{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"  AHTNAMASSIVART L ","gend":1,"add":"            TEERTS  LAPO   011                              ","city":"PEARISBURG                    ","state":"VA","zip":"24134-1118","dob":"1990-07-05","age":"","mstatus":"","insh":"50015443","cliId":"","pno":"0504588835","cno":"","email":"","ename":"","eno":"","pphy":"SOLOMON, ROBERT C                                           ","ppno":5409516070,"pcpadd":"3698 S Main St,","pcpcity":"Blacksburg                    ","pcpstate":"VA","pcpzip":240607015,"pcpcounty":"","pcpid":"","pcpname":"","plan":"VPHP","program":"MEDICAID","lob":"MLTSS","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"LOT 18                                                      ","add3":"","madd1":"110 OPAL STREET","madd2":"LOT 18","madd3":"","mcity":"PEARISBURG                    ","mstate":"VA","mzip":"24134-1118","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F43.12","R10.811","R10.812","R10.9","R11.0","R19.7","R10.84","N20.0","Z90.710","F17.210","R00.0","R53.83","F17.200","Z23","Z29.14","Z20.3","M79.642","E86.0","R11.2","Z01.411","N76.0","N63.21","Z11.3","Z11.8","F31.81","R15.2","R15.9","F43.10","F41.1","J11.1","N13.2","R10.31","N13.4","N23","K59.00","R93.89","M54.2","S16.1XXA","R51","X58.XXXA","N20.1","N20.2","K21.9","R10.11","F17.290","B37.3","B96.89","N95.2","S30.1XXA","W22.8XXA","Y93.16","R07.89","R06.02","K82.9","K80.10","K82.8","J45.909","F31.9","Z20.828","K81.1","R10.12","R74.0","Z90.49","T81.31XA","F41.9","R10.32","M79.10","R51.9","Z11.59","F90.2","Z79.899","R79.89","N60.01","Z78.9","H66.002","Z20.822","R92.2"],"date":["2020-07-21","2020-09-05","2019-05-17","2020-10-13","2020-11-19","2020-11-19","2019-05-17","2020-10-13","2020-11-19","2020-11-19","2019-05-17","2019-07-11","2020-10-13","2019-08-09","2019-08-12","2019-08-09","2019-08-20","2019-09-27","2019-09-27","2019-10-11","2020-05-07","2019-10-11","2019-10-11","2019-10-11","2021-11-10","2019-11-07","2019-11-07","2020-09-15","2019-11-07","2020-02-04","2020-02-11","2020-05-14","2020-02-11","2020-02-11","2020-02-19","2020-02-19","2020-02-20","2020-02-20","2020-02-20","2020-02-20","2020-10-13","2020-02-21","2020-09-05","2020-09-09","2020-11-19","2020-05-07","2020-05-07","2020-05-07","2020-07-26","2020-07-26","2020-07-26","2020-08-27","2020-08-27","2020-09-17","2020-09-15","2020-09-17","2020-09-15","2020-09-15","2021-11-26","2020-09-17","2020-10-13","2020-09-24","2020-11-19","2020-09-27","2020-09-27","2020-10-13","2020-11-19","2020-11-19","2020-11-19","2021-08-27","2021-08-27","2021-10-18","2021-10-21","2021-10-18","2021-11-26","2021-11-26","2021-10-21"],"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":[["","50228017805","GABAPENTIN","TAB 800MG","120","Select","Select",""],["","16729013716","CLONAZEPAM","TAB 1MG","120","Select","Select",""],["","00406114201","METHYLPHENID","TAB 5MG","60","Select","Select",""],["","68180032002","BUPROPN","TAB 300MG XL","30","Select","Select",""],["","61874016030","VRAYLAR","CAP 6MG","30","Select","Select",""],["","68382095201","AMPHET\/DEXTR","TAB 10MG","30","Select","Select",""],["","59267100002","PFIZER","INJ COVID-19","0.3","Select","Select",""],["","29300011101","LAMOTRIGINE","TAB 25MG","60","Select","Select",""],["","68462010630","ONDANSETRON","TAB 8MG","30","Select","Select",""],["","69097080232","TESTOST","INJ 200MG\/ML","2","Select","Select",""],["","68382052860","CHOLESTYRAM","POW 4GM","60","Select","Select",""],["","35573042030","ATOMOXETINE","CAP 80MG","30","Select","Select",""],["","65862001501","AMOXICILLIN","TAB 875MG","20","Select","Select",""],["","68382070718","DOXYCYC","CAP 100MG","14","Select","Select",""],["","65862050220","AMOX\/K","TAB 500-125","21","Select","Select",""],["","55111025760","ZIPRASIDONE","CAP 40MG","60","Select","Select",""],["","13107003234","MIRTAZAPINE","TAB 45MG","30","Select","Select",""],["","00555088602","ESTRADIOL","TAB 1MG","30","Select","Select",""],["","68382013201","TAMSULOSIN","CAP 0.4MG","7","Select","Select",""],["","10702000350","PROMETHAZINE","TAB 25MG","20","Select","Select",""],["","00713052612","PROMETHEGAN","SUP 25MG","12","Select","Select",""],["","00406051205","OXYCOD\/APAP","TAB 5-325MG","15","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","00046087221","PREMARIN","CRE 0.625MG","30","Select","Select",""],["","57237000511","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","20","Select","Select",""],["","52817033200","CYCLOBENZAPR","TAB 10MG","20","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","6","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","20","Select","Select",""],["","00406012305","HYDROCO\/APAP","TAB 5-325MG","14","Select","Select",""],["","00363023820","STOOL","CAP 100MG","30","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","69238126601","OSELTAMIVIR","CAP 75MG","10","Select","Select",""],["","55111015810","OMEPRAZOLE","CAP 20MG","30","Select","Select",""],["","60505016501","FLUVOXAMINE","TAB 50MG","30","Select","Select",""],["","65862069730","VENLAFAXINE","CAP 150MG ER","60","Select","Select",""],["","63402031230","LATUDA","TAB 120MG","30","Select","Select",""],["","65862066130","ARIPIPRAZOLE","TAB 2MG","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":""}]}]}