{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LAEKIN   S HOSTETTER","gend":1,"add":"303 W 29TH STREET","city":"BUENA VISTA","state":"VA","zip":"24416-1315","dob":"1996-02-10","age":"","mstatus":"","insh":6836292,"cliId":"","pno":5408179306,"cno":"","email":"","ename":"","eno":"","pphy":"HARCUS, SINCLAIR JOHN","ppno":5404639158,"pcpadd":"123 S Randolph St Apt A, ","pcpcity":"Lexington","pcpstate":"VA","pcpzip":244502065,"pcpcounty":"","pcpid":"","pcpname":"CARILION FAMILY MEDICINE","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"APT 1","add3":"","madd1":"303 W 29TH STREET","madd2":"APT 1","madd3":"","mcity":"BUENA VISTA","mstate":"VA","mzip":"24416-1315","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z01.419","Z11.3","Z97.5","F10.10","K08.89","F33.2","N26.1","R30.0","R10.9","Z87.442","N30.00","N70.11","B37.3","N76.0","B96.89","R10.31","N18.9","F17.210","Z87.42","Z79.899","R10.2","N83.8","S91.332A","S92.512A","X58.XXXA","S92.515B","M79.672","W45.0XXA","Y93.89","Y92.9","S90.32XA","Z86.69","Z23","S99.922A","S92.515A","S91.135A","M25.512","M54.2","M54.9","R07.89","R07.9","S30.0XXA","R91.8","R51","S00.03XA","S01.01XA","S02.80XA","S22.32XA","G44.311","S02.0XXA","V89.2XXA","Y93.I9","Y92.410","S80.12XA","S70.212A","M47.898","S02.91XA","S22.49XA","R68.89","S06.0X9A","S22.32XD","S06.330A","V49.9XXD","V49.9XXA","Z87.891","R42","Y04.8XXA","Z87.81","Z88.0","S49.92XA","Z48.02","S46.812A","F07.81","T74.91XA","Y07.499","Z32.02","H60.502","H66.92","F41.9","F43.10","F32.1","F41.0","S81.811A","W22.8XXA","W26.8XXA","Z72.0","N93.8","N89.8"],"date":["2020-03-24","2020-03-24","2020-03-24","2020-09-01","2020-11-24","2021-10-14","2021-08-02","2021-08-02","2021-08-02","2021-08-02","2021-08-02","2021-08-02","2021-08-02","2021-08-02","2021-08-02","2021-08-02","2021-09-14","2021-09-14","2021-08-02","2021-09-14","2021-08-02","2021-08-02","2021-09-14","2021-09-14","2021-09-14","2021-09-14","2021-09-14","2021-09-14","2021-09-14","2021-09-14","2021-09-14","2021-09-14","2021-09-14","2021-09-14","2021-09-14","2021-09-14","2019-01-19","2019-01-14","2019-01-14","2019-01-14","2019-01-19","2019-01-15","2019-01-14","2019-01-14","2019-01-14","2019-01-15","2019-01-14","2019-01-19","2019-01-14","2019-01-14","2019-01-14","2019-01-14","2019-01-14","2019-01-14","2019-01-14","2019-01-14","2019-01-14","2019-01-14","2019-01-15","2019-01-15","2019-01-15","2019-01-15","2019-01-15","2019-01-15","2019-01-15","2019-01-19","2019-01-19","2019-01-19","2019-07-30","2019-01-19","2019-01-24","2019-01-29","2019-02-05","2019-01-31","2019-01-31","2019-08-01","2019-02-21","2019-02-21","2019-07-24","2019-07-24","2019-07-24","2019-07-24","2019-07-30","2019-07-30","2019-07-30","2019-07-30","2019-08-01","2019-08-01"],"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":[["","33342002208","LEVOFLOXACIN","TAB 500MG","7","Select","Select",""],["","63304069301","CLINDAMYCIN","CAP 300MG","28","Select","Select",""],["","43547030303","ARIPIPRAZOLE","TAB 5MG","30","Select","Select",""],["","42806016005","HYDROXYZ","TAB 25MG","90","Select","Select",""],["","57664049983","MIRTAZAPINE","TAB 15MG","30","Select","Select",""],["","23155019101","BUPROPION","TAB 75MG","30","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","12","Select","Select",""],["","00143992801","CIPROFLOXACN","TAB 500MG","20","Select","Select",""],["","50111033401","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","40","Select","Select",""],["","50111064701","FLUOXETINE","CAP 10MG","30","Select","Select",""],["","00555904358","APRI","TAB ","28","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","10","Select","Select",""],["","17478071311","OFLOXACIN","DRO 0.3% OP","10","Select","Select",""],["","68180016013","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","59746017710","CYCLOBENZAPR","TAB 10MG","42","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":""}]}]}