{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"PHILLIP   E REYNOLDS","gend":0,"add":"3348 HERSHBERGER RD APT 7","city":"ROANOKE","state":"VA","zip":"24017-9998","dob":"1985-12-30","age":"","mstatus":"","insh":"20056688*01","cliId":"","pno":"540\/960-3395","cno":"","email":"","ename":"","eno":"","pphy":"GREGORY, DAVID S MD","ppno":"540\/562-5700","pcpadd":"1314 PETERS CREEK RD","pcpcity":"ROANOKE","pcpstate":"VA","pcpzip":24017,"pcpcounty":"","pcpid":"","pcpname":"Carilion Clinic Family Medicine Southeast","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"540\/562-4278","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M79.605","F32.9","V62.84","G89.29","R51.","Z86.718","F19.20","F43.25","F84.0","F60.2","I26.99","D68.51","Z71.89","Z79.01","Z71.3","S22.32XA","R07.9","F22.","R45.1","Z20.822","R00.0","I44.4","R94.31","J45.909","R07.81","F17.210","R06.02","R00.2","H53.8","NO DATA","R05.","M79.89","Z87.09","F33.8","F20.9","F99.","R45.4","Z04.89","F33.0","J45.30","D68.59","R60.9","F29.","F11.20","Z86.711","Z51.81","R09.1","F12.99","K04.7","R53.83","E16.2","Z68.26","Z79.899","I82.409","R49.1","Z68.25","X58.XXXA","D53.0","R07.89","E55.9","F20.89","Y04.0XXA","R11.2","R46.89","V62.85","F31.9","D68.318","F11.10","Z76.5","Z65.8","Z11.59","S09.90XA","S01.01XA","M25.522","V72.85","R51.9","W18.39XA","T14.90XA","F39.","F23."],"date":["2021-02-23","2019-07-05","2019-07-05","2019-09-10","2019-07-05","2022-05-27","2019-07-05","2019-07-08","2021-03-26","2019-08-20","2020-01-02","2021-02-24","2020-08-05","2022-05-27","2020-08-05","2021-01-29","2021-03-26","2022-03-24","2021-02-22","2022-06-20","2022-05-27","2021-02-24","2021-03-21","2022-06-19","2021-03-21","2022-05-27","2021-03-26","2021-03-21","2021-03-21","2022-05-31","2021-03-21","2021-07-09","2021-07-09","2021-11-15","2022-05-31","2022-06-20","2021-09-01","2021-09-02","2020-04-19","2021-07-19","2022-03-24","2021-03-26","2022-06-20","2019-07-05","2020-03-30","2020-10-07","2020-11-17","2021-04-26","2019-05-21","2019-07-11","2019-05-21","2019-07-11","2022-03-24","2021-07-19","2019-11-27","2019-11-27","2021-01-29","2021-02-24","2021-03-26","2019-09-10","2020-08-07","2020-11-19","2019-04-24","2019-04-24","2019-04-24","2019-07-06","2019-08-24","2019-08-24","2019-08-24","2022-02-09","2020-11-15","2022-06-20","2022-06-19","2022-06-19","2022-06-19","2022-06-19","2022-06-19","2022-06-19","2022-03-24","2022-05-27"],"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":[["","","SYMBICORT"," SYMBICORT ","10","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","","BUDES\/FORMOT","AER 160-4.5","","Select","Select",""],["","00003089421","ELIQUIS","TAB 5MG","60","Select","Select",""],["","","MELATONIN","CAP 5MG","","Select","Select",""],["","","ALBUTEROL"," ALBUTEROL ","18","Select","Select",""],["","45802020625","NICOTINE","GUM 2MG MINT","190","Select","Select",""],["","43598016630","OLANZAPINE","TAB 10MG","60","Select","Select",""],["","50458030006","RISPERDAL","TAB 1MG","30","Select","Select",""],["","00378064205","PREDNISONE","TAB 20MG","6","Select","Select",""],["","51672403101","WARFARIN","TAB 4MG","30","Select","Select",""],["","69315090501","LORAZEPAM","TAB 1MG","14","Select","Select",""],["","65162068090","PROMETHAZINE","SOL DM","100","Select","Select",""],["","00781223410","OMEPRAZOLE","CAP 40MG","7","Select","Select",""],["","","PROVENTIL","AER HFA","","Select","Select",""],["","43547034106","RISPERIDONE","TAB 1MG","30","Select","Select",""],["","27241005303","ARIPIPRAZOLE","TAB 10MG","14","Select","Select",""],["","","STOOL","CAP 100MG","","Select","Select",""],["","","HALOPERIDOL","TAB 2MG","","Select","Select",""],["","","QUETIAPINE","TAB 100MG","","Select","Select",""],["","","BENZTROPINE","TAB 0.5MG","","Select","Select",""],["","","DOK","CAP 100MG","","Select","Select",""],["","","MILK","SUS 1200\/15","","Select","Select",""],["","","MINTOX","SUS ","","Select","Select",""],["","","HYDROXYZ","CAP 50MG","","Select","Select",""],["","","ACETAMIN","TAB 500MG","","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","12","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":""}]}]}