{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" YEVRAHESOR L","gend":0,"add":"RUBUA408EUNEVA N","city":"RADFORD","state":"VA","zip":"24141-5011","dob":"1964-10-15","age":"","mstatus":"","insh":"50013137","cliId":"","pno":"2304579400","cno":2766864018,"email":"","ename":"","eno":"","pphy":"FREED, ELLIOT S","ppno":5404430500,"pcpadd":"133 BOSTIC LN,","pcpcity":"Pembroke","pcpstate":"VA","pcpzip":"24136-3678","pcpcounty":"","pcpid":"","pcpname":"LEWIS-GALE PHYSICIANS LLC","plan":"VPHP","program":"MEDICAID","lob":"MLTSS","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"804AUBURN AVENUE","add3":"","madd1":"804AUBURN AVENUE","madd2":"","madd3":"","mcity":"RADFORD","mstate":"VA","mzip":"24141-5011","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.9","I10","E78.49","J44.9","Z71.6","L45","G56.91","G89.29","N48.1","K76.0","K80.20","R07.9","E80.6","K83.9","R10.13","I25.10","E78.5","F17.200","Z79.84","R74.01","K80.61","K80.21","K85.10","Z66","Z20.822","K21.9","Z79.4","Z95.5","M19.90","K29.70","K83.1","R10.9","K83.8","K86.89","R17","E11.42","K29.80","K29.50","K80.50","K81.2","I25.119","Z79.82","Z79.51","I73.9","I65.23","R09.89","R20.8","R20.0","R20.2","E78.2","Z72.0","E66.3","Z71.3"],"date":["2023-05-24","2023-05-24","2022-06-15","2023-05-24","2023-05-24","2023-05-24","2023-05-24","2023-05-24","2021-03-03","2021-04-01","2021-04-02","2021-04-01","2021-04-01","2021-04-01","2021-04-05","2021-04-04","2021-04-04","2021-04-19","2021-04-01","2021-04-02","2021-04-01","2021-04-01","2021-04-19","2021-04-01","2021-04-01","2021-04-02","2021-04-15","2021-04-01","2021-04-15","2021-04-05","2021-04-02","2021-04-02","2021-04-02","2021-04-02","2021-04-05","2021-04-02","2021-04-05","2021-04-04","2021-04-04","2021-04-19","2021-04-19","2021-04-15","2021-04-15","2022-10-18","2022-10-18","2022-10-18","2022-10-19","2022-10-19","2022-10-19","2023-05-24","2022-10-19","2023-05-24","2023-05-24"],"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":[["","00310654004","BYDUREON BC","INJ 2\/0.85ML","3.4","Select","Select",""],["","61442012210","FAMOTIDINE","TAB 40MG","30","Select","Select",""],["","47781045704","NITROGLYCERN","SUB 0.4MG","25","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8.5","Select","Select",""],["","00193731150","CONTOUR","TES NEXT","50","Select","Select",""],["","16729000301","GLIMEPIRIDE","TAB 4MG","30","Select","Select",""],["","67877056310","METFORMIN","TAB 1000MG","60","Select","Select",""],["","00169643810","LEVEMIR","INJ FLEXTOUC","3","Select","Select",""],["","50228017805","GABAPENTIN","TAB 800MG","90","Select","Select",""],["","00186037020","SYMBICORT","AER 160-4.5","10.2","Select","Select",""],["","68462052917","CLOBETASOL","CRE 0.0005","15","Select","Select",""],["","50458014130","INVOKANA","TAB 300MG","30","Select","Select",""],["","08290320119","BD PEN NEEDL","MIS 31GX5MM","100","Select","Select",""],["","00193658621","MICROLET","MIS LANCETS","100","Select","Select",""],["","52817036000","METOPROL TAR","TAB 25MG","30","Select","Select",""],["","72205002590","ATORVASTATIN","TAB 80MG","30","Select","Select",""],["","43547035110","LISINOPRIL","TAB 2.5MG","30","Select","Select",""],["","10702018901","HYDROCO\/APAP","TAB 5-325MG","30","Select","Select",""],["","00093317431","ALBUTEROL SUL","FAT E","8.5","Select","Select",""],["","59310030480","QVAR REDIHA","AER 80MCG","10.6","Select","Select",""],["","29300042001","AMITRIPTYLIN","TAB 25MG","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":""}]}]}