{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SHAYLAN   N SHERMAN","gend":1,"add":"165   SOPHIA LANE                                           ","city":"CHRISTAINSBURG                ","state":"VA","zip":"24073-3430","dob":"1984-10-26","age":"","mstatus":"","insh":6882536,"cliId":"","pno":5408185315,"cno":"","email":"","ename":"","eno":"","pphy":"KADIRI, MOHAMED I                                           ","ppno":5403816000,"pcpadd":"205 Roanoke St,","pcpcity":"Christiansburg                ","pcpstate":"VA","pcpzip":240733025,"pcpcounty":"","pcpid":"","pcpname":"CARILION FAMILY MEDICINE CHRISTIANBURG","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"                                                            ","add3":"","madd1":"165 SOPHIA LANE","madd2":"                                                            ","madd3":"","mcity":"CHRISTAINSBURG                ","mstate":"VA","mzip":"24073-3430","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I10","M79.643","M25.531","M79.641","R07.89","R07.9","R42","R06.02","E78.5","R94.31","R06.83","H53.8","R09.89","R52","R59.9","Z79.899","Z71.3","I51.7","R53.83","R60.9","E78.1","F43.10","F32.9","R51","T30.0","T23.202A","X08.8XXA","Y93.89","Y92.89","T21.22XA","T24.211A","T20.00XA","Z77.22","R03.0","T23.099D","K59.00","J02.9","R05","R20.0","D64.9","K11.5","R22.0","K11.20","G50.1","R13.10","R11.0","K11.21","R60.0","R51.9","D72.829","E87.6","F41.9","R59.1","K11.1","K11.23","K11.8","K12.2","R49.9","Z20.822","L02.01","R68.84","K11.22","G89.18","K11.3","T81.41XA","L08.9","Z91.040","T81.42XA","Z98.890","T81.89XA","L03.90","R70.0","R79.82","F31.81","F11.21","F11.11","M25.512","V89.2XXA","M54.2","S49.92XA","M79.10","V43.52XA","Y92.410"],"date":["2021-04-10","2019-02-11","2019-02-11","2019-02-11","2019-05-31","2019-04-08","2019-04-18","2019-05-31","2019-05-28","2019-04-11","2019-05-28","2019-04-18","2020-03-26","2020-06-30","2019-05-28","2021-10-14","2019-04-30","2019-04-30","2020-06-30","2019-05-28","2019-05-28","2021-05-27","2021-04-09","2019-05-28","2020-06-30","2019-07-12","2019-07-12","2019-07-12","2019-07-12","2019-07-12","2019-07-12","2019-07-12","2021-04-18","2019-07-12","2019-07-15","2020-06-30","2020-03-26","2020-03-26","2020-06-02","2020-06-30","2021-04-10","2021-04-09","2021-04-09","2021-04-06","2021-04-09","2021-04-09","2021-04-10","2021-04-06","2021-04-09","2021-04-09","2021-04-19","2021-04-09","2021-04-09","2021-04-09","2021-04-10","2021-04-09","2021-04-18","2021-04-09","2021-04-09","2021-04-09","2021-04-18","2021-04-10","2021-04-18","2021-04-21","2021-04-18","2021-04-18","2021-04-18","2021-04-21","2021-04-18","2021-04-18","2021-04-19","2021-04-19","2021-04-19","2021-05-19","2021-06-16","2021-06-02","2021-10-14","2021-10-14","2021-10-14","2021-10-14","2021-10-14","2021-10-14","2021-10-14"],"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":[["","10702001801","OXYCODONE","TAB 5MG","20","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","28","Select","Select",""],["","68180021509","LOSARTAN\/HCT","TAB 50-12.5","90","Select","Select",""],["","69097084507","CYCLOBENZAPR","TAB 5MG","10","Select","Select",""],["","49483060350","IBUPROFEN","TAB 600MG","15","Select","Select",""],["","65862059601","CLINDAMYCIN","SOL 75MG\/5ML","600","Select","Select",""],["","71930002743","HYDROCO\/APAP","SOL 7.5-325","120","Select","Select",""],["","00245531911","KLOR-CON","TAB 20MEQ ER","30","Select","Select",""],["","80777027399","MODERNA","INJ COVID-19","0.5","Select","Select",""],["","00093227534","AMOX\/K","TAB 875-125","12","Select","Select",""],["","68382002310","ATENOLOL","TAB 50MG","30","Select","Select",""],["","00406052201","OXYCOD\/APAP","TAB 7.5-325","20","Select","Select",""],["","11917005092","FIRST","OIN ANTIBIOT","56","Select","Select",""],["","00378020810","FUROSEMIDE","TAB 20MG","30","Select","Select",""],["","50111064801","FLUOXETINE","CAP 20MG","30","Select","Select",""],["","69097094312","GABAPENTIN","CAP 300MG","60","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":""}]}]}