{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"HOPE HUBBARD","gend":1,"add":"1934 LEE ELGIN ROAD","city":"WOOLWINE","state":"VA","zip":"24185-9998","dob":"1971-10-28","age":"","mstatus":"","insh":"20051814*01","cliId":"","pno":"276\/229-2015","cno":"276\/229-2015","email":"","ename":"","eno":"","pphy":"LEWIS, WILLIAM BENTON MD","ppno":"540\/921-6000","pcpadd":"159 HARTLEY WAY","pcpcity":"PEARISBURG","pcpstate":"VA","pcpzip":24134,"pcpcounty":"","pcpid":"","pcpname":"Carilion Medical Associates Martinsville","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"540\/921-5606","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N64.53","N60.21","N60.22","M47.812","J38.3","F17.200","E78.5","J44.9","H43.811","H52.03","H52.223","H52.4","M54.9","NO DATA","M54.2","G89.29","Z01.810","N64.52","R92.1","Z80.3","J38.1","Z72.0","R22.1","I10.","R00.0","C14.0","I51.7","R06.02","R94.31","F17.210","D38.0","J38.7","M54.6","Z23.","F41.9","Z01.89","M25.562","K59.00","R12.","R29.3","J06.9","J20.9","Z11.52","M47.817","R07.9","N64.4","R10.31","R10.2"],"date":["2021-12-01","2021-12-01","2021-12-01","2022-03-22","2022-02-16","2021-05-17","2021-11-26","2021-05-17","2021-07-12","2021-07-12","2021-07-12","2021-07-12","2022-05-11","2022-05-11","2022-06-09","2022-05-11","2021-05-14","2021-05-26","2021-05-26","2021-05-26","2022-08-25","2022-06-09","2022-06-09","2022-09-16","2021-05-14","2021-05-14","2021-05-14","2021-11-26","2021-05-14","2021-11-26","2021-05-17","2022-08-25","2021-05-18","2022-09-16","2021-11-15","2021-05-14","2022-09-16","2022-09-16","2022-09-16","2021-04-26","2022-01-07","2022-01-03","2022-01-03","2022-05-11","2021-11-15","2021-11-15","2022-06-28","2022-06-28"],"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":[["","43598044674","NICOTINE","DIS 7MG\/24HR","14","Select","Select",""],["","00093505998","ATORVASTATIN","TAB 20MG","90","Select","Select",""],["","10702000709","CYCLOBENZAPR","TAB 10MG","90","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","500","Select","Select",""],["","70700015010","OMEPRAZOLE","CAP 20MG","30","Select","Select",""],["","43547040111","FUROSEMIDE","TAB 20MG","5","Select","Select",""],["","60432060616","PROMETH\/COD","SOL 6.25-10","120","Select","Select",""],["","68645055254","LISINOPRIL","TAB 10MG","90","Select","Select",""],["","68645051654","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","00173068224","VENTOLIN","AER ","8","Select","Select",""],["","80777027399","MODERNA","INJ COVID-19","0","Select","Select",""],["","43598065530","BUPROPN","TAB 150MG XL","30","Select","Select",""],["","00781261305","AMOXICILLIN","CAP 500MG","21","Select","Select",""],["","68645052154","SERTRALINE","TAB 25MG","30","Select","Select",""],["","00603533831","PREDNISONE","PAK 10MG","48","Select","Select",""],["","42806040021","METHYLPRED","TAB 4MG","21","Select","Select",""],["","67877021905","CEPHALEXIN","CAP 500MG","28","Select","Select",""],["","42858000101","OXYCODONE","TAB 5MG","8","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","00085113204","PROVENTIL","AER HFA","7","Select","Select",""],["","00069046956","CHANTIX","TAB 1MG","60","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","59676058015","JANSSEN","INJ COVID-19","0","Select","Select",""],["","16714008210","HYDROXYZ","TAB 25MG","90","Select","Select",""],["","00116200116","CHLORHEX","SOL 0.0012","473","Select","Select",""],["","43598075205","BUPROPION","TAB 150MG SR","60","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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}