{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TONYA S BROWN","gend":1,"add":"55 OTTER AVENUE","city":"SALEM","state":"VA","zip":24153,"dob":"1971-08-20","age":"","mstatus":"","insh":6853096,"cliId":"","pno":5408924192,"cno":"","email":"","ename":"","eno":"","pphy":"CHEN, ERIC HONG WEN","ppno":5408924192,"pcpadd":"1906 BELLEVIEW AVE SE,","pcpcity":"ROANOKE","pcpstate":"VA","pcpzip":24014,"pcpcounty":"","pcpid":"","pcpname":"CARILION ROANOKE MEMORIAL HOSP","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"ROANOKE\/ALLEGHANY","aligned":"","ano":"","add2":"55 OTTER AVENUE","add3":"","madd1":"55 OTTER AVENUE","madd2":"APARTMENT 67","madd3":"","mcity":"SALEM                         ","mstate":"VA","mzip":"24153-4250","pcpfaxno":"(540) 427-3237","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z01.419","Z12.4","N89.8","N76.0","B96.89","J45.31","R05","J30.2","Z87.891","Z23","J22","Z20.828","F11.20","G89.29","M54.2","R20.2","M54.6","V89.2XXA","Y92.410","I10","E11.9","J45.909","E66.9","Z79.51","Z68.38","V49.40XA","T14.90XA","G56.02","R20.0","M54.12","G56.03","G56.22","G56.01","E78.00","F32.9","J45.20","F41.9","Z76.89","F41.8","R73.09","K59.00","J30.89","Z01.818","D64.9","Z98.890","M54.9","M62.838","W01.0XXA","Z68.35","S19.80XA","Z98.1","S39.82XA","I16.9","J01.90","M25.561","S83.91XA","S80.01XA","R09.81","G50.1","S80.01XD","R35.0","E86.0","J32.1","A41.9","J18.9","Z20.822","J45.901","F17.200","Z90.49","Z86.39","Z87.39","Z87.09","Z87.448","Z86.69","J98.4","Z72.0","J45.40","J30.9","J96.01","E44.1","D86.9","D50.9","E83.39","E87.6","R59.0","T38.0X5A","K80.20","D18.03","R09.02","R00.0","R07.81","R79.1","Z74.01","R07.89","I88.8","R06.02","Z48.813","R91.8","J90","H02.88A","H02.88B","H18.593","H53.8","H43.12","M62.830","R22.0","Y04.2XXA","S00.531A","R51.9","Y04.8XXA","Z68.36","Z04.3","Z04.89","R42","E11.69","F33.9","F32.A","Z12.31","R06.00","M79.89","H54.40","R07.9","D86.89","R90.82","H53.9","I34.0","I05.8","G47.00","F33.0","R05.9"],"date":["2021-11-10","2020-01-31","2021-11-10","2020-02-04","2021-04-07","2020-02-04","2021-06-06","2020-02-04","2021-01-13","2020-02-04","2020-04-29","2021-03-21","2021-01-10","2021-09-14","2021-09-14","2021-01-13","2021-01-13","2020-09-21","2020-09-21","2021-11-24","2021-11-24","2021-11-17","2021-11-17","2021-11-17","2020-09-21","2020-09-21","2020-09-21","2020-10-01","2021-01-13","2020-10-12","2020-11-13","2020-11-13","2020-10-16","2020-10-21","2021-11-24","2021-06-02","2021-06-29","2020-10-21","2021-06-10","2020-11-04","2021-04-07","2021-04-07","2020-11-10","2021-06-06","2020-11-13","2021-09-14","2021-09-14","2021-01-13","2021-01-13","2021-01-13","2021-11-24","2021-01-13","2021-02-17","2021-04-07","2021-02-17","2021-02-17","2021-02-22","2021-03-21","2021-03-21","2021-03-31","2021-04-07","2021-05-03","2021-04-21","2021-06-10","2021-12-13","2021-06-06","2021-05-04","2021-11-17","2021-05-03","2021-05-03","2021-05-03","2021-11-18","2021-05-03","2021-05-03","2021-06-06","2021-11-24","2021-11-24","2021-11-01","2021-11-17","2021-06-06","2021-11-24","2021-06-09","2021-06-06","2021-06-08","2021-11-17","2021-06-06","2021-06-10","2021-06-10","2021-06-06","2021-11-17","2021-06-06","2021-06-06","2021-06-06","2021-06-08","2021-06-09","2021-11-24","2021-06-09","2021-11-17","2021-07-15","2021-07-22","2021-07-22","2021-11-05","2021-12-17","2021-12-17","2021-09-14","2021-09-14","2021-09-14","2021-09-14","2021-11-18","2021-09-14","2021-09-14","2021-09-14","2021-09-14","2021-11-22","2021-10-13","2021-10-13","2021-11-10","2021-11-10","2021-11-17","2021-11-17","2021-11-17","2021-11-17","2021-11-18","2021-11-18","2021-11-18","2021-11-22","2021-11-23","2021-11-24","2021-11-24","2021-12-13"],"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":[["","00406052301","OXYCOD\/APAP","TAB 