{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SERENITY J WILLIAMS","gend":1,"add":"611 HENSON AVE","city":"PEARISBURG","state":"VA","zip":"24134-9998","dob":"1999-05-29","age":"","mstatus":"","insh":"1541152*01","cliId":"","pno":5402357138,"cno":5402357138,"email":"","ename":"","eno":"","pphy":"GRUBE, RICHARD D MD","ppno":5409216110,"pcpadd":"430 BOXWOOD LN,","pcpcity":"PEARISBURG","pcpstate":"VA","pcpzip":"24134-9998","pcpcounty":"","pcpid":"","pcpname":"Carilion Giles Community Hospital","plan":"OHP","program":"MEDICAID","lob":"M4","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":5409213796,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G43.709","F41.8","S49.92XA","I49.3","I49.1","R00.2","F31.9","Z01.419","Z20.822","J01.00","R09.81","J02.9","J32.9","J10.1","R50.9","Z87.891","Z30.2","Z20.828","J01.90","M62.81","R27.9","M62.89","N39.3","R39.198","Z39.2","R20.0","J06.9","D64.9","NO DATA","M25.562","O99.345","G89.29","O99.893","Z01.812","M22.2X2","R11.2","G43.109","A08.4","S66.912A","R00.0","G47.00","F51.4","R07.2","K21.9","N92.0","N94.6","J45.909","M25.561","R07.89","B96.89","R42.","M25.512","Z09.","U07.1","J30.2","R06.02","F33.2"],"date":["2023-03-10","2023-01-13","2021-05-04","2022-04-17","2022-04-17","2022-03-31","2022-06-22","2022-07-12","2022-12-10","2023-01-13","2022-12-10","2023-02-16","2021-09-20","2022-12-10","2022-12-10","2022-12-10","2021-02-17","2022-08-05","2022-12-02","2021-02-11","2021-02-11","2021-02-11","2021-02-11","2021-02-11","2021-02-11","2021-02-11","2022-11-29","2023-01-13","2023-01-13","2023-02-07","2023-01-13","2023-02-07","2021-02-09","2021-02-12","2021-04-28","2021-05-13","2021-06-09","2021-07-22","2022-08-22","2022-09-01","2022-10-17","2021-06-02","2022-09-01","2022-09-01","2022-11-14","2022-11-14","2023-04-20","2021-04-20","2021-06-25","2021-09-10","2022-03-31","2021-05-10","2021-05-10","2021-06-29","2021-10-04","2023-04-20","2023-05-18"],"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":[["","17478007035","ERYTHROMYCIN","OIN 5MG\/GM","4","Select","Select",""],["","45802005935","NYSTATIN","CRE 100000","15","Select","Select",""],["","49035019502","EQ NICOTINE","DIS 14MG\/24H","14","Select","Select",""],["","00093005405","BUSPIRONE","TAB 10MG","90","Select","Select",""],["","42858000101","OXYCODONE","TAB 5MG","5","Select","Select",""],["","67877032101","IBUPROFEN","TAB 800MG","90","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8","Select","Select",""],["","16571020210","DICLOFENAC","TAB 50MG DR","60","Select","Select",""],["","65862017260","TOPIRAMATE","TAB 50MG","90","Select","Select",""],["","55111015330","ONDANSETRON","TAB 4MG","12","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","00093406701","PRAZOSIN HCL","CAP 1MG","60","Select","Select",""],["","00143988701","AMOXICILLIN","SUS 400\/5ML","100","Select","Select",""],["","00143924920","AMOX\/K CLAV","TAB 875-125","20","Select","Select",""],["","49035061246","ALLERGY RELF","TAB 10MG","30","Select","Select",""],["","45802065078","LORATADINE","TAB 10MG","30","Select","Select",""],["","42571012290","LEVOCETIRIZI","TAB 5MG","90","Select","Select",""],["","29300022019","MONTELUKAST","TAB 10MG","90","Select","Select",""],["","17478071310","OFLOXACIN","DRO 0.3% OP","5","Select","Select",""],["","10939054844","SM IRON","TAB 45MG","30","Select","Select",""],["","96295013568","IRON SLOW","TAB 45MG","60","Select","Select",""],["","37205056965","IRON","TAB 45MG","30","Select","Select",""],["","60258019701","PRENATAL 19","CHW TAB","90","Select","Select",""],["","46122008365","GNP IRON","TAB 45MG","30","Select","Select",""],["","00121075908","PREDNISOLONE","SOL 15MG\/5ML","60","Select","Select",""],["","31722000290","VENLAFAXINE","CAP 37.5 ER","30","Select","Select",""],["","00603533815","PREDNISONE","10 MG","21","Select","Select",""],["","00603548221","PROPRANOLOL","TAB 10MG","60","Select","Select",""],["","65862014636","SUMATRIPTAN","TAB 25MG","9","Select","Select",""],["","82607066026","FLOWFLEX","KIT TEST","4","Select","Select",""],["","62332041510","OSELTAMIVIR","CAP 75MG","10","Select","Select",""],["","68180087673","NORETHINDRON","TAB 0.35MG","28","Select","Select",""],["","00074709430","QULIPTA","60 MG","30","Select","Select",""],["","29300022019","MONTELUKAST SODIUM","10 MG","90","Select","Select",""],["","00093005405","BUSPIRONE HCL","10 MG","90","Select","Select",""],["","16571020210","DICLOFENAC SODIUM","50 MG","180","Select","Select",""],["","60258019701","PRENATAL","19 29 MG-1 MG","90","Select","Select",""],["","00487980125","IPRATROPIUM BROMIDE","0.2 MG\/ML","62.5","Select","Select",""],["","00603548321","PROPRANOLOL HCL","20 MG","180","Select","Select",""],["","00054327099","FLUTICASONE PROPIONATE","50 MCG","16","Select","Select",""],["","65862017601","PENICILLIN V POTASSIUM","500 MG","20","Select","Select",""],["","00378827052","ALBUTEROL SULFATE","2.5 MG\/3ML","75","Select","Select",""],["","66993001968","ALBUTEROL SULFATE HFA","90 MCG","18","Select","Select",""],["","16571020210","DICLOFENAC TAB","50MG DR","60","Select","Select",""],["","00093406801","PRAZOSIN HCL CAP","2MG","30","Select","Select",""],["","96295013568","IRON SLOW TAB","45MG","30","Select","Select",""],["","65862017260","TOPIRAMATE TAB","50MG","90","Select","Select",""],["","68180096301","ALBUTEROL AER HFA","","8","Select","Select",""],["","59310057922","PROAIR HFA AER","","8","Select","Select",""],["","00093005405","BUSPIRONE TAB","10MG","90","Select","Select",""],["","29300022019","MONTELUKAST TAB","10MG","30","Select","Select",""],["","10939054844","SM IRON TAB","45MG","30","Select","Select",""],["","42571012290","LEVOCETIRIZI TAB","5MG","30","Select","Select",""],["","46122008365","GNP IRON TAB","45MG","30","Select","Select",""],["","00054327099","FLUTICASONE SPR","50MCG","16","Select","Select",""],["","37205056965","IRON TAB","45MG","30","Select","Select",""],["","00143988701","AMOXICILLIN SUS","400\/5ML","100","Select","Select",""],["","31722000290","VENLAFAXINE CAP","37.5 ER","30","Select","Select",""],["","00121075908","PREDNISOLONE SOL","15MG\/5ML","60","Select","Select",""],["","55111015330","ONDANSETRON TAB","4MG","12","Select","Select",""],["","59746017509","PREDNISONE TