{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" LEHCARNAHAM Y","gend":1,"add":"LUTS 557DAOR ZT","city":"MARTINSVILLE","state":"VA","zip":24112,"dob":"1972-07-19","age":"","mstatus":"","insh":"60013676","cliId":"","pno":"8443435113","cno":4344831153,"email":"","ename":"","eno":"","pphy":"KING, BRODERICK D","ppno":4344831153,"pcpadd":"1627 SEYMORE DR,STE B","pcpcity":"SOUTH BOSTON","pcpstate":"VA","pcpzip":24592,"pcpcounty":"","pcpid":"","pcpname":"HEALTH CENTER OF THE PIEDMONT","plan":"VPHP","program":"MEDICAID","lob":"MLTSS","region":"ROANOKE\/ALLEGHANY","aligned":"","ano":"","add2":"755 STULTZ ROAD","add3":"","madd1":"755 STULTZ ROAD","madd2":"APT 702","madd3":"","mcity":"MARTINSVILLE","mstate":"VA","mzip":"24112-1223","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F20.9","F33.1","M62.830","I10","E78.00","R73.03","B37.9","M25.562","Z53.29","J44.9","F17.210","Z90.710","M17.12","M23.92","E87.6","N39.0","R10.13","R11.2","R10.9","Z32.02","G62.9","Z79.899","R10.84","E66.9","R10.11","K76.0","R11.0","Z79.1","Z11.59","F31.5","K29.50","K21.9","E11.9","F41.9","N28.9","E78.5","Z79.82","Z79.84","Z79.891","K29.70","R30.0","N83.8","R63.4","E66.01","Z23","R09.81","R68.89","J01.90","Z20.822","K59.00","Z80.0","Z79.51","M25.462","R60.0","Z12.11","M10.9","M54.40","G89.29","M54.5","M25.569","R07.9","Z09","R06.00","L02.411","N10","R10.12","R10.10","K85.90","Z12.31","R93.3","Z01.818","K31.89","K86.2","I12.9","E11.22","N18.30","E11.40","J30.2","Z68.41","L72.3","L60.0","M79.674","M79.675","M79.671","L60.2","D23.71","F06.4","F31.9","J44.1","J22","N64.52","M54.9","E22.1","R92.1","G47.00","F40.01","N18.2","R19.7","F32.9"],"date":["2022-03-27","2021-07-25","2020-01-10","2021-10-13","2021-05-11","2020-09-22","2021-05-11","2021-05-11","2021-03-11","2021-10-06","2021-11-10","2021-10-06","2021-04-14","2021-04-14","2020-06-16","2020-09-18","2020-09-21","2020-08-21","2020-06-16","2020-06-16","2021-08-21","2021-10-06","2020-06-23","2020-06-23","2020-07-27","2020-10-08","2021-11-02","2021-11-10","2020-11-19","2020-08-26","2020-08-21","2021-11-10","2021-11-10","2020-11-03","2020-08-18","2021-11-10","2021-11-10","2021-03-29","2020-08-18","2020-08-21","2020-09-18","2020-09-21","2020-09-21","2021-05-11","2021-03-17","2020-10-14","2021-01-04","2021-01-19","2021-03-11","2021-05-11","2021-03-04","2021-08-21","2021-03-10","2021-03-10","2021-03-11","2021-03-17","2021-03-29","2021-03-29","2021-09-01","2021-04-14","2021-07-13","2021-05-11","2021-07-13","2021-08-21","2021-10-06","2021-11-02","2021-10-06","2022-03-28","2021-10-13","2021-11-10","2021-11-05","2021-11-10","2021-11-10","2021-11-10","2021-11-10","2021-11-10","2021-11-10","2021-11-10","2021-11-10","2022-03-23","2022-03-23","2022-03-23","2022-03-23","2022-03-23","2022-03-23","2022-03-23","2019-02-07","2019-02-07","2019-02-07","2019-02-26","2019-03-11","2019-09-09","2019-03-20","2019-03-28","2019-06-19","2019-06-20","2019-12-12","2019-08-29","2019-11-27"],"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":[["","68382004101","PROMETHAZINE","TAB 25MG","40","Select","Select",""],["","69543013650","TRAMADOL","TAB 50MG","180","Select","Select",""],["","57237009960","CEFDINIR","CAP 300MG","14","Select","Select",""],["","69097084607","CYCLOBENZAPR","TAB 10MG","20","Select","Select",""],["","00378064205","PREDNISONE","TAB 20MG","10","Select","Select",""],["","00168005430","NYSTATIN","CRE 100000","60","Select","Select",""],["","68382005001","MELOXICAM","TAB 7.5MG","20","Select","Select",""],["","16571040250","CETIRIZINE","TAB 10MG","90","Select","Select",""],["","52817018110","CLONIDINE","TAB 0.2MG","60","Select","Select",""],["","00143992801","CIPROFLOXACN","TAB 500MG","6","Select","Select",""],["","67877019905","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","00378020810","FUROSEMIDE","TAB 20MG","30","Select","Select",""],["","65862019405","FLUOXETINE","CAP 40MG","90","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","10","Select","Select",""],["","65862020399","LOSARTAN","TAB 100MG","90","Select","Select",""],["","00472037945","CLOTRIM\/BETA","CRE DIPROP","45.00","Select","Select",""],["","59310057922","PROAIR","AER ","8.5","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","00172572880","FAMOTIDINE","TAB 20MG","10","Select","Select",""],["","67877021901","CEPHALEXIN","CAP 500MG","20","Select","Select",""],["","68462015713","ONDANSETRON","TAB 4MG ODT","12","Select","Select",""],["","00536105227","PEG3350","POW ","510","Select","Select",""],["","00093100601","NAPROXEN","TAB 500MG","60","Select","Select",""],["","68462010340","FLUCONAZOLE","TAB 150MG","5","Select","Select",""],["","65862050320","AMOX\/K","TAB 875-125","20","Select","Select",""],["","65162027210","SMZ\/TMP","TAB 800-160","14","Select","Select",""],["","00781148601","AMITRIPTYLIN","TAB 10MG","90","Select","Select",""],["","00527128201","DICYCLOMINE","TAB 20MG","120","Select","Select",""],["","00603389021","HYDROCO\/APAP","TAB 5-325MG","15","Select","Select",""],["","00143301830","COLCHICINE","CAP 0.6MG","3","Select","Select",""],["","59762040101","SUCRALFATE","TAB 1GM","120","Select","Select",""],["","67877032105","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","70010075401","METHOCARBAM","TAB 500MG","30","Select","Select",""],["","00172409680","BACLOFEN","TAB 10MG","90","Select","Select",""],["","70000042001","ASPIRIN","CHW 81MG","30","Select","Select",""],["","16729000916","PRAVASTATIN","TAB 20MG","30","Select","Select",""],["","00173069600","ADVAIR","AER 250\/50","60","Select","Select",""],["","50458056401","INVEGA","INJ 234\/1.5","1.5","Select","Select",""],["","50111078867","AZITHROMYCIN","TAB 500MG","3","Select","Select",""],["","62756014202","METFORMIN","TAB 500MG ER","30","Select","Select",""],["","60505083305","AZELASTINE","SPR 0.001","30","Select","Select",""],["","68382080610","TRAZODONE","TAB 100MG","30","Select","Select",""],["","67877022305","GABAPENTIN","CAP 300MG","90","Select","Select",""],["","00093529410","OMEPRAZOLE","CAP 40MG","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":""}]}]}