{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TABBETHA   R DUNCAN","gend":1,"add":"4532 PALMER AVENUE NE","city":"ROANOKE","state":"VA","zip":"24019-5234","dob":"1995-08-15","age":"","mstatus":"","insh":6852915,"cliId":"","pno":5403555171,"cno":5403150031,"email":"","ename":"","eno":"","pphy":"EPLING, JOHN WILSON","ppno":5405625700,"pcpadd":"1314 PETERS CREEK ROAD, ","pcpcity":"ROANOKE","pcpstate":"VA","pcpzip":240172500,"pcpcounty":"","pcpid":"","pcpname":"CARILION FAMILY MEDICINE ROANOKE SALEM","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"4532 PALMER AVENUE NE","madd2":"","madd3":"","mcity":"ROANOKE","mstate":"VA","mzip":"24019-5234","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F31.73","R10.2","R11.2","G89.29","J45.909","D68.0","E66.9","Z68.36","N93.8","E28.2","E66.01","A08.4","N92.0","R10.9","R19.7","N93.9","G43.909","N75.1","R11.0","N89.8","K58.0","F31.9","R10.33","R45.86","J30.89","J45.20","F43.9","K21.9","J45.40","G43.809","Z13.29","F33.1","F41.1","F51.5","F41.0","F15.10","F43.10","R68.89","R14.2","R12","M25.561","S80.01XA","W10.9XXA","J45.41","M94.0","J30.2","Z87.891","Z98.890","Z79.51","Z88.8","R00.0","R94.31","R06.02","R07.9","Z87.01","R07.89","F17.210","K52.9","R05","S91.201A","F31.32","G43.009","R51.9","G43.919","F33.0","F60.3","G47.00","F90.8","F31.31","F33.2","R07.81","L03.114","F98.8","M79.89","L53.9","S61.451A","S61.452A","L03.113","S61.452D","Y92.017","W55.01XD","W55.01XA","M79.10","R10.84","R50.9","M25.59","R31.9","T50.B95A","M25.50","M79.606","F41.9","S61.552A","Y93.89","Y92.009","F33.8","Z91.5","F13.10","F12.10","N10","N12","K76.0","R10.30","Z86.2","Z87.42","G43.001","Z79.899","R04.0","M54.2","E83.51","H53.8","M99.01","M62.838","R10.31","K62.5","K92.1","R06.82","Z87.19","E03.9","Z91.030","E07.9","F32.9","D64.9","R10.32","R68.83","Z79.890","G43.109","E04.2","E04.9","Z91.018","Z30.9","Z30.430","Z62.810","N92.1","Z97.5","Z84.89","Z13.83","J30.1","J30.81","T83.39XA","E55.9","J45.50","N97.0","Z31.69","F39","R53.82","F32.2","J30.9","B34.9","H66.001","J45.901","H69.93","J45.21","R59.0","K37","K81.9","Z76.0","S93.401A","S93.601A","R30.0","N39.0"],"date":["2020-11-04","2020-02-07","2021-07-16","2020-02-04","2021-07-14","2022-01-25","2021-03-10","2020-09-17","2020-02-07","2020-02-07","2020-09-17","2020-02-16","2020-02-17","2021-11-28","2021-07-16","2020-05-20","2021-11-13","2020-03-06","2021-11-28","2020-03-06","2020-05-08","2021-07-16","2020-05-08","2020-05-28","2020-06-23","2020-05-28","2020-11-25","2021-11-28","2020-09-14","2020-06-23","2020-06-23","2020-08-12","2022-03-02","2020-06-24","2021-07-16","2020-08-12","2020-09-13","2020-08-27","2020-08-27","2020-08-27","2020-08-30","2020-08-30","2020-08-30","2020-09-13","2020-09-22","2020-09-13","2021-11-28","2020-09-13","2020-09-13","2020-09-13","2022-01-25","2021-03-10","2021-04-21","2021-04-21","2020-09-14","2021-04-21","2020-09-15","2020-09-28","2021-04-21","2020-10-10","2022-03-28","2021-01-02","2021-08-27","2021-08-02","2021-03-19","2021-03-19","2021-01-27","2021-01-27","2021-02-24","2021-02-26","2021-03-10","2021-03-20","2021-03-19","2021-03-19","2021-03-19","2021-03-20","2021-05-04","2021-03-20","2021-03-19","2021-03-19","2021-03-19","2021-05-04","2021-04-19","2021-11-10","2021-07-15","2021-04-19","2021-07-16","2021-04-19","2021-04-19","2021-04-20","2021-11-13","2021-05-04","2021-05-04","2021-05-04","2022-03-02","2022-03-02","2022-03-02","2022-03-02","2021-07-14","2021-07-15","2021-11-09","2021-07-16","2021-11-09","2021-07-16","2021-08-27","2021-11-28","2021-08-02","2021-08-27","2021-08-27","2021-08-27","2021-08-27","2021-08-27","2021-11-28","2021-11-10","2021-11-09","2021-11-09","2021-11-09","2022-01-25","2021-11-10","2021-11-13","2021-11-13","2021-11-13","2021-11-28","2021-11-28","2021-11-28","2022-01-25","2022-02-07","2022-02-07","2019-01-28","2019-02-05","2019-02-05","2019-02-05","2019-02-05","2019-02-08","2019-02-12","2019-02-12","2019-02-12","2019-02-12","2019-02-15","2019-04-02","2019-04-02","2019-02-26","2019-02-26","2019-03-26","2019-03-26","2019-03-26","2019-12-20","2019-04-15","2019-04-15","2019-04-29","2019-04-29","2019-12-20","2019-07-17","2019-07-17","2019-07-17","2019-07-22","2019-10-03","2019-10-03","2019-12-11","2019-12-17"],"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":[["","60505283603","ATOMOXETINE","CAP 