{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"EDDIE   L MARTIN","gend":0,"add":"7383 DEER RUN DR SE","city":"COPPER HILL","state":"VA","zip":"24079-9998","dob":"1960-09-03","age":"","mstatus":"","insh":"20031576*01","cliId":"","pno":"540\/651-4818","cno":"276\/730-5199","email":"","ename":"","eno":"","pphy":"BRADY, DON I MD","ppno":"540\/725-7800","pcpadd":"SUITE 2 3707 BRAMBLETON AVE SW","pcpcity":"ROANOKE","pcpstate":"VA","pcpzip":24018,"pcpcounty":"","pcpid":"","pcpname":"Carilion Family Medicine Brambleton","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"540\/989-6752","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z48.89","E11.621","L97.412","E08.621","L97.511","NO DATA","E11.21","I10.","E78.2","E11.40","F41.1","F41.0","Z79.4","I13.0","J96.01","I50.33","E11.22","Z20.822","J44.9","J91.8","M10.379","E78.5","I12.9","N40.0","F32.9","K21.9","M19.90","R00.1","J44.1","R09.02","R06.03","R06.02","Z87.891","I50.9","E16.2","C34.11","C61.","J90.","J18.9","J45.909","I50.32","N17.9","F41.8","Z00.00","E87.1","V54.17","Z23.","L57.0","L82.0","J20.9","Z08.","Z85.118","Z90.2","Z92.21","M54.16","W19.XXXA","R55.","E11.65","Z03.818","F10.10","F41.9","M54.6","R94.31","H66.93","B96.89","R06.00","R22.42","Z92.3","N18.3","H93.8X3","H61.23","L85.9","L84.","S30.1XXA","R05.","R42.","N18.31","S32.000D","J44.0","J30.9","Z79.84","C33.","C77.1","Z51.11","J30.1","S98.111A","E11.42","M86.171","J01.01","Z86.010","Z09.","K63.5","Z12.11","D12.2","D12.5","D12.8","K57.30","K64.8","R73.9","V54.16","U07.1","E87.6","E11.9","E87.8","E87.5","E83.39","E83.42","E11.622","L98.499","F32.89","Z85.46","E55.9","Z53.29","Z86.16","Z79.51","Z79.899","Z79.82","R94.4","R60.0","C34.90","M85.852","M81.0","R09.81","E87.2","R74.01","M48.54XA","R05.9","E22.2","E86.1","C34.91"],"date":["2020-02-03","2020-02-03","2020-02-03","2020-03-06","2020-03-06","2022-10-25","2021-10-19","2022-11-16","2022-11-16","2022-11-16","2022-11-16","2022-01-31","2022-01-31","2022-05-26","2021-12-31","2021-02-27","2022-05-26","2022-09-30","2022-11-16","2021-02-27","2021-02-27","2022-06-06","2022-06-06","2021-02-27","2022-06-01","2022-11-16","2021-02-27","2022-06-07","2022-05-26","2022-06-03","2021-12-28","2022-09-30","2022-09-30","2021-12-29","2020-04-07","2022-10-27","2021-08-16","2022-10-05","2022-01-31","2022-05-26","2022-05-26","2022-06-10","2021-12-31","2021-03-16","2022-11-16","2021-03-16","2022-10-05","2021-10-19","2021-10-19","2021-12-28","2022-07-19","2022-11-16","2022-04-19","2022-02-02","2022-01-31","2020-08-24","2021-03-02","2021-03-02","2021-03-02","2021-03-02","2022-05-26","2021-03-08","2022-06-07","2020-06-15","2020-06-15","2021-02-27","2020-01-28","2022-07-19","2020-03-12","2020-06-03","2020-06-03","2020-05-01","2020-07-06","2021-02-27","2021-02-27","2021-02-27","2021-07-15","2021-07-15","2022-05-26","2021-12-29","2021-12-29","2019-04-24","2019-04-24","2019-11-22","2022-11-16","2019-08-19","2022-05-26","2019-01-11","2019-03-05","2019-06-25","2022-06-06","2019-06-25","2019-06-25","2019-06-25","2019-06-25","2019-06-25","2019-06-25","2019-06-25","2019-02-08","2019-05-24","2022-10-03","2022-05-27","2022-10-25","2022-06-07","2022-06-10","2022-05-31","2022-05-31","2022-08-15","2022-08-15","2022-08-15","2022-11-16","2022-05-03","2022-06-06","2022-06-06","2022-06-06","2022-06-06","2022-06-06","2022-06-07","2022-09-30","2022-10-17","2022-01-05","2022-01-05","2022-05-23","2022-06-03","2022-06-03","2022-04-19","2022-05-26","2022-05-26","2022-05-26","2022-06-10"],"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":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"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":[["","00310737020","BUDES\/FORMOT","AER 160-4.5","10","Select","Select",""],["","","SIMVASTATIN"," SIMVASTATIN ","30","Select","Select",""],["","","NORTRIPTYLIN"," NORTRIPTYLIN ","30","Select","Select",""],["","","FERROUS"," FERROUS ","60","Select","Select",""],["","","AMLODIPINE"," AMLODIPINE ","30","Select","Select",""],["","","ALBUTEROL"," ALBUTEROL ","8","Select","Select",""],["","","PANTOPRAZOLE"," PANTOPRAZOLE ","30","Select","Select",""],["","","CETIRIZINE","TAB 10MG","","Select","Select",""],["","","BUPROPN"," BUPROPN ","60","Select","Select",""],["","00173087310","INCRUSE","INH 62.5MCG","30","Select","Select",""],["","","PIOGLITAZONE"," PIOGLITAZONE ","30","Select","Select",""],["","","FLUTICASONE"," FLUTICASONE ","16","Select","Select",""],["","00173088210","BREO","INH 200-25","60","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0","Select","Select",""],["","","MONTELUKAST"," MONTELUKAST ","30","Select","Select",""],["","","PROAIR"," PROAIR ","8","Select","Select",""],["","","GLIPIZIDE"," GLIPIZIDE ","60","Select","Select",""],["","","ALPRAZOLAM"," ALPRAZOLAM ","120","Select","Select",""],["","43547040111","FUROSEMIDE","TAB 20MG","180","Select","Select",""],["","","BUSPIRONE"," BUSPIRONE ","135","Select","Select",""],["","00378064205","PREDNISONE","TAB 20MG","10","Select","Select",""],["","","METOPROL"," METOPROL ","30","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","30","Select","Select",""],["","","LOSARTAN"," LOSARTAN ","30","Select","Select",""],["","00761055520","VITAMIN","TAB 100MG","30","Select","Select",""],["","00223176001","SOD","TAB 1GM","90","Select","Select",""],["","59779030603","CVS","POW ","510","Select","Select",""],["","","TRAMADOL","TAB 50MG","","Select","Select",""],["","33342002208","LEVOFLOXACIN","TAB 500MG","15","Select","Select",""],["","53885024450","ONETOUCH","TES ULTRA","50","Select","Select",""],["","","AMOX\/K","TAB 875-125","","Select","Select",""],["","45802065078","LORATADINE","TAB 10MG","30","Select","Select",""],["","","AZITHROMYCIN","TAB 250MG","","Select","Select",""],["","","LEVOCETIRIZI","TAB 5MG","","Select","Select",""],["","","CARISOPRODOL","TAB 350MG","","Select","Select",""],["","","NEO\/POLY\/HC","SUS 1% OTIC","","Select","Select",""],["","","NARCAN","SPR ","","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":""}]}]}