{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LAFAYETTE   T EDWARDS SR","gend":0,"add":"1011 HUNT AVE NW","city":"ROANOKE","state":"VA","zip":"24012-9998","dob":"1965-12-27","age":"","mstatus":"","insh":"20040087*01","cliId":"","pno":"540\/230-6197","cno":"","email":"","ename":"","eno":"","pphy":"DONAHUE, DAVID NP","ppno":"540\/362-0360","pcpadd":"3716 MELROSE AVE NW","pcpcity":"ROANOKE","pcpstate":"VA","pcpzip":24017,"pcpcounty":"","pcpid":"","pcpname":"KUUMBA COMMUNITY HEALTH AND WELLNESS CENTER INC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"540\/362-5590","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R07.89","R07.9","R30.0","R10.9","R53.83","R00.1","R25.2","G47.33","K52.9","R51.","I10.","E78.5","M19.90","G62.9","K21.9","R11.0","G89.29","M51.16","Z01.818","M54.16","M50.10","M48.02","T15.01XA","N52.9","Z23.","R00.2","J06.9","J02.9","M25.569","M54.5","J30.1","B97.89","G47.30","J45.909","R73.03","E66.9","Z71.3","Z71.89","F41.9","D64.9","R79.89","M25.561","M54.6","NO DATA","B35.1","M51.36","Z91.013","J45.30","L29.9","Z99.89","Z79.899","R05.","J30.2","J01.01","J45.20","M76.31","J02.8","E66.01","T15.91XA","M25.511"],"date":["2019-02-06","2019-02-27","2019-07-06","2019-07-06","2019-07-31","2019-07-31","2019-09-11","2021-09-15","2020-02-22","2020-02-22","2021-11-09","2020-02-22","2020-02-22","2020-02-22","2020-02-22","2020-02-22","2021-10-05","2021-10-05","2021-11-04","2021-11-09","2019-04-25","2019-04-25","2019-11-05","2020-01-30","2021-11-03","2019-08-27","2019-03-18","2021-10-23","2021-08-04","2020-01-14","2021-07-29","2021-10-23","2019-03-14","2019-03-14","2019-03-14","2019-03-14","2019-03-14","2019-03-14","2019-03-14","2019-08-09","2019-08-09","2021-02-08","2021-02-05","2021-03-01","2021-03-03","2021-08-04","2019-03-28","2019-03-28","2019-03-28","2019-03-28","2020-02-10","2020-04-03","2020-04-03","2020-04-03","2020-04-03","2020-08-20","2021-10-23","2019-08-27","2019-11-05","2020-09-11"],"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":[["","","LOSARTAN"," LOSARTAN ","30","Select","Select",""],["","","HYDROCHLOROT"," HYDROCHLOROT ","30","Select","Select",""],["","","AMLODIPINE"," AMLODIPINE ","30","Select","Select",""],["","","HYDROCO\/APAP"," HYDROCO\/APAP ","15","Select","Select",""],["","","RANITIDINE"," RANITIDINE ","60","Select","Select",""],["","","METHOCARBAM"," METHOCARBAM ","120","Select","Select",""],["","","MONTELUKAST"," MONTELUKAST ","30","Select","Select",""],["","","EPINEPHRINE"," EPINEPHRINE ","2","Select","Select",""],["","","TRIAMCINOLON"," TRIAMCINOLON ","34","Select","Select",""],["","","ALBUTEROL"," ALBUTEROL ","8","Select","Select",""],["","","TOPIRAMATE"," TOPIRAMATE ","45","Select","Select",""],["","","POT  CHLORIDE"," POT  CHLORIDE","60","Select","Select",""],["","","BUSPIRONE"," BUSPIRONE ","90","Select","Select",""],["","","TAMSULOSIN"," TAMSULOSIN ","30","Select","Select",""],["","","FLUTICASONE"," FLUTICASONE ","16","Select","Select",""],["","","PROAIR"," PROAIR ","8","Select","Select",""],["","","ALLERGY"," ALLERGY ","17","Select","Select",""],["","","POLYMYXIN"," POLYMYXIN ","10","Select","Select",""],["","","CIPROFLOXACN"," CIPROFLOXACN ","5","Select","Select",""],["","","GABAPENTIN"," GABAPENTIN ","30","Select","Select",""],["","","NEO\/POLY\/DEX"," NEO\/POLY\/DEX ","5","Select","Select",""],["","","CELECOXIB"," CELECOXIB ","60","Select","Select",""],["","","TIZANIDINE","TAB 4MG","","Select","Select",""],["","","BUT\/APAP\/CAF","TAB ","","Select","Select",""],["","","PSEUDOEPHEDR","TAB 120MG ER","","Select","Select",""],["","","CETIRIZINE","TAB 10MG","","Select","Select",""],["","","MELATONIN","TAB MAX ST","","Select","Select",""],["","","TERBINAFINE","TAB 250MG","","Select","Select",""],["","","PREGABALIN","CAP 50MG","","Select","Select",""],["","","ANDROGEL","GEL 0.0162","","Select","Select",""],["","","LORATADINE","TAB 10MG","","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":""}]}]}