100MG","30","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","12","Select","Select",""],["","00228141003","LAMOTRIGINE","TAB 25MG ER","30","Select","Select",""],["","68382003616","VENLAFAXINE","CAP 150MG ER","30","Select","Select",""],["","00115169449","EPINEPHRINE","INJ 0.3MG","2","Select","Select",""],["","00093770198","LEVOCETIRIZI","TAB 5MG","30","Select","Select",""],["","41167005840","ASPERCREME","PAD LIDO 4%","10","Select","Select",""],["","00085720601","DULERA","AER 100-5MCG","13","Select","Select",""],["","69097014260","ALBUTEROL","AER HFA","6.7","Select","Select",""],["","70710122600","AMITRIPTYLIN","TAB 25MG","30","Select","Select",""],["","65862050320","AMOX\/K","TAB 875-125","14","Select","Select",""],["","16729028912","BUSPIRONE","TAB 30MG","60","Select","Select",""],["","00378181977","LEVOTHYROXIN","TAB 200MCG","30","Select","Select",""],["","55111029136","SUMATRIPTAN","TAB 25MG","9","Select","Select",""],["","75826011410","PHENAZOPYRID","TAB 100MG","6","Select","Select",""],["","59651000305","OMEPRAZOLE","CAP 40MG","30","Select","Select",""],["","69097083305","SERTRALINE","TAB 25MG","30","Select","Select",""],["","10702001050","HYDROXYZ","TAB 10MG","90","Select","Select",""],["","49483034150","ACETAMINOPHN","TAB 500MG","30.00","Select","Select",""],["","63402030830","LATUDA","TAB 80MG","30","Select","Select",""],["","65162089129","MOMETASONE","SPR 50MCG","17","Select","Select",""],["","00143122701","DICYCLOMINE","TAB 20MG","20","Select","Select",""],["","59746011506","PROCHLORPER","TAB 10MG","20","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","00378041510","DIPHEN\/ATROP","TAB 2.5MG","20","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","50111064801","FLUOXETINE","CAP 20MG","30","Select","Select",""],["","65162052110","PROMETHAZINE","TAB 25MG","12","Select","Select",""],["","69918030130","TRANEX","TAB 650MG","18","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","00603533831","PREDNISONE","PAK 10MG","48","Select","Select",""],["","00115166003","PROPRANOLOL","TAB 20MG","30.00","Select","Select",""],["","67877026218","RIZATRIPTAN","TAB 10MG","9","Select","Select",""],["","13668013601","ESCITALOPRAM","TAB 10MG","30.00","Select","Select",""],["","69097012203","TOPIRAMATE","TAB 25MG","30","Select","Select",""],["","65162019050","NAPROXEN","TAB 500MG","20","Select","Select",""],["","80777027399","MODERNA","INJ COVID-19","0.5","Select","Select",""],["","73086090299","LIDOCAINE","PAD 0.04","10","Select","Select",""],["","70954001910","PRAZOSIN","CAP 1MG","30","Select","Select",""],["","50111043301","TRAZODONE","TAB 50MG","30","Select","Select",""],["","00591565810","CYCLOBENZAPR","TAB 10MG","30","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","12","Select","Select",""],["","49100040007","CULTURELLE","CAP ","30","Select","Select",""],["","31722054201","INDOMETHACIN","CAP 25MG","90","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","10","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","15","Select","Select",""],["","00186091612","PULMICORT","INH 180MCG","1","Select","Select",""],["","68180061207","QUETIAPINE","TAB 50MG ER","30","Select","Select",""],["","59310057922","PROAIR","AER ","8.5","Select","Select",""],["","69452015120","VITAMIN","CAP 50000UNT","4","Select","Select",""],["","67877032105","IBUPROFEN","TAB 800MG","42","Select","Select",""],["","51991081403","AZELASTINE","SPR 0.001","30","Select","Select",""],["","00093742698","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","45802065078","LORATADINE","TAB 10MG","30","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","20","Select","Select",""],["","00186037220","SYMBICORT","AER 80-4.5","10.2","Select","Select",""],["","51991083801","CYPROHEPTAD","TAB 4MG","60","Select","Select",""],["","00555077902","MEDROXYPR","TAB 10MG","10","Select","Select",""],["","00093005805","TRAMADOL","TAB 50MG","12","Select","Select",""],["","65862001501","AMOXICILLIN","TAB 875MG","20","Select","Select",""],["","59779008002","ATHLETE","CRE 0.01","30","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","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":""}]}]}