{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ALICE VAUGHN","gend":1,"add":"C\/O CASEY MABERY 575 GRAVEYARD KNOB ROAD","city":"CALLAWAY","state":"VA","zip":"24067-9998","dob":"2001-07-06","age":"","mstatus":"","insh":"1983373*01","cliId":"","pno":"276\/692-6126","cno":"","email":"","ename":"","eno":"","pphy":"COLEMAN, ANGELA PA","ppno":"540\/725-3060","pcpadd":"5303 INDIAN GRAVE RD","pcpcity":"ROANOKE","pcpstate":"VA","pcpzip":24018,"pcpcounty":"","pcpid":"","pcpname":"LEWIS GALE PHYSICIANS LLC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"540\/772-4948","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R45.4","T78.40XA","B07.0","Z02.5","R25.8","J45.909","Z76.0","H92.01","R11.2","Z87.440","F90.9","F41.9","G47.00","N30.00","R06.02","R53.83","Z20.822","N39.0","R30.0","R35.0","J35.1","R13.10","R56.9","Z87.891","Z82.0","Z01.419","Z11.3","R07.0","J35.01","R55.","R10.32","R10.9","K90.0","R00.0","M41.23","Z79.51","R50.9","R07.89","R09.1","J06.9","B97.89","Z01.812","R11.0","B07.9","M79.672","G40.909","T30.4","G56.21","F12.929","R25.1","R07.9","T40.7X1A","J02.9","B37.3","N89.8","F90.0","Z02.0","F33.2","F43.10","F94.1","R10.31","R68.89","R42.","J45.20","J30.89","L84.","R39.15","R07.81","R10.2","V62.84","F32.9","R53.81","R53.1","R00.2","E10.9","F17.200","R73.09","S41.112A","Z23.","Z79.899","M79.602","T14.90XA","R73.9","J45.901","NO DATA","R51.9","R05.9","Z72.0","H53.8","J30.9","H93.90","Z72.89","I11.9","F17.210"],"date":["2020-03-11","2021-06-04","2020-01-17","2020-01-30","2020-09-22","2022-10-30","2021-06-04","2021-03-27","2021-04-29","2021-05-28","2021-07-12","2021-07-12","2021-07-12","2021-08-12","2022-10-30","2022-05-03","2022-09-29","2022-08-12","2022-08-12","2020-04-25","2020-07-20","2022-05-03","2021-02-28","2022-02-01","2021-02-28","2021-04-29","2021-04-29","2020-07-20","2020-07-20","2020-08-20","2021-04-29","2021-04-29","2021-04-29","2022-02-01","2021-09-23","2022-10-30","2021-11-30","2020-12-08","2020-12-08","2021-04-22","2020-12-08","2021-02-23","2021-10-08","2020-01-17","2020-01-17","2020-09-01","2020-12-12","2021-07-29","2021-08-15","2021-08-15","2022-08-24","2021-08-15","2021-04-22","2019-01-10","2019-02-08","2019-05-22","2019-03-11","2019-04-17","2019-05-28","2019-04-17","2019-02-08","2019-10-28","2022-06-23","2019-10-28","2019-10-28","2019-10-28","2019-02-08","2019-02-21","2019-01-28","2019-04-17","2019-04-17","2022-03-23","2022-03-23","2022-08-24","2022-08-04","2022-10-30","2022-08-22","2022-02-01","2022-02-01","2022-02-01","2022-02-01","2022-02-01","2022-06-23","2022-09-29","2022-09-29","2022-09-29","2022-09-29","2022-09-29","2022-03-04","2022-09-25","2022-03-15","2022-02-01","2022-08-25","2022-09-25"],"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":[["","61314032001","OLOPATADINE","SPR 0.006","30","Select","Select",""],["","69367027216","CODEINE\/GG","SOL 10-100\/5","60","Select","Select",""],["","68180016011","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","36","Select","Select",""],["","42806071401","BENZONATATE","CAP 100MG","30","Select","Select",""],["","65862001501","AMOXICILLIN","TAB 875MG","14","Select","Select",""],["","00378064010","PREDNISONE","TAB 5MG","21","Select","Select",""],["","53885001110","ONETOUCH","MIS PLUS 30G","100","Select","Select",""],["","70010049110","METFORMIN","TAB 500MG ER","60","Select","Select",""],["","57599080000","FREESTY","KIT 2 SENSOR","2","Select","Select",""],["","53489011905","DOXYCYCL","CAP 100MG","14","Select","Select",""],["","59651021430","AZELASTINE","SPR 0.001","30","Select","Select",""],["","00121086802","NYSTATIN","SUS 100000","140","Select","Select",""],["","08373996900","INNOSPIRE","MIS NEBULIZE","1","Select","Select",""],["","00121177505","GG\/CODEINE","SOL 100-10\/5","60","Select","Select",""],["","","CEPHALEXIN","CAP 500MG","","Select","Select",""],["","65162047810","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","60505283203","ATOMOXETINE","CAP 25MG","30","Select","Select",""],["","00065853302","CIPRODEX","SUS 0.3-0.1%","8","Select","Select",""],["","00781618667","CIPRO\/DEXA","SUS 0.3-0.1%","8","Select","Select",""],["","24979053301","GUANFACINE","TAB 1MG ER","30","Select","Select",""],["","42806016105","HYDROXYZ","TAB 50MG","60","Select","Select",""],["","42571016142","AMOX\/K","TAB 500-125","14","Select","Select",""],["","75826011510","PHENAZOPYRID","TAB 200MG","6","Select","Select",""],["","16729020001","BUSPIRONE","TAB 5MG","60","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0","Select","Select",""],["","16571020210","DICLOFENAC","TAB 50MG DR","14","Select","Select",""],["","00555903270","TRI-LEGEST","TAB FE","28","Select","Select",""],["","16714089803","LORATADINE","TAB 10MG","30","Select","Select",""],["","29300022019","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","6","Select","Select",""],["","68180086613","BLISOVI","TAB 1.5\/30","28","Select","Select",""],["","00173068220","VENTOLIN","AER ","36","Select","Select",""],["","51862007206","AZURETTE","TAB 28 DAY","28","Select","Select",""],["","70710113908","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","00555905058","KARIVA","TAB 28 DAY","84","Select","Select",""],["","60505015801","BUPROPION","TAB 75MG","60","Select","Select",""],["","00067611730","ALLERGY","TAB 10MG","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":""}]}]}