{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JON   D CARNOT","gend":0,"add":"1515 MEMORIAL AVE SW APT 2","city":"ROANOKE","state":"VA","zip":"24015-9998","dob":"1961-11-15","age":"","mstatus":"","insh":"20050573*01","cliId":"","pno":"540\/904-8208","cno":"540\/904-8208","email":"","ename":"","eno":"","pphy":"BROCHERO, ALFONSO MD","ppno":"540\/769-3964","pcpadd":"1111 S JEFFERSON ST STE B","pcpcity":"ROANOKE","pcpstate":"VA","pcpzip":24016,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"540\/473-3458","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J44.1","G47.33","H61.21","E11.9","N43.3","R09.02","M16.12","M16.11","M25.552","M25.562","J44.9","F43.23","F41.1","F32.1","F33.1","NO DATA","V62.84","F33.2","N10.","L02.11","R00.0","R70.0","I13.0","Z20.822","E11.22","I50.9","E78.5","F17.220","Z79.84","Z99.81","Z79.899","Z04.9","N49.2","N45.4","N43.1","M62.81","R26.2","Z48.816","I50.32","N18.2","I10.","N40.1","F41.9","R41.82","R94.31","A41.9","I50.42","I42.9","F15.20","I95.9","D50.9","D63.1","E66.01","R10.2","F39.","F51.01","F32.89","F19.10","N43.0","Z01.810","K08.89","Z87.891","N43.2","Z99.89","D64.9","G47.00","Z59.00","R26.89","R50.9","F32.2","Z23.","I11.0","E11.69","E66.9","Z68.42","J96.11","F15.10","N50.89","M43.3","N50.82","I25.10","E11.649","G93.40","R06.02","Z74.3","R07.89","R19.7","R00.2","R42.","R10.9","E03.9","N39.0","I50.22","E87.0","G89.29","T40.3X4A","Z71.3","D63.8"],"date":["2022-10-05","2022-10-01","2020-02-03","2022-10-05","2022-08-10","2020-02-03","2021-06-03","2021-04-20","2022-06-29","2022-08-08","2022-08-10","2021-10-28","2022-09-07","2022-07-31","2022-09-07","2022-10-01","2022-07-31","2022-07-30","2022-07-22","2022-07-22","2022-07-22","2022-07-22","2022-07-30","2022-07-22","2022-07-30","2022-07-22","2022-07-30","2022-07-22","2022-07-22","2022-07-22","2022-07-22","2022-08-08","2022-08-30","2022-10-05","2022-10-05","2022-10-05","2022-10-01","2022-10-01","2022-10-05","2022-10-01","2022-10-05","2022-10-01","2022-10-01","2022-06-29","2022-07-30","2022-08-08","2022-07-31","2022-07-30","2022-07-31","2022-07-30","2022-07-30","2022-07-30","2022-07-30","2022-08-08","2022-09-07","2022-09-07","2022-09-07","2022-09-07","2020-02-12","2021-06-03","2020-11-03","2022-08-10","2022-08-08","2022-08-08","2022-08-08","2022-08-08","2022-08-07","2022-08-08","2022-08-08","2021-01-15","2021-04-20","2021-06-03","2021-06-03","2021-08-02","2021-08-02","2022-02-25","2022-07-30","2022-08-09","2020-02-10","2022-07-30","2022-06-05","2022-06-14","2022-06-07","2022-07-21","2022-07-21","2022-07-21","2022-07-21","2022-07-21","2022-07-21","2022-07-21","2022-07-30","2022-07-30","2022-08-02","2022-10-05","2022-06-29","2022-06-06","2020-10-06","2022-07-31"],"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":[["","53885000810","ONETOUCH","MIS PLUS 33G","100","Select","Select",""],["","72205001290","PREGABALIN","CAP 50MG","90","Select","Select",""],["","57664050658","METOPROL","TAB 25MG","180","Select","Select",""],["","10370010250","BUPROPN","TAB 300MG XL","30","Select","Select",""],["","29300015001","QUETIAPINE","TAB 200MG","30","Select","Select",""],["","16729020001","BUSPIRONE","TAB 5MG","90","Select","Select",""],["","57237001999","DULOXETINE","CAP 60MG","30","Select","Select",""],["","60505265901","TRAZODONE","TAB 300MG","30","Select","Select",""],["","57237001401","TAMSULOSIN","CAP 0.4MG","30","Select","Select",""],["","68180098003","LISINOPRIL","TAB 10MG","90","Select","Select",""],["","00591354360","BUPROPION","TAB 150MG SR","30","Select","Select",""],["","68382075810","METFORMIN","TAB 500MG","60","Select","Select",""],["","00378021610","FUROSEMIDE","TAB 40MG","90","Select","Select",""],["","70377002911","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","13668001105","CITALOPRAM","TAB 40MG","30","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","25","Select","Select",""],["","65862007701","CIPROFLOXACN","TAB 500MG","10","Select","Select",""],["","14539067401","HYDROXYZ","CAP 25MG","90","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":""}]}]}