{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JANICE   L MOWLES","gend":1,"add":"2033 MOUNTAIN PASS ROAD","city":"TROUTVILLE","state":"VA","zip":"24175-9998","dob":"1967-10-30","age":"","mstatus":"","insh":"20048268*01","cliId":"","pno":"540\/819-3737","cno":"","email":"","ename":"","eno":"","pphy":"SAKS, JONATHAN C MD","ppno":"540\/725-7800","pcpadd":"3707 BRAMBLETON AVE SW SUITE 2","pcpcity":"ROANOKE","pcpstate":"VA","pcpzip":24018,"pcpcounty":"","pcpid":"","pcpname":"Carilion Tazewell Community Hospital Family Medicine","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":["M62.81","M25.551","R26.81","R26.89","R29.3","M54.5","R10.32","J44.9","F41.8","K21.9","H54.3","R06.02","M54.12","M48.02","M50.30","M43.16","G47.33","F32.89","H92.01","M50.222","M50.223","NO DATA","M51.36","Z01.812","M50.20","F12.10","Z86.718","M79.604","K85.90","H66.004","Z01.810","M20.11","R00.1","L73.2","R25.2","E66.01","Z68.39","I10.","E55.9","R79.9","Z23.","J45.20","Z01.818","M72.2","R10.84","R74.8","R11.0","Z48.89","M20.12","Z98.890","M50.10","M47.22","G47.30","G89.29","E03.9","E66.9","Z87.442","R94.31","Z86.010","M47.816","Z72.0","Z71.6","Z68.41","R10.9","M19.049","M54.31","Z87.891","Z20.822","R13.10","K76.6","K29.70","K31.89","K57.30","Z66.","Z20.828","T38.3X5A","K86.9","K29.80","K21.0","F31.9","F41.9","Z88.6","Z85.41","T40.2X5A","M19.071","D48.5","F32.9","F43.10","M54.42","M62.838","M54.41","L91.8","M50.00","M54.2","L02.211","M21.611","Q66.211","R73.03","R10.13","Z12.31","Z68.38","Z99.89","J02.9","F17.210","H60.311","K29.50","M19.90","G43.909","M50.922","M75.102","Z00.00","M47.817","M43.17","R13.12","M54.16","M79.605","Z11.3","R30.0","Z12.39","N90.89","M54.15","R20.2","R50.9","F17.200","M65.4","Z79.899","R26.2","L02.229","J01.90","N39.0","R31.9","R22.30","Z12.4"],"date":["2020-07-29","2020-07-29","2020-07-29","2020-07-29","2020-07-29","2021-08-05","2020-09-29","2021-10-21","2020-09-29","2021-11-23","2021-03-09","2021-05-10","2021-10-06","2021-08-05","2021-09-02","2021-08-05","2021-11-23","2021-10-16","2021-09-16","2021-10-01","2021-10-01","2021-10-27","2021-10-01","2021-11-04","2021-12-21","2021-12-21","2021-12-21","2020-06-10","2020-10-07","2021-05-25","2021-11-29","2021-02-02","2021-11-29","2021-11-04","2021-02-24","2021-10-06","2021-10-06","2021-10-06","2021-09-02","2021-02-24","2021-09-23","2021-09-23","2021-12-16","2020-03-05","2020-09-29","2020-09-29","2020-09-29","2021-03-26","2021-11-09","2021-03-26","2021-09-02","2021-09-02","2021-09-02","2021-10-06","2021-09-02","2021-11-23","2021-09-02","2021-10-04","2021-11-23","2020-01-06","2020-01-06","2020-01-06","2021-10-21","2020-09-30","2020-08-31","2020-08-31","2021-07-01","2021-11-04","2021-10-21","2021-10-21","2021-10-21","2021-10-21","2020-09-28","2020-09-28","2020-09-28","2020-09-28","2020-09-28","2020-09-28","2020-09-28","2020-09-28","2020-09-28","2020-09-28","2020-09-28","2020-09-28","2020-12-30","2021-04-20","2021-10-06","2021-10-06","2021-10-06","2021-10-06","2021-10-06","2021-11-04","2021-11-29","2021-12-07","2020-02-17","2020-12-30","2021-02-02","2021-05-25","2021-05-25","2021-05-25","2021-06-23","2021-06-23","2021-08-04","2020-04-29","2021-06-02","2021-10-21","2021-10-21","2021-10-21","2021-12-21","2020-01-21","2020-09-14","2021-07-30","2021-07-30","2021-09-22","2019-08-15","2019-07-13","2019-10-15","2019-10-15","2019-10-15","2019-11-22","2019-04-23","2019-06-28","2019-06-28","2019-06-28","2019-04-24","2019-06-19","2019-08-08","2019-11-05","2019-11-05","2019-01-06","2019-01-06","2019-05-03","2019-11-22"],"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":[["","60505025103","TIZANIDINE","TAB 2MG","45","Select","Select",""],["","70710113908","FLUCONAZOLE","TAB 150MG","3","Select","Select",""],["","24208072002","DEXAMETH","SOL 0.1% OP","5","Select","Select",""],["","65862052305","GABAPENTIN","TAB 600MG","90","Select","Select",""],["","57237016199","OMEPRAZOLE","CAP 20MG","90","Select","Select",""],["","24208091055","ERYTHROMYCIN","OIN 5MG\/GM","4","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","180","Select","Select",""],["","59310058020","PROAIR","AER ","1","Select","Select",""],["","59779030603","CVS","POW ","510","Select","Select",""],["","42806016105","HYDROXYZ","TAB 50MG","90","Select","Select",""],["","00832105410","BACLOFEN","TAB 10MG","90","Select","Select",""],["","21922000201","CLINDAMYCIN","SOL 0.01","60","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","30","Select","Select",""],["","69452015120","VITAMIN","CAP 50000UNT","12","Select","Select",""],["","00069046956","CHANTIX","TAB 1MG","60","Select","Select",""],["","71930002012","HYDROCO\/APAP","TAB 7.5-325","20","Select","Select",""],["","80777027399","MODERNA","INJ COVID-19","0","Select","Select",""],["","69097014260","ALBUTEROL","AER HFA","7","Select","Select",""],["","69584061150","METHOCARBAM","TAB 500MG","60","Select","Select",""],["","68462018556","FLUOCIN","OIL 0.0001","5","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","15","Select","Select",""],["","60505036301","OFLOXACIN","DRO 0.3%OTIC","5","Select","Select",""],["","13668013601","ESCITALOPRAM","TAB 10MG","90","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":""}]}]}