{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KIMBERLY MAHMOUD","gend":1,"add":"405 MEADOWVIEW DR","city":"PULASKI","state":"VA","zip":"24301-9998","dob":"1978-12-16","age":"","mstatus":"","insh":"1539023*01","cliId":"","pno":5403150000,"cno":5403150000,"email":"","ename":"","eno":"","pphy":"CARD, RICHARD D DO","ppno":5405095443,"pcpadd":"141 E MAIN ST STE 420,","pcpcity":"PULASKI","pcpstate":"VA","pcpzip":"24301-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":5404408924,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F41.1","R06.2","R05.","R10.84","R13.19","Z86.010","M79.7","M54.12","G62.9","M79.671","G89.4","E11.42","G57.12","Z72.0","Z79.899","G47.30","M72.2","M77.31","S86.912A","M23.92","N92.1","Z12.4","N89.8","H65.03","J01.10","H11.422","M25.561","F34.81","E66.01","M79.89","R60.0","M79.672","K76.0","R19.09","M25.562","Z87.42","M79.604","M79.605","Z12.39","G47.33","J45.20","D72.828","E78.2","H10.45","G47.10","K29.50","K21.9","K44.9","K57.30","K64.1","K62.89","J45.909","F17.200","Z68.42","Z20.822","R13.10","K29.70","R68.84","K04.7","R20.2","R20.0","R09.81","J06.9","M23.301","M23.304","M17.12","M25.552","F15.20","R74.01","R10.9","K46.9","U07.1","Z23.","J02.9","J01.81","M25.512","M77.41","I70.213","Z87.891","S83.512A","R05.9","M51.36","M54.16","NO DATA","M62.81","M54.5","J44.9","J40.","M62.830","M54.6","R53.81","M54.42","M54.41","K64.8","K13.79","Z98.890","F31.81","R22.43","M22.42","M54.9","F17.210","R09.82","R06.02","R51.9","E66.09","H93.8X3","D72.829","M51.16","R00.2","I34.0","Z90.49","Z12.11","R05.1","H66.90","G56.03","M79.642","M79.641","R52.","J30.2","J10.1","R07.9","R50.9","R00.0","J02.0","R07.89","R11.0","M79.602"],"date":["2022-01-24","2023-08-28","2021-08-03","2021-09-01","2021-09-01","2021-09-01","2022-09-20","2021-12-13","2023-05-16","2022-06-27","2023-05-16","2023-05-16","2021-12-02","2022-08-19","2022-03-31","2023-01-16","2022-05-23","2022-06-27","2022-05-23","2022-10-28","2022-12-13","2022-08-19","2022-08-19","2023-01-03","2023-01-03","2023-01-03","2021-04-22","2021-01-14","2023-01-16","2022-06-03","2022-03-21","2021-08-31","2021-11-02","2021-11-02","2022-10-27","2022-07-11","2022-09-08","2022-09-08","2023-01-16","2023-03-23","2023-01-16","2023-01-16","2023-01-16","2023-01-26","2021-09-01","2021-10-01","2021-10-01","2021-10-01","2021-10-01","2021-10-01","2021-10-01","2021-10-01","2023-09-01","2021-10-01","2023-08-28","2021-10-01","2021-10-01","2021-11-01","2022-04-07","2021-12-13","2021-12-13","2022-11-17","2022-03-07","2022-10-28","2022-10-28","2023-02-01","2022-10-05","2021-07-15","2021-08-23","2021-10-08","2021-10-08","2021-10-25","2021-10-25","2022-01-27","2022-02-08","2022-02-24","2022-05-02","2022-09-02","2022-09-02","2022-09-29","2022-11-17","2023-02-08","2023-02-08","2023-02-08","2021-02-02","2021-02-02","2021-07-16","2021-07-16","2021-07-16","2021-12-30","2022-04-07","2022-10-27","2022-10-27","2021-10-01","2021-10-04","2021-10-04","2021-10-18","2022-06-03","2022-06-07","2022-10-31","2023-03-10","2021-03-26","2021-08-03","2023-09-01","2021-10-21","2022-10-24","2022-12-30","2023-03-10","2021-06-23","2021-07-02","2021-08-03","2021-08-03","2023-08-28","2023-04-25","2023-09-22","2023-06-02","2023-06-02","2023-08-22","2023-08-22","2023-08-22","2023-09-01","2023-08-28","2023-08-28","2023-08-28","2023-09-01","2023-09-01","2023-09-01"],"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":[["","00310654004","BYDUREON