{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MANUBHAI   M TRIVEDI","gend":0,"add":"4215 PINEY WOODS ROAD","city":"CHRISTIANSBURG","state":"VA","zip":"24073-9998","dob":"1928-10-01","age":"","mstatus":"","insh":"20036405*01","cliId":"","pno":"540\/588-1335","cno":"","email":"","ename":"","eno":"","pphy":"MICK, MARY-ELLEN C DO","ppno":"540\/639-9071","pcpadd":"SUITE 250 2900 LAMB CIR","pcpcity":"CHRISTIANSBURG","pcpstate":"VA","pcpzip":24073,"pcpcounty":"","pcpid":"","pcpname":"Carilion Internal Medicine Radford","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"540\/639-0976","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H35.81","H35.373","H35.371","NO DATA","R13.19","I63.232","E03.9","N18.2","I69.398","R26.81","N18.3","H40.1112","H30.91","G62.89","G44.89","G45.9","R47.01","I65.21","E04.1","E53.8","Z23.","H35.3130","H40.1130","H47.233","H53.8","H40.1132","H26.493","H04.123","R73.03","H40.9","L30.4","Z96.1","H43.813","I65.23","I25.10","Z86.73","H61.23","K21.9","I05.8","H34.8122","H90.3","L29.9","Z20.822","R73.9","H92.01","H35.379","H31.013","H16.223","T16.2XXA","H40.1123","R94.31","D64.9","E87.5"],"date":["2021-10-18","2019-08-28","2019-11-21","2021-10-29","2021-06-24","2019-10-26","2021-10-29","2019-10-27","2019-12-03","2019-12-03","2020-07-24","2021-12-21","2021-10-18","2021-06-24","2021-06-24","2019-10-25","2019-10-25","2019-10-25","2019-10-31","2021-10-29","2021-10-29","2019-11-14","2020-05-18","2020-05-18","2020-05-18","2021-06-16","2021-06-16","2020-09-15","2021-10-29","2021-10-29","2021-04-30","2021-06-16","2019-05-09","2020-03-09","2020-03-09","2020-03-09","2021-05-21","2021-10-29","2019-10-26","2019-11-21","2021-05-21","2021-05-21","2021-11-29","2020-07-24","2019-05-17","2019-10-03","2020-05-18","2020-01-08","2020-06-03","2020-08-11","2019-10-25","2020-07-24","2020-07-24"],"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":[["","24208048610","DORZOL\/TIMOL","SOL 22.3-6.8","10","Select","Select",""],["","00378180010","LEVOTHYROXIN","TAB 25MCG","30","Select","Select",""],["","00536100836","ASPIRIN","CHW 81MG","30","Select","Select",""],["","60505257908","ATORVASTATIN","TAB 20MG","90","Select","Select",""],["","10006073043","VITAMIN","TAB 1000MCG","60","Select","Select",""],["","12843053642","BAYER","TAB 81MG EC","90","Select","Select",""],["","55111039890","LANSOPRAZOLE","CAP 15MG DR","30","Select","Select",""],["","","CLOTRIM\/BETA","LOT DIPROP","","Select","Select",""],["","61314054701","LATANOPROST","SOL 0.00005","2","Select","Select",""],["","80777027310","MODERNA","INJ COVID-19","0","Select","Select",""],["","60758011905","PREDNISOLONE","SUS 1% OP","5","Select","Select",""],["","","KETOROLAC","SOL 0.005","","Select","Select",""],["","61314014305","BRIMONIDINE","SOL 0.2% OP","5","Select","Select",""],["","","CLOTRIMAZOLE","CRE 0.01","","Select","Select",""],["","60505025303","CLOPIDOGREL","TAB 75MG","30","Select","Select",""],["","","AMOXICILLIN","CAP 500MG","","Select","Select",""],["","","CIPROFLOXACN","SOL 0.3% OP","","Select","Select",""],["","","ATROPINE","SOL 1% OP","","Select","Select",""],["","17478028811","TIMOLOL","SOL 0.5% OP","10","Select","Select",""],["","17478071310","OFLOXACIN","DRO 0.3% OP","5","Select","Select",""],["","24208048510","DORZOLAMIDE","SOL 2% OP","10","Select","Select",""],["","00065853302","CIPRODEX","SUS 0.3-0.1%","8","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":""}]}]}