{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"PAMELA A ROBERTSON","gend":1,"add":"311N MONTGOMERY","city":"PEARISBURG  ","state":"VA","zip":"24134-9998","dob":"1982-10-29","age":"","mstatus":"","insh":11014491,"cliId":"8HC4CR3EU95","pno":5409210312,"cno":5409210312,"email":"","ename":"","eno":"","pphy":"DEVEREAUX, ROBERT ","ppno":5409213636,"pcpadd":"430 Boxwood Ln","pcpcity":"Pearisburg  ","pcpstate":"VA","pcpzip":241341168,"pcpcounty":"","pcpid":"P0117831","pcpname":"CARILION CLINIC FAMILY MEDICINE GILES","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"","add3":"","madd1":"PO BOX 214  ","madd2":"","madd3":"","mcity":"PEARISBURG  ","mstate":"VA","mzip":"24134-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["F41.0","F33.1","F51.05","N76.0","N92.6","B96.89","F33.41","E66.09","F41.1","F41.9","R07.89","F32.9","Z20.822","K21.9","Z86.711","R30.0","R46.2","R07.9","R94.31","F32.1","N39.0","B96.20","F40.01","Z23","G47.00","G43.909","M54.5","R10.9","R60.9","G43.109","B00.1","Z79.899","M79.662","R63.5","K64.4","L30.4","M79.605","R10.13","R53.1","F41.8","R11.0","R06.02","R53.83","Z87.19","F33.2","K59.09","Z97.5","E66.01","G62.9","F99","G89.29","Z87.59","Z68.41","B37.2","I10","R73.03","Z90.49","R79.1","R93.2","R45.851","K04.7","M54.9","E66.9","Z62.810","Z88.0","Z88.8","R42","R20.0","Z79.01","R68.84","I26.94","F43.10","I26.99","E55.9","F40.00","D68.59","R87.610","Z12.4","F51.01","N87.0","R87.810","R71.8"],"date":["2021-11-02","2021-11-16","2021-03-08","2020-09-17","2020-09-17","2020-09-17","2020-10-14","2020-12-02","2021-09-23","2021-03-23","2021-04-10","2021-03-25","2021-03-23","2021-07-19","2021-04-10","2021-01-09","2021-03-25","2021-04-11","2021-01-10","2021-01-20","2021-01-16","2021-01-16","2021-03-13","2021-03-08","2021-01-11","2021-03-25","2021-03-07","2021-01-12","2021-01-12","2021-07-19","2021-02-25","2021-03-23","2021-02-25","2021-02-25","2021-02-25","2021-02-25","2021-02-26","2021-03-06","2021-03-06","2021-03-06","2021-03-06","2021-03-06","2021-03-06","2021-03-06","2021-10-06","2021-03-07","2021-03-07","2021-03-08","2021-03-07","2021-03-07","2021-03-25","2021-03-07","2021-03-25","2021-03-08","2021-03-25","2021-03-08","2021-03-25","2021-03-23","2021-03-23","2021-03-25","2021-03-25","2021-03-25","2021-03-25","2021-03-25","2021-03-25","2021-03-25","2021-04-10","2021-04-10","2021-04-10","2021-03-23","2021-03-24","2021-03-24","2021-07-19","2021-05-24","2021-09-23","2021-10-26","2021-10-12","2021-09-07","2021-09-23","2021-10-12","2021-10-12","2021-10-26"],"priorHcc":[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":[["","57237000730","MIRTAZAPINE","TAB 7.5MG","","Select","Select",""],["","115166001","PROPRANOLOL","TAB 20MG","","Select","Select",""],["","16729021716","SERTRALINE","TAB 100MG","","Select","Select",""],["","168008031","HYDROCORT","CRE 0.025","","Select","Select",""],["","781107710","ALPRAZOLAM","TAB 0.5MG","","Select","Select",""],["","43547040750","CLONAZEPAM","TAB 1MG","","Select","Select",""],["","69238111906","BUSPIRONE","TAB 30MG","","Select","Select",""],["","65862044990","VALACYCLOVIR","TAB 1GM","","Select","Select",""],["","67877024901","QUETIAPINE","TAB 50MG","","Select","Select",""],["","27241009803","DULOXETINE","CAP 30MG","","Select","Select",""],["","62175011843","OMEPRAZOLE","CAP 20MG","","Select","Select",""],["","3089470","ELIQUIS","TAB 5MG","","Select","Select",""],["","64380076111","OMEGA-3-ACID","CAP 1GM","","Select","Select",""],["","65862052890","VENLAFAXINE","CAP 75MG ER","","Select","Select",""],["","574200830","NYSTOP","POW 100000","","Select","Select",""],["","52817018000","CLONIDINE","TAB 0.1MG","","Select","Select",""],["","3376474","ELIQUIS ST P","TAB 5MG","","Select","Select",""],["","781707787","METRONIDAZOL","GEL 0.75%VAG","","Select","Select",""],["","228285111","GUANFACINE","TAB 2MG ER","","Select","Select",""],["","57237000730","MIRTAZAPINE ","TAB 7.5MG","30","Select","Select",""],["","781107710","ALPRAZOLAM ","TAB 0.5MG","30","Select","Select",""],["","16729021716","SERTRALINE ","TAB 100MG","60","Select","Select",""],["","52817018000","CLONIDINE ","TAB 0.1MG","30","Select","Select",""],["","65862049101","QUETIAPINE ","TAB 100MG","60","Select","Select",""],["","68180029606","DULOXETINE ","CAP 60MG","60","Select","Select",""],["","57664078686","CLONAZEP ","TAB 1MG","60","Select","Select",""],["","69238111906","BUSPIRONE ","TAB 30MG","60","Select","Select",""],["","65862044990","VALACYCLOVIR ","TAB 1GM","12","Select","Select",""],["","65862052890","VENLAFAXINE ","CAP 75MG ER","90","Select","Select",""],["","43547040750","CLONAZEPAM ","TAB 1MG","56","Select","Select",""],["","115166001","PROPRANOLOL ","TAB 20MG","180","Select","Select",""],["","168008031","HYDROCORT ","CRE 0.025","30","Select","Select",""],["","60505006501","OMEPRAZOLE ","CAP 20MG","90","Select","Select",""],["","3089470","ELIQUIS ","TAB 5MG","60","Select","Select",""],["","781707787","METRONIDAZOL ","GEL 0.75%VAG","70","Select","Select",""],["","574200830","NYSTOP ","POW 100000","30","Select","Select",""],["","64380076111","OMEGA-3-ACID ","CAP 1GM","30","Select","Select",""],["","228285111","GUANFACINE ","2MG ER","30","Select","Select",""],["","57664078686","CLONAZEP","1MG","60","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":""}]}]}