10-325MG","6","Select","Select",""],["","00406012301","HYDROCO\/APAP","TAB 5-325MG","20","Select","Select",""],["","00310183030","FASENRA","INJ 30MG\/ML","1","Select","Select",""],["","69097081312","GABAPENTIN","CAP 100MG","30","Select","Select",""],["","68180051902","LISINOP\/HCTZ","TAB 20-12.5","90","Select","Select",""],["","52817036000","METOPROL","TAB 25MG","60","Select","Select",""],["","65862019405","FLUOXETINE","CAP 40MG","30","Select","Select",""],["","00115180301","HYDROXYZ","CAP 25MG","120","Select","Select",""],["","13107003134","MIRTAZAPINE","TAB 15MG","30","Select","Select",""],["","69097084615","CYCLOBENZAPR","TAB 10MG","15","Select","Select",""],["","69543038810","KETOROLAC","TAB 10MG","15","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","68180063709","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","65862047099","LOSARTAN\/HCT","TAB 100-25","30","Select","Select",""],["","61442010305","DICLOFENAC","TAB 75MG DR","30","Select","Select",""],["","00603533815","PREDNISONE","PAK 10MG","21","Select","Select",""],["","68645056054","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","64380080807","IBUPROFEN","TAB 600MG","90","Select","Select",""],["","49884072703","DOXYCYC","CAP 100MG","5","Select","Select",""],["","00781261305","AMOXICILLIN","CAP 500MG","15","Select","Select",""],["","33342002332","LEVOFLOXACIN","TAB 750MG","7","Select","Select",""],["","00173069700","ADVAIR","AER 500\/50","60","Select","Select",""],["","00591352530","LIDOCAINE","PAD 0.05","15","Select","Select",""],["","00172392670","DIAZEPAM","TAB 5MG","15","Select","Select",""],["","00143980350","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","00781185220","AMOX\/K","TAB 875-125","14","Select","Select",""],["","42571012290","LEVOCETIRIZI","TAB 5MG","30","Select","Select",""],["","45802008801","ALBUTEROL","AER HFA","8.5","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","57896055510","SENNA-PLUS","TAB 8.6-50MG","30","Select","Select",""],["","65862017760","CEFDINIR","CAP 300MG","14","Select","Select",""],["","65862064163","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","00536106229","STOOL","CAP 100MG","30","Select","Select",""],["","66993058497","FLUTIC\/SALME","AER 100\/50","60","Select","Select",""],["","67877024901","QUETIAPINE","TAB 50MG","60","Select","Select",""],["","00536100901","FERROUS","TAB 325MG","12","Select","Select",""],["","31722053401","METHOCARBAM","TAB 750MG","20","Select","Select",""],["","65162062750","TRAMADOL","TAB 50MG","15","Select","Select",""],["","68462030529","NORETHINDRON","TAB 0.35MG","28","Select","Select",""],["","50111033401","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","68180098101","LISINOPRIL","TAB 20MG","30","Select","Select",""],["","00904646420","ROBAFEN","LIQ 10-100\/5","118","Select","Select",""],["","65862000901","METFORMIN","TAB 850MG","28","Select","Select",""],["","59762444002","METHYLPRED","TAB 4MG","21","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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}