{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"VERONICA   L MATTHEWS","gend":1,"add":"1020 GILMER AVE NW","city":"ROANOKE","state":"VA","zip":"24016-9998","dob":"1967-09-16","age":"","mstatus":"","insh":"20056984*01","cliId":"","pno":"540\/525-8257","cno":"","email":"","ename":"","eno":"","pphy":"DULANEY, KIMBERLY A MD","ppno":"540\/427-9200","pcpadd":"2145 MT PLEASANT BLVD","pcpcity":"ROANOKE","pcpstate":"VA","pcpzip":24014,"pcpcounty":"","pcpid":"","pcpname":"Carilion Clinic Family Medicine Southeast","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"540\/427-3237","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R20.2","E11.3213","M54.12","G56.01","Z01.810","R94.31","M54.16","S63.502A","J45.20","G47.33","M24.131","M75.82","M77.12","M62.81","M25.512","M75.102","E11.65","I10.","I95.1","G43.109","M54.40","G89.29","R45.0","M70.62","E66.9","K21.9","Z68.37","F33.1","G43.009","J30.9","V58.89","R60.9","E11.3212","E11.3291","Z01.818","M25.522","M25.622","R73.09","K44.9","E11.42","M54.2","M51.36","M25.552","S93.402A","M25.572","M25.472","R26.9","G56.03","E11.3211","M51.16","M25.531","R07.89","R11.0","E04.1","E78.5","F41.9","R06.02","R07.9","M54.6","N64.4","R55.","K59.00","E11.3293","F54.","I49.9","I51.7","E11.319","H52.13","G43.709","Z23.","E11.9","H92.02","H69.82"],"date":["2020-06-11","2020-05-22","2020-07-22","2020-09-03","2020-09-03","2021-01-10","2020-11-23","2020-08-27","2021-11-10","2021-11-10","2021-04-12","2021-09-01","2021-09-01","2021-09-28","2021-09-28","2021-09-28","2020-12-11","2020-09-29","2020-05-12","2020-05-12","2020-05-12","2021-04-28","2021-01-10","2021-03-02","2021-06-02","2021-06-02","2021-06-02","2020-09-29","2020-03-19","2020-06-02","2021-03-15","2020-09-29","2021-10-20","2021-07-05","2020-11-18","2021-08-25","2021-08-25","2021-01-10","2021-03-05","2020-01-23","2020-01-23","2021-04-28","2021-04-28","2021-11-23","2021-11-06","2021-11-06","2021-11-06","2020-06-04","2021-10-20","2020-11-04","2021-05-04","2019-12-12","2019-11-13","2019-12-16","2019-12-16","2019-07-31","2019-11-14","2019-11-13","2019-04-11","2019-05-28","2019-12-12","2019-12-12","2019-11-20","2019-11-06","2019-11-13","2019-11-18","2019-05-02","2019-08-27","2019-06-25","2019-10-16","2019-11-13","2019-09-03","2019-09-03"],"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":[["","62332014131","CELECOXIB","CAP 100MG","60","Select","Select",""],["","","PROAIR","AER ","","Select","Select",""],["","00169633910","NOVOLOG","INJ FLEXPEN","60","Select","Select",""],["","00169406012","VICTOZA","INJ 18MG\/3ML","27","Select","Select",""],["","","JARDIANCE","TAB 25MG","","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","","D3","CAP 2000UNIT","","Select","Select",""],["","53885027150","ONETOUCH","TES VERIO","50","Select","Select",""],["","00169643810","LEVEMIR","INJ FLEXTOUC","54","Select","Select",""],["","","AZELASTINE","SPR 0.001","","Select","Select",""],["","","SM","POW ","","Select","Select",""],["","68645058259","METFORMIN","TAB 500MG","60","Select","Select",""],["","68645055354","LISINOPRIL","TAB 20MG","30","Select","Select",""],["","68645056854","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","55111015930","OMEPRAZOLE","CAP 40MG","30","Select","Select",""],["","","INSULIN","INJ FLEXPEN","","Select","Select",""],["","45802086803","POLYETH","POW 3350 NF","510","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0","Select","Select",""],["","08290320119","BD  PEN NEEDL","MIS 31GX5MM","100","Select","Select",""],["","","FREESTYLE    KIT SENSOR","KIT SENSOR","","Select","Select",""],["","","FREESTYLE    MIS READER","MIS READER","","Select","Select",""],["","55513084101","AIMOVIG","INJ 70MG\/ML","1","Select","Select",""],["","72205001390","PREGABALIN","CAP 75MG","90","Select","Select",""],["","","EMGALITY","INJ 120MG\/ML","","Select","Select",""],["","","ALBUTEROL","AER HFA","","Select","Select",""],["","00591352530","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","65862024508","LEVETIRACETA","TAB 250MG","120","Select","Select",""],["","57237001830","DULOXETINE","CAP 30MG","30","Select","Select",""],["","","DICLOFENAC","GEL 0.01","","Select","Select",""],["","00071101468","LYRICA","CAP 75MG","90","Select","Select",""],["","68645055654","LISINOP\/HCTZ","TAB 10-12.5","30","Select","Select",""],["","70010077001","METHOCARBAM","TAB 750MG","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":""}]}]}