{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ELIZABETH LINKOUS","gend":1,"add":"316 PENN AVE NW APT 32  ","city":"FLOYD ","state":"VA","zip":"24091-9998","dob":"1951-05-24","age":"","mstatus":"","insh":11008526,"cliId":"3C45QU4VK51","pno":2762667934,"cno":2762667934,"email":"","ename":"","eno":"","pphy":"HULLETT, JOEL  ","ppno":5407455700,"pcpadd":"40 Wiley Dr","pcpcity":"Ferrum","pcpstate":"VA","pcpzip":240881100,"pcpcounty":"","pcpid":"P0117378","pcpname":"CARILION FAMILY MEDICINE FLOYD","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"","add3":"","madd1":"316 PENN AVE NW APT 32  ","madd2":"","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":["H40.1132","G47.33","E66.3","Z68.34","F31.9","E66.9","Z99.89","M25.571","M79.671","M76.61","M89.8X7","M25.561","F31.64","F31.70","G47.10","R74.8","Z79.899","R25.1","M89.9","M17.11","M25.562","G89.29","K31.9","D13.2","K31.89","D12.2","D12.3","K63.5","K57.30","K31.7","J44.9","Z12.11","Z85.038","K21.9","K76.0","Z68.31","J45.50","F17.210","Z99.81","Z80.0","Z23","I45.10","R94.31","M62.81","E83.42","W19.XXXA","R10.9","R11.10","R53.1","M50.30","R94.4","J96.10","Z79.51","Z85.048","W01.0XXA","Y92.009","S09.90XA","S19.9XXA","D72.820","M54.2","R42","Z01.818","G47.30","J45.909","E03.9","F41.9","E78.1","Z98.890","Z85.828","Z87.891","Z88.8","Z11.59","M54.6","R11.0","R19.7","R31.29","R10.13","K76.89","R10.10","R11.2","R93.3","R82.81","S86.011A","I65.23","R91.8","Z12.2","J84.10","I25.10","R26.2","K29.70","R10.11","R16.0","K76.9","Z90.49","I70.8","M51.36","G40.909","J41.1","J20.9","J96.11","F17.201","G47.36","G47.61","R06.83","C18.7","Z01.810","J01.10","R05","M25.671","R10.30","M54.5","W57.XXXA","Z71.6","F31.2","L84","M15.9","R79.9","J44.1","Q82.8","M25.512","M25.511","F43.20","Z00.8","F32.9","Z20.822","Z91.5","F43.23","F31.75","R60.9","Z51.81","Z13.220","J06.9"],"date":["2020-01-02","2021-11-13","2020-01-06","2020-01-06","2021-02-08","2021-07-29","2020-01-06","2020-03-11","2020-03-11","2020-01-24","2020-01-24","2020-10-01","2021-11-08","2021-06-22","2021-11-13","2021-11-15","2021-05-10","2021-07-08","2020-08-13","2020-02-21","2020-10-01","2020-02-21","2020-02-27","2020-07-10","2020-02-27","2020-02-27","2020-02-27","2020-02-27","2020-02-27","2020-07-10","2021-05-07","2020-02-27","2021-05-07","2020-02-27","2021-02-08","2020-02-27","2021-02-08","2021-08-31","2020-07-10","2020-02-27","2021-11-15","2020-02-29","2021-05-07","2021-05-03","2020-02-29","2020-02-29","2020-08-05","2020-02-29","2020-02-29","2020-02-29","2020-02-29","2020-02-29","2020-07-10","2020-02-29","2020-02-29","2020-02-29","2020-02-29","2020-02-29","2020-06-23","2020-07-01","2020-08-24","2020-07-07","2020-07-10","2020-07-10","2021-07-29","2021-05-07","2020-11-04","2020-07-10","2021-05-07","2021-08-31","2020-07-10","2020-07-10","2020-08-05","2020-07-31","2020-12-02","2020-07-31","2020-07-31","2020-07-31","2020-07-31","2020-07-31","2020-07-31","2020-08-05","2020-08-13","2020-08-24","2021-08-31","2021-08-31","2020-08-28","2020-08-28","2021-05-03","2019-09-16","2019-09-16","2019-09-16","2019-09-16","2019-09-16","2019-09-16","2019-09-16","2019-09-16","2020-10-12","2020-10-12","2020-10-12","2021-02-08","2019