BC","INJ 2\/0.85ML","3","Select","Select",""],["","00536355601","VITAMIN B-12","TAB 1000MCG","30","Select","Select",""],["","00310653004","BYDUREON PEN","INJ 2MG","4","Select","Select",""],["","50228014605","HYDROCHLOROT","CAP 12.5MG","30","Select","Select",""],["","00228202996","ALPRAZOLAM","0.5 MG","112","Select","Select",""],["","37205024678","VITAMIN D-3","TAB 5000UNIT","90","Select","Select",""],["","16714073301","CELECOXIB","200 MG","60","Select","Select",""],["","00406012505","HYDROCO\/APAP","TAB 10-325MG","84","Select","Select",""],["","59746000106","METHYLPRED","TAB 4MG","21","Select","Select",""],["","16714089803","LORATADINE","10 MG","60","Select","Select",""],["","16714012303","OMEPRAZOLE","40 MG","30","Select","Select",""],["","65162046650","IBUPROFEN","TAB 800MG","90","Select","Select",""],["","55111068405","IBU","TAB 800MG","90","Select","Select",""],["","16714081303","EZETIMIBE","10 MG","30","Select","Select",""],["","00536109203","ALLERGY","TAB 10MG","30","Select","Select",""],["","16729011917","MONTELUKAST","TAB 10MG","60","Select","Select",""],["","16714066302","GABAPENTIN","400 MG","84","Select","Select",""],["","59762219803","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","69238149001","BUMETANIDE","1 MG","60","Select","Select",""],["","00185005501","METOLAZONE","TAB 5MG","30","Select","Select",""],["","43547040211","FUROSEMIDE","TAB 40MG","30","Select","Select",""],["","52817033200","CYCLOBENZAPR","TAB 10MG","7","Select","Select",""],["","00591544210","PREDNISONE","10 MG","20","Select","Select",""],["","00487020160","IPRATROPIUM\/","SOL ALBUTER","1080","Select","Select",""],["","65862052205","NAPROXEN","TAB 500MG","20","Select","Select",""],["","63304061650","DOXYCYC MONO","CAP 100MG","20","Select","Select",""],["","08222095633","PEN NEEDLES","MIS 31GX6MM","100","Select","Select",""],["","00169413212","OZEMPIC","INJ 2\/1.5ML","2","Select","Select",""],["","0","COMPOUND"," ","210","Select","Select",""],["","00193731150","CONTOUR","TES NEXT","50","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","08222142400","ULTICARE PEN","MIS 31GX6MM","100","Select","Select",""],["","00116200116","CHLORHEX GLU","SOL 0.0012","473","Select","Select",""],["","00143928501","AMOXICILLIN","875 MG","20","Select","Select",""],["","00054350049","LIDOCAINE","SOL 2% VISC","210","Select","Select",""],["","00172572860","FAMOTIDINE","TAB 20MG","30","Select","Select",""],["","86227030105","SURE COMFORT","MIS LANCETS","100","Select","Select",""],["","00169406012","VICTOZA","INJ 18MG\/3ML","6","Select","Select",""],["","16714007106","BACLOFEN","10 MG","60","Select","Select",""],["","16714069301","FLUCONAZOLE","200 MG","4","Select","Select",""],["","68382005001","MELOXICAM","TAB 7.5MG","10","Select","Select",""],["","00781717612","NALOXONE","SPR 4MG","2","Select","Select",""],["","54629794101","VITAMIN D3","TAB 5000UNIT","30","Select","Select",""],["","16714025901","AMITRIPTYLIN","TAB 50MG","30","Select","Select",""],["","57664037718","TRAMADOL HCL","TAB 50MG","30","Select","Select",""],["","00527143501","METAXALONE","TAB 