{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LATRICIA N PORTER","gend":1,"add":"7262 S BARRENS RD ","city":"ROANOKE  ","state":"VA","zip":"24019-9998","dob":"1987-09-11","age":"","mstatus":"","insh":11002133,"cliId":"8KU8E24JF10","pno":5404799121,"cno":5409706135,"email":"","ename":"","eno":"","pphy":"KLAWONN, NATALIE K","ppno":5402243870,"pcpadd":"615 McDowell Ave NW","pcpcity":"Roanoke  ","pcpstate":"VA","pcpzip":240161225,"pcpcounty":"","pcpid":"P0117426","pcpname":"CARILION CLINIC INTERNAL MEDICINE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"APT 101  ","add3":"","madd1":"7262 S BARRENS RD ","madd2":"APT 101  ","madd3":"","mcity":"ROANOKE  ","mstate":"VA","mzip":"24019-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["F33.1","F70","R26.9","R39.81","R15.9","L22","F33.0","G43.709","R56.9","F91.9","F51.01","K58.2","M62.3","F79","M79.609","S90.31XA","R60.0","V00.811A","Y93.89","Y92.89","R26.89","I10","G40.909","F17.210","S89.91XA","X58.XXXA","S99.911A","S99.921A","B34.9","H65.03","K11.9","R19.7","R35.0","R05","R09.81","M79.10","G43.809","J45.40","Z72.0","R73.03","F41.8","M54.5","D50.0","F12.90","D50.1","R53.1","R73.9","Z20.5","E55.9","A64","M79.1","M79.605","M25.519","R79.89","D50.8","J41.0","E78.2","K21.9","R10.11","R10.84","R10.9","R11.0","F17.200","R53.81","R00.0","R06.02","R42","R55","Z99.3","G43.909","J42","G89.29","Z01.419","Z11.3","K59.00","R11.2","E87.6","Z98.51","K59.09","R10.31","R94.31","R07.9","R40.4","R00.1","I49.9","R52","G43.009","R68.89","R14.0","G82.20","K92.1","D64.9","G43.109","R10.2","E66.09","N92.0","Z68.32","N93.9","f33.1","T20.05XA","R09.02","X08.8XXA","T20.15XA","Y92.009","T31.0","Z23","N76.0","B37.3","N89.9","N89.8","S89.82XA","E87.2","G89.18","R79.82","R50.9","Z79.899","M79.669","L53.9","Z48.00","S89.82XD","Z51.89","S81.012A","D50.9","S89.92XA","V03.09XA","Y93.9","Y92.410","Z91.19","S81.802A","R51.9","M54.2","S81.802D","S81.812A","Z04.3","M25.562","M79.89","B96.89","Z48.01","S81.812D","G40.89","Z79.51","Z79.891"],"date":["2021-11-24","2021-08-02","2019-09-23","2021-10-25","2021-10-25","2021-10-25","2020-06-25","2021-10-06","2021-08-02","2020-06-25","2020-06-25","2018-10-08","2021-10-25","2021-11-23","2018-11-09","2018-11-09","2021-10-21","2018-11-09","2021-03-23","2018-11-09","2018-11-09","2021-11-23","2021-10-23","2021-11-23","2018-11-10","2018-11-10","2018-11-10","2018-11-10","2018-01-03","2018-01-03","2018-01-03","2020-02-12","2018-01-03","2019-03-23","2019-02-08","2019-02-08","2020-02-12","2020-02-12","2020-02-12","2020-02-12","2020-02-12","2020-02-12","2021-10-19","2020-02-12","2018-02-28","2019-03-23","2019-02-28","2018-02-28","2019-02-28","2018-02-28","2018-02-28","2021-10-23","2018-02-28","2021-10-21","2019-05-29","2019-05-16","2019-02-28","2019-02-28","2019-03-16","2019-03-16","2019-03-16","2019-03-16","2019-03-23","2019-03-16","2021-10-21","2019-03-23","2019-03-23","2019-03-23","2019-03-23","2018-03-29","2019-05-16","2018-07-02","2020-08-18","2020-08-18","2018-08-05","2018-08-02","2021-10-19","2018-07-26","2018-08-05","2018-07-26","2018-07-30","2018-08-05","2018-07-28","2018-07-30","2018-07-30","2021-03-23","2018-07-31","2021-03-24","2018-08-02","2018-08-05","2018-08-05","2018-08-05","2018-08-16","2020-09-10","2019-08-19","2019-08-19","2019-08-19","2020-09-10","2018-01-03","2021-03-23","2021-03-23","2021-03-23","2021-03-23","2021-03-23","2021-03-23","2021-10-19","2021-09-03","2021-09-03","2021-09-03","2021-09-03","2021-10-19","2021-10-19","2021-10-21","2021-10-21","2021-10-21","2021-10-23","2021-10-21","2021-10-21","2021-10-23","2021-10-24","2021-10-24","2021-10-19","2021-10-19","2021-10-19","2021-10-19","2021-10-19","2021-10-19","2021-10-19","2021-10-21","2021-10-21","2021-10-21","2021-11-18","2021-10-19","2021-10-19","2021-10-21","2021-10-21","2021-09-03","2021-10-23","2021-11-23","2021-11-23","2021-11-23","2021-11-23"],"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]}},{"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":[["","65862001401","AMOXICILLIN","TAB 