{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KELSEA   R MULLINS","gend":1,"add":"127   BELLER STREET                                         ","city":"NARROWS                       ","state":"VA","zip":"24124-1601","dob":"1997-01-20","age":"","mstatus":"","insh":6826220,"cliId":"","pno":5402356856,"cno":"","email":"","ename":"","eno":"","pphy":"GRUBE, RICHARD                                              ","ppno":2762288686,"pcpadd":"1375 W Ridge Rd                                             ,                                                            ","pcpcity":"Wytheville                    ","pcpstate":"VA","pcpzip":243825011,"pcpcounty":"","pcpid":"","pcpname":"CARILION CLINIC FAMILY MEDICINE GILES","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"127   BELLER STREET                                         ","add3":"","madd1":"127   BELLER STREET                                         ","madd2":"                                                            ","madd3":"","mcity":"NARROWS                       ","mstate":"VA","mzip":"24124-1601","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G43.001","G43.909","I10","Z72.0","Z87.891","R68.89","S93.401A","Z98.890","K35.80","E66.01","Z68.41","R10.31","F17.220","R10.10","R10.11","R93.3","L76.82","G89.18","Z09","G47.30","E78.5","R87.612","R06.83","R06.81","G47.19","E78.2","J30.9","K21.9","E03.9","Z68.42","G44.89","R51","Z86.711","R55","M54.2","Z20.828","Z01.419","Z13.79","M25.511","S43.432A","M25.312","M19.011","M75.82","M75.81","X58.XXXA","M25.812","E28.2","Z79.84","Z01.810","I49.8","M75.42","S43.439A","G44.309","M25.512","R51.9","V59.40XA","Y93.9","Y92.410","S49.92XA","R20.2","Z86.14","Z90.49","V89.2XXA","S19.9XXA","S43.92XA","M75.100","N94.89","R53.83","R73.9","E66.09","N85.8","R14.0","J84.10","F43.10","F43.0","V89.2XXD","R42","F07.81","M62.838","R60.9","W19.XXXA","M79.621","S49.91XA","W18.42XA","Y93.89","Y92.9","F17.290","S00.03XA","W01.0XXA","Y92.89","F17.210","S09.90XA","J06.9","R05.9","Z20.822","M79.672"],"date":["2020-01-15","2020-01-15","2022-11-05","2020-01-15","2022-11-05","2021-01-06","2020-01-27","2020-01-27","2020-02-01","2022-01-10","2020-02-01","2020-02-01","2020-02-01","2020-02-01","2020-02-01","2020-02-01","2020-02-14","2020-12-23","2020-02-14","2021-11-04","2020-02-18","2020-03-11","2020-06-04","2020-06-04","2020-06-04","2020-06-04","2020-06-04","2021-05-11","2022-11-05","2022-01-10","2020-06-10","2020-06-12","2021-05-11","2020-06-10","2020-06-13","2020-12-21","2020-10-15","2020-10-15","2022-04-20","2020-12-21","2020-12-07","2020-11-20","2020-11-20","2020-11-20","2022-12-05","2020-12-21","2020-12-21","2020-12-21","2020-12-21","2020-12-21","2020-12-23","2020-12-23","2021-08-25","2021-05-11","2022-11-05","2021-05-11","2021-05-11","2021-05-11","2021-05-11","2021-05-11","2021-05-11","2021-05-11","2021-05-11","2021-05-11","2021-06-22","2021-06-22","2021-06-30","2021-06-25","2021-06-29","2021-06-25","2021-06-30","2021-06-30","2021-08-05","2021-08-25","2021-08-25","2021-08-25","2022-01-10","2021-11-04","2021-12-03","2021-12-03","2022-04-20","2022-04-20","2022-04-20","2022-04-20","2022-06-26","2022-04-20","2022-04-20","2022-06-26","2022-06-26","2022-06-26","2022-06-26","2022-06-26","2022-11-05","2022-11-05","2022-11-05","2022-12-05"],"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":[["","62332002331","FLUOXETINE","CAP 20MG","30","Select","Select",""],["","65862014736","SUMATRIPTAN","TAB 50MG","9","Select","Select",""],["","","LISINOPRIL","TAB 10MG","30","Select","Select",""],["","68462015713","ONDANSETRON","TAB 4MG ODT","10","Select","Select",""],["","60258015001","SF","CRE 0.011","51","Select","Select",""],["","57237001760","DULOXETINE","CAP 20MG","30","Select","Select",""],["","68645058259","METFORMIN","TAB 500MG","60","Select","Select",""],["","62332014231","CELECOXIB","CAP 200MG","30","Select","Select",""],["","68382005105","MELOXICAM","TAB 15MG","30","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","30","Select","Select",""],["","70010077001","METHOCARBAM","TAB 750MG","21","Select","Select",""],["","65162019011","NAPROXEN","TAB 500MG","20","Select","Select",""],["","16729022501","SPIRONOLACT","TAB 25MG","30","Select","Select",""],["","59746012206","MECLIZINE","TAB 12.5MG","30","Select","Select",""],["","69543038810","KETOROLAC","TAB 10MG","17","Select","Select",""],["","68645056259","IBUPROFEN","TAB 600MG","20","Select","Select",""],["","59746011506","PROCHLORPER","TAB 10MG","20","Select","Select",""],["","68382000514","TOPIRAMATE","CAP 25MG","60","Select","Select",""],["","49035007841","EQ","CAP SOFTENER","30","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":""}]}]}