800MG","103","Select","Select",""],["","16714098901","ROSUVASTATIN CALCIUM","10 MG","30","Select","Select",""],["","31722072610","MONTELUKAST SODIUM","10 MG","60","Select","Select",""],["","57896087005","LACTOBACILLUS","1MM CELL","28","Select","Select",""],["","00406012505","HYDROCODONE-ACETAMINOPHEN","10MG-325MG","21","Select","Select",""],["","60505082901","FLUTICASONE PROPIONATE","50 MCG","16","Select","Select",""],["","65862050220","AMOXICILLIN-CLAVULANATE POTASS","500-125 MG","21","Select","Select",""],["","00121093316","BROMPHENIRAMINE-PSEUDOEPHED-DM","2-30-10\/5","172","Select","Select",""],["","16714073301","CELECOXIB CAP","200MG","60","Select","Select",""],["","31722072610","MONTELUKAST TAB","10MG","60","Select","Select",""],["","00172572860","FAMOTIDINE TAB","20MG","30","Select","Select",""],["","00228202996","ALPRAZOLAM TAB","0.5MG","112","Select","Select",""],["","00406012505","HYDROCO\/APAP TAB","10-325MG","84","Select","Select",""],["","08222142400","ULTICARE PEN MIS","31GX6MM","100","Select","Select",""],["","00169406012","VICTOZA INJ","18MG\/3ML","6","Select","Select",""],["","16714007106","BACLOFEN TAB","10MG","60","Select","Select",""],["","16714012303","OMEPRAZOLE CAP","40MG","30","Select","Select",""],["","68382052601","BUMETANIDE TAB","1MG","60","Select","Select",""],["","67877049005","EZETIMIBE TAB","10MG","30","Select","Select",""],["","43547040211","FUROSEMIDE TAB","40MG","30","Select","Select",""],["","00054327099","FLUTICASONE SPR","50MCG","16","Select","Select",""],["","08222095633","PEN NEEDLES MIS","31GX6MM","100","Select","Select",""],["","59762219803","AZITHROMYCIN TAB","250MG","6","Select","Select",""],["","16714066302","GABAPENTIN CAP","400MG","84","Select","Select",""],["","45802065065","LORATADINE TAB","10MG","60","Select","Select",""],["","16714029904","AMOXICILLIN CAP","500MG","30","Select","Select",""],["","16714069211","FLUCONAZOLE TAB","150MG","1","Select","Select",""],["","68382005001","MELOXICAM TAB","7.5MG","10","Select","Select",""],["","00169413212","OZEMPIC INJ","2\/1.5ML","2","Select","Select",""],["","54629794101","VITAMIN D","3 TAB 5000UNIT","30","Select","Select",""],["","16714025802","AMITRIPTYLIN TAB","25MG","30","Select","Select",""],["","52817033200","CYCLOBENZAPR TAB","10MG","7","Select","Select",""],["","59746017506","PREDNISONE TAB","20MG","13","Select","Select",""],["","57664037718","TRAMADOL HCL TAB","50MG","30","Select","Select",""],["","00781717612","NALOXONE SPR","4MG","2","Select","Select",""],["","00527143501","METAXALONE TAB","800MG","103","Select","Select",""],["","00487020160","IPRATROPIUM\/ SOL ALBUTER","","360","Select","Select",""],["","31722063231","OSELTAMIVIR PHOSPHATE","75 MG","10","Select","Select",""],["","52817033200","CYCLOBENZAPRINE HCL","10 MG","9","Select","Select",""],["","68180096301","ALBUTEROL SULFATE HFA","90 MCG","8.5","Select","Select",""],["","70677014503","ALL DAY ALLERGY RELIEF","10 MG","60","Select","Select",""],["","00006505506","LAGEVRIO (EUA)","200 MG","40","Select","Select",""],["","00487020160","IPRATROPIUM-ALBUTEROL","0.5-3MG\/3","180","Select","Select",""],["","00121086816","NYSTATIN","100000\/ML","340","Select","Select",""],["","70010019905","GUAIFENESIN ER","600 MG","20","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":""}]}]}