{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"APRIL  L BROWN","gend":1,"add":"7313 LITTLE RIVER DAM ROAD","city":"RADFORD","state":"VA","zip":"24141-9998","dob":"1977-04-25","age":"","mstatus":"","insh":"2141445*01","cliId":"","pno":5407314216,"cno":5407314216,"email":"","ename":"","eno":"","pphy":"KELLY, DANIEL R MD","ppno":5407313200,"pcpadd":"SUITE 120 701 RANDOLPH ST,","pcpcity":"RADFORD","pcpstate":"VA","pcpzip":"24141-9998","pcpcounty":"","pcpid":"","pcpname":"Carilion Healthcare Corp","plan":"OHP","program":"MEDICAID","lob":"M4","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":5406391048,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G37.9","G37.0","B00.9","L98.9","G95.89","A54.9","R26.2","R53.1","R26.81","G37.8","G35.","N39.0","N76.0","J34.1"],"date":["2023-06-28","2023-06-28","2023-06-28","2021-10-06","2021-05-23","2022-12-08","2023-07-17","2023-07-17","2023-07-17","2023-07-17","2023-07-17","2023-07-13","2023-07-13","2023-07-13"],"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":[["","00069024230","TOVIAZ","TAB 4MG","30","Select","Select",""],["","54092017112","CARBATROL","100 MG","90","Select","Select",""],["","72205001490","PREGABALIN","100 MG","120","Select","Select",""],["","60505280507","CARBAMAZEPIN","CAP 100MG ER","90","Select","Select",""],["","31722077801","ACYCLOVIR","800 MG","30","Select","Select",""],["","31722065832","DIMETHYL FUM","CAP 240MG DR","60","Select","Select",""],["","67877006430","FESOTERODINE","TAB 4MG ER","30","Select","Select",""],["","43353041330","LYRICA","CAP 100MG","120","Select","Select",""],["","65862044930","VALACYCLOVIR","TAB 1GM","20","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","60505280507","CARBAMAZEPINE ER","100 MG","90","Select","Select",""],["","67877006430","FESOTERODINE FUMARATE ER","4 MG","30","Select","Select",""],["","00069024230","TOVIAZ TAB","4MG","30","Select","Select",""],["","60505280507","CARBAMAZEPIN CAP","100MG ER","90","Select","Select",""],["","54092017112","CARBATROL CAP","100MG","90","Select","Select",""],["","43598029490","PREGABALIN CAP","100MG","120","Select","Select",""],["","43353041330","LYRICA CAP","100MG","120","Select","Select",""],["","31722065832","DIMETHYL FUM CAP","240MG DR","60","Select","Select",""],["","69238162603","DIMETHYL FUM MIS STARTER","","120","Select","Select",""],["","68382079201","ACYCLOVIR TAB","800MG","30","Select","Select",""],["","67877006430","FESOTERODINE TAB","4MG ER","30","Select","Select",""],["","65862044930","VALACYCLOVIR TAB","1GM","20","Select","Select",""],["","50111033402","METRONIDAZOL TAB","500MG","14","Select","Select",""],["","27241009706","DULOXETINE HCL","20 MG","30","Select","Select",""],["","00078051005","TEGRETOL XR","100 MG","60","Select","Select",""],["","00093101042","MUPIROCIN","2 %","22","Select","Select",""],["","42806031250","DOXYCYCLINE HYCLATE","100 MG","14","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":""}]}]}