-11-04","2019-11-04","2019-11-04","2020-11-04","2019-11-11","2019-11-19","2019-11-19","2019-12-04","2020-12-02","2019-12-17","2019-12-17","2021-02-08","2021-02-08","2021-04-06","2021-05-03","2020-10-29","2021-03-23","2021-04-16","2021-05-03","2021-05-03","2021-05-07","2021-05-07","2021-05-07","2021-05-07","2021-05-07","2021-06-17","2021-11-16","2021-07-29","2021-07-29","2021-07-29","2021-09-09"],"priorHcc":["",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":[["","173069700","ADVAIR DISKU","AER 500\/50","","Select","Select",""],["","378180510","LEVOTHYROXIN","TAB 75MCG","","Select","Select",""],["","55111015810","OMEPRAZOLE","CAP 20MG","","Select","Select",""],["","55111053401","DIVALPROEX","TAB 500MG ER","","Select","Select",""],["","65414727","SIMBRINZA","SUS 1-0.2%","","Select","Select",""],["","66993068130","OLANZAPINE","TAB 5MG","","Select","Select",""],["","24208046325","LATANOPROST","SOL 0.00005","","Select","Select",""],["","527193206","CLARITHROMYC","TAB 500MG","","Select","Select",""],["","378064110","PREDNISONE","TAB 10MG","","Select","Select",""],["","185094098","CHOLESTYRAM","POW 4GM","","Select","Select",""],["","186037020","SYMBICORT","AER 160-4.5","","Select","Select",""],["","597010061","SPIRIVA","SPR 2.5MCG","","Select","Select",""],["","378827052","ALBUTEROL","NEB 0.00083","","Select","Select",""],["","65862042005","SMZ\/TMP DS","TAB 800-160","","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","","Select","Select",""],["","24208046325","LATANOPROST ","SOL 0.00005","2.5","Select","Select",""],["","66993068330","OLANZAPINE ","TAB 10MG","30","Select","Select",""],["","55111053401","DIVALPROEX ","TAB 500MG ER","60","Select","Select",""],["","378180510","LEVOTHYROXIN ","TAB 75MCG","90","Select","Select",""],["","55111015810","OMEPRAZOLE ","CAP 20MG","90","Select","Select",""],["","65414727","SIMBRINZA ","SUS 1-0.2%","8","Select","Select",""],["","173069700","ADVAIR ","AER 500\/50","60","Select","Select",""],["","527193206","CLARITHROMYC ","TAB 500MG","20","Select","Select",""],["","378064110","PREDNISONE ","TAB 10MG","20","Select","Select",""],["","185094098","CHOLESTYRAM ","POW 4GM","60","Select","Select",""],["","186037020","SYMBICORT ","AER 160-4.5","10.2","Select","Select",""],["","597010061","SPIRIVA ","SPR 2.5MCG","4","Select","Select",""],["","378827052","ALBUTEROL ","NEB 0.00083","225","Select","Select",""],["","65862039010","ONDANSETRON ","4MG ODT","10","Select","Select",""],["","65862042005","SMZ\/TMP ","800-160","6","Select","Select",""],["","00173069700","ADVAIR","500\/50","60","Select","Select",""],["","00378020810","FUROSEMIDE","20MG","30","Select","Select",""],["","65862042005","SMZ\/TMP","800-160","6","Select","Select",""],["","53489011905","DOXYCYCL","100MG","20","Select","Select",""],["","65862050220","AMOX\/K","500-125","20","Select","Select",""],["","53489011905","DOXYCYCL ","CAP 100MG","20","Select","Select",""],["","00378020810","FUROSEMIDE ","TAB 20MG","30","Select","Select",""],["","65862050220","AMOX\/K ","TAB 500-125","20","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","",""],["Yes","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":""}]}]}