{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BELLE W HYLTON","gend":1,"add":"316 PENN AVE","city":"FLOYD ","state":"VA","zip":"24091-9998","dob":"1938-04-13","age":"","mstatus":"","insh":11001015,"cliId":"2RV7G70RP46","pno":5407453093,"cno":"","email":"","ename":"","eno":"","pphy":"KUIKEN, GARRY","ppno":5407455700,"pcpadd":",","pcpcity":"Floyd","pcpstate":"VA","pcpzip":240912893,"pcpcounty":"","pcpid":"P0124153","pcpname":"CARILION CLINIC PRIMARY CARE ASSOCIATES FLOYD","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"APT 31","add3":"","madd1":"316 PENN AVE","madd2":"APT 31","madd3":"","mcity":"FLOYD ","mstate":"VA","mzip":"24091-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["I10","D64.9","I48.2","N18.3","Z79.899","I50.32","E55.9","E11.65","E03.9","I48.20","E79.0","E83.42","N39.46","M62.81","N39.3","N39.41","L57.0","E78.2","Z91.14","J45.20","E66.01","R10.13","R25.2","R60.9","Z86.19","G47.33","Z79.01","M54.2","S60.211A","S69.91XA","W22.8XXA","E11.9","E78.5","Z79.84","Z79.890","S30.860A","W57.XXXA","Z86.39","M79.604","M79.89","L53.9","J06.9","E11.29","R80.9","Z86.010","Z00.00","I95.9","I87.2","N18.30","Z68.32","M10.9","I13.0","F17.200","Z23","E61.2","M79.661","L03.115","E13.9","Z13.1","E11.22","N18.9","R81","R41.3","F03.90","I12.9","R73.9","E86.0","R31.29","R35.89","M19.90","G30.9","F01.50","F02.80","R53.83","R11.0","I50.9","Z79.82","I48.91","I25.10","I45.19","R94.31","R63.1"],"date":["2021-08-13","2020-07-20","2019-08-16","2020-09-28","2021-08-13","2021-08-13","2021-08-13","2021-10-14","2021-10-14","2021-08-13","2021-08-13","2021-08-13","2021-11-16","2021-11-16","2021-11-16","2021-11-16","2018-06-22","2021-08-13","2020-09-28","2020-05-27","2021-08-13","2021-01-29","2021-08-13","2021-08-13","2019-07-29","2021-08-13","2021-10-14","2018-10-02","2019-10-05","2019-10-05","2019-10-05","2021-10-14","2021-10-14","2021-10-14","2019-10-05","2018-11-09","2018-11-09","2019-11-18","2020-11-25","2020-11-25","2020-11-25","2020-01-24","2020-07-20","2018-02-23","2018-03-28","2020-03-30","2018-05-25","2020-05-27","2021-11-02","2020-07-20","2020-07-20","2021-10-14","2020-07-20","2020-09-28","2020-09-28","2020-11-25","2020-11-25","2020-07-20","2020-07-20","2021-11-12","2021-10-14","2021-11-03","2021-11-02","2021-11-02","2021-11-02","2021-10-14","2021-10-14","2021-10-19","2021-11-03","2021-11-16","2021-11-17","2021-11-17","2021-11-17","2021-10-14","2021-10-14","2021-10-14","2021-10-14","2021-10-14","2021-10-14","2021-10-14","2021-10-14","2021-10-19"],"priorHcc":[null,"","","",null,null,null,null,null,null,null,null,null,null,null,null,"",null,"","",null,"",null,null,"",null,null,"","","","",null,null,null,"","","","","","","","","","","","","","",null,"","",null,"","","","","","","",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null]}},{"a":[]}]},{"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":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}}]},{"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":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","55111015810","OMEPRAZOLE","CAP 20MG","","Select","Select",""],["","378180510","LEVOTHYROXIN","TAB 75MCG","","Select","Select",""],["","99073070827","FREESTYLE","TES LITE","","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","","Select","Select",""],["","68382002401","ATENOLOL","TAB 100MG","","Select","Select",""],["","68382075810","METFORMIN","TAB 500MG","","Select","Select",""],["","378020810","FUROSEMIDE","TAB 20MG","","Select","Select",""],["","53746051101","SPIRONOLACT","TAB 25MG","","Select","Select",""],["","3089421","ELIQUIS","TAB 5MG","","Select","Select",""],["","55111032101","GLIMEPIRIDE","TAB 2MG","","Select","Select",""],["","76385011350","CARVEDILOL","TAB 25MG","","Select","Select",""],["","70710121005","ALLOPURINOL","TAB 300MG","","Select","Select",""],["","70377002911","ATORVASTATIN","TAB 40MG","","Select","Select",""],["","68180016013","AZITHROMYCIN","TAB 250MG","","Select","Select",""],["","69097015807","MELOXICAM","TAB 7.5MG","","Select","Select",""],["","55111015810","OMEPRAZOLE ","CAP 20MG","90","Select","Select",""],["","378180310","LEVOTHYROXIN ","TAB 50MCG","90","Select","Select",""],["","68382002401","ATENOLOL ","TAB 100MG","90","Select","Select",""],["","68180012202","CEPHALEXIN ","CAP 500MG","30","Select","Select",""],["","55111032101","GLIMEPIRIDE ","TAB 2MG","30","Select","Select",""],["","53746051101","SPIRONOLACT ","TAB 25MG","30","Select","Select",""],["","76385011350","CARVEDILOL ","TAB 25MG","60","Select","Select",""],["","68382075810","METFORMIN ","TAB 500MG","60","Select","Select",""],["","378020810","FUROSEMIDE ","TAB 20MG","30","Select","Select",""],["","99073070827","FREESTYLE    TES LITE","TES LITE","100","Select","Select",""],["","70710121005","ALLOPURINOL ","TAB 300MG","30","Select","Select",""],["","70377002911","ATORVASTATIN ","TAB 40MG","90","Select","Select",""],["","3089421","ELIQUIS ","TAB 5MG","60","Select","Select",""],["","69097015807","MELOXICAM ","TAB 7.5MG","30","Select","Select",""],["","68180016013","AZITHROMYCIN ","TAB 250MG","6","Select","Select",""],["","00597015230","JARDIANCE ","TAB 10MG","30","Select","Select",""]]}},{"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":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[[["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""]]]},{"t":"Mini-Cog","q":[{"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":""}]}]}