500MG","","Select","Select",""],["","99073013001","FREESTYLE","MIS LANCETS","","Select","Select",""],["","51991065116","LEVETIRACETA","SOL 100MG\/ML","","Select","Select",""],["","173069600","ADVAIR DISKU","AER 250\/50","","Select","Select",""],["","68382014014","TOPIRAMATE","TAB 100MG","","Select","Select",""],["","59746028490","PANTOPRAZOLE","TAB 40MG","","Select","Select",""],["","64380080307","RANITIDINE","TAB 150MG","","Select","Select",""],["","50111043403","TRAZODONE","TAB 100MG","","Select","Select",""],["","10702001150","HYDROXYZ HCL","TAB 25MG","","Select","Select",""],["","49884093547","DICLOFENAC","GEL 0.01","","Select","Select",""],["","186037020","SYMBICORT","AER 160-4.5","","Select","Select",""],["","68382091634","METHYLPRED","TAB 4MG","","Select","Select",""],["","67877032105","IBUPROFEN","TAB 800MG","","Select","Select",""],["","116200116","CHLORHEX GLU","SOL 0.0012","","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","","Select","Select",""],["","51991065116","LEVETIRACETA ","SOL 100MG\/ML","750","Select","Select",""],["","173069600","ADVAIR ","AER 250\/50","60","Select","Select",""],["","65862001401","AMOXICILLIN ","TAB 500MG","30","Select","Select",""],["","68382014014","TOPIRAMATE ","TAB 100MG","270","Select","Select",""],["","50111043403","TRAZODONE ","TAB 100MG","70","Select","Select",""],["","99073071227","FREESTYLE    TES INSULINX","TES INSULINX","100","Select","Select",""],["","99073013001","FREESTYLE    MIS LANCETS","MIS LANCETS","100","Select","Select",""],["","59746028490","PANTOPRAZOLE ","TAB 40MG","90","Select","Select",""],["","186037020","SYMBICORT ","AER 160-4.5","10.2","Select","Select",""],["","64380080307","RANITIDINE ","TAB 150MG","30","Select","Select",""],["","10702001150","HYDROXYZ ","TAB 25MG","60","Select","Select",""],["","49884093547","DICLOFENAC ","GEL 0.01","300","Select","Select",""],["","68382091634","METHYLPRED ","4MG","21","Select","Select",""],["","116200116","CHLORHEX ","0.12%","473","Select","Select",""],["","42858010201","OXYCOD\/APAP ","5-325MG","16","Select","Select",""],["","67877032105","IBUPROFEN ","800MG","20","Select","Select",""],["","00173069600","ADVAIR","250\/50","60","Select","Select",""],["","99073013001","FREESTYLE MIS LANCETS","LANCETS","100","Select","Select",""],["","99073071227","FREESTYLE TES INSULINX","INSULINX","100","Select","Select",""],["","10702001150","HYDROXYZ","25MG","60","Select","Select",""],["","00116200116","CHLORHEX","0.0012","473","Select","Select",""],["","50111033401","METRONIDAZOL","500MG","14","Select","Select",""],["","59310057922","PROAIR","","8.5","Select","Select",""],["","50111033401","METRONIDAZOL ","TAB 500MG","14","Select","Select",""],["","53746010901","HYDROCO\/APAP ","TAB 5-325MG","12","Select","Select",""],["","59310057922","PROAIR ","AER ","8.5","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":[[["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["No","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":""}]}]}