21","2021-11-08","2021-06-15","2020-10-08","2020-11-20","2020-12-28","2020-11-20","2020-12-28","2020-12-28","2020-12-28","2021-03-23","2021-06-01","2021-03-17","2021-03-13","2021-03-14","2021-03-14","2021-03-14","2021-03-13","2021-03-17","2021-03-16","2021-03-14","2021-03-16","2021-03-12","2021-03-12","2021-03-12","2021-03-13","2021-03-12","2021-03-13","2021-03-12","2021-08-30","2021-03-16","2021-03-16","2021-03-12","2021-03-16","2021-03-14","2021-03-13","2021-03-13","2021-03-13","2021-03-13","2021-03-13","2021-03-13","2021-03-13","2021-03-16","2021-03-14","2021-03-23","2021-03-13","2021-03-15","2021-03-16","2021-03-15","2021-03-15","2021-03-15","2021-03-16","2021-03-22","2021-08-30","2021-03-23","2021-06-01","2021-10-04","2021-10-04","2021-10-04","2021-11-08","2021-11-08","2021-11-08","2021-11-08","2021-12-28","2021-12-28","2021-12-01","2021-12-28","2021-12-28"],"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":[["","12496120803","SUBOXONE","MIS 8-2MG","30","Select","Select",""],["","42806008505","BUSPIRONE","TAB 15MG","30","Select","Select",""],["","00093216568","NALOXONE","SPR ","2","Select","Select",""],["","65862019299","FLUOXETINE","CAP 10MG","30","Select","Select",""],["","00093506201","HYDROXYZ","TAB 50MG","56","Select","Select",""],["","27241005103","ARIPIPRAZOLE","TAB 2MG","30","Select","Select",""],["","00143992801","CIPROFLOXACN","TAB 500MG","14","Select","Select",""],["","00143211250","DOXYCYCL","TAB 100MG","14","Select","Select",""],["","50111033401","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","68462011944","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","62332025130","AZITHROMYCIN","TAB 250MG","4","Select","Select",""],["","00536106229","STOOL","CAP 100MG","90","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","21","Select","Select",""],["","55111029309","SUMATRIPTAN","TAB 100MG","9","Select","Select",""],["","69097083512","SERTRALINE","TAB 100MG","180","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","68382009305","CARVEDILOL","TAB 6.25MG","180","Select","Select",""],["","68180051303","LISINOPRIL","TAB 5MG","90","Select","Select",""],["","55111064505","OMEPRAZOLE","CAP 40MG","30","Select","Select",""],["","00904699880","DOCUSATE","CAP 100MG","30","Select","Select",""],["","69097081312","GABAPENTIN","CAP 100MG","90","Select","Select",""],["","00069046956","CHANTIX","TAB 1MG","60","Select","Select",""],["","60505530601","ACYCLOVIR","TAB 400MG","30","Select","Select",""],["","57237007530","ONDANSETRON","TAB 4MG","9","Select","Select",""],["","43598075260","BUPROPION","TAB 150MG SR","60","Select","Select",""],["","13811071910","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","68382013905","TOPIRAMATE","TAB 50MG","30","Select","Select",""],["","00781185220","AMOX\/K","TAB 875-125","14","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":""}]}]}