{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ALLISON   C BROWN","gend":1,"add":"3533 FERNCLIFFE AVE NW APT 110J","city":"ROANOKE","state":"VA","zip":"24017-9998","dob":"1962-01-30","age":"","mstatus":"","insh":"20062974*01","cliId":"","pno":"540\/682-1705","cno":"540\/682-1705","email":"","ename":"","eno":"","pphy":"MURCHISON, ROSS MD","ppno":"540\/853-0755","pcpadd":"2001 CRYSTAL SPRNG AVE","pcpcity":"ROANOKE","pcpstate":"VA","pcpzip":24014,"pcpcounty":"","pcpid":"","pcpname":"Carilion Clinic Internal Medicine Riverside 3","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"540\/344-0757","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I08.1","I42.2","R94.31","R07.9","I10.","E11.21","I15.9","D50.8","N39.46","N81.4","N95.8","I50.32","R01.1","E78.5","R06.02","E11.59","M25.512","E11.40","I50.30","K59.09","M10.372","N39.41","M25.60","H25.11","M48.02","M54.2","M96.1","M54.12","E78.2","I35.0","R00.2","I42.1","I25.10","E66.09","Z68.37","I51.7","R93.1","R06.83","G47.19","R06.81","F41.9","E66.9","E11.9","K21.9","NO DATA","G45.9","M79.604","R60.0","L53.9","E83.42","I87.2","L03.116","Z23.","M79.89","R53.83","R79.0","Z87.39","R06.09","R07.89","I16.0","I11.0","Z86.73","Z79.899","Z79.02","Z79.51","Z88.5","Z88.8","Z82.49","Z83.3","Z09.","R51.9","R45.89","L60.0","L60.3","R30.0","Z01.419","Z12.4","Z68.38","I51.9","Z72.821","R41.3","B34.9","Z20.822","R50.9","F32.9","T14.8XXA","Z71.3","L03.031","M10.9","B35.4","M62.81","R05.","N84.1","R10.2","R87.612","R87.610","R43.8","G89.29","N30.00","D64.9","G47.33","I15.2"],"date":["2020-03-16","2021-11-16","2021-09-17","2021-09-24","2022-09-16","2022-09-16","2022-03-25","2022-06-03","2022-09-15","2022-04-26","2022-04-26","2022-07-13","2022-07-13","2022-09-16","2022-09-28","2021-12-10","2020-03-17","2022-07-22","2022-03-11","2020-03-17","2020-04-24","2022-09-15","2022-09-15","2020-12-28","2021-07-14","2021-07-14","2021-07-14","2021-07-14","2021-04-13","2021-09-17","2021-10-20","2021-10-13","2021-10-13","2021-10-13","2022-03-11","2022-09-28","2022-05-20","2022-03-11","2022-03-11","2022-03-11","2022-03-11","2022-03-11","2022-04-12","2022-06-03","2022-03-11","2022-03-11","2022-06-03","2022-04-28","2022-04-28","2022-06-03","2022-06-03","2022-09-16","2022-09-16","2022-09-16","2022-09-16","2022-09-16","2020-12-09","2021-09-17","2021-09-17","2021-09-17","2021-09-17","2021-09-17","2021-09-17","2021-09-17","2021-09-17","2021-09-17","2021-09-17","2021-09-17","2021-09-17","2021-09-24","2021-09-24","2021-09-24","2022-07-22","2022-06-23","2022-03-01","2022-03-01","2022-04-01","2020-12-15","2022-09-28","2020-03-30","2020-03-30","2022-08-28","2022-08-28","2022-08-28","2020-10-12","2022-04-01","2022-05-03","2022-07-22","2020-12-09","2021-01-25","2021-07-14","2021-09-17","2022-03-01","2022-03-01","2022-03-01","2020-03-12","2020-03-12","2020-09-09","2021-05-27","2021-11-02","2021-11-02","2021-12-10"],"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":[]},{"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":[["","59267100001","PFIZER","INJ COVID-19","0","Select","Select",""],["","00536100901","FERROUS","TAB 325MG","12","Select","Select",""],["","00591554310","ALLOPURINOL","TAB 100MG","60","Select","Select",""],["","51224002070","METFORMIN","TAB 500MG","60","Select","Select",""],["","16729018301","HYDROCHLOROT","TAB 25MG","30","Select","Select",""],["","00173068220","VENTOLIN","AER ","18","Select","Select",""],["","69097012805","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","68462026290","ROSUVASTATIN","TAB 10MG","150","Select","Select",""],["","68462039610","OMEPRAZOLE","CAP 20MG","90","Select","Select",""],["","00378581477","VALSARTAN","TAB 160MG","60","Select","Select",""],["","68462029201","VERAPAMIL","TAB 120MG ER","60","Select","Select",""],["","00254200801","COLCHICINE","TAB 0.6MG","30","Select","Select",""],["","53746051105","SPIRONOLACT","TAB 25MG","30","Select","Select",""],["","70000044702","SENNA","TAB 8.6MG","30","Select","Select",""],["","00168000615","TRIAMCINOLON","OIN 0.001","15","Select","Select",""],["","70000041503","CLEARLAX","POW ","510","Select","Select",""],["","57664016758","METOPROL","TAB 100MG","180","Select","Select",""],["","96295012853","SLOW","TAB 70-117MG","30","Select","Select",""],["","69315011710","FUROSEMIDE","TAB 40MG","90","Select","Select",""],["","65862042001","SMZ\/TMP","TAB 800-160","20","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","30","Select","Select",""],["","00781185220","AMOX\/K","TAB 875-125","14","Select","Select",""],["","00143980350","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","67405060301","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","67877022205","GABAPENTIN","CAP 100MG","120","Select","Select",""],["","60505258009","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","68382009505","CARVEDILOL","TAB 25MG","60","Select","Select",""],["","51672208001","TERBINAFINE","CRE 0.01","15","Select","Select",""],["","50111032701","HYDRALAZINE","TAB 25MG","90","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","00185012201","NITROFURANTN","CAP 100MG","10","Select","Select",""],["","00193731221","CONTOUR","TES NEXT","100","Select","Select",""],["","00536123441","ASPIRIN","TAB 81MG EC","30","Select","Select",""],["","00603020922","MAG","TAB 400MG","42","Select","Select",""],["","00781148710","AMITRIPTYLIN","TAB 25MG","30","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","60","Select","Select",""],["","16729000517","SIMVASTATIN","TAB 20MG","30","Select","Select",""],["","00904645760","DOK","CAP 100MG","30","Select","Select",""],["","57896040803","STOOL","CAP 100MG","30","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","59316010220","BIOFREEZE","GEL 0.04","118","Select","Select",""],["","75826011410","PHENAZOPYRID","TAB 100MG","15","Select","Select",""],["","65862019399","FLUOXETINE","CAP 20MG","30","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":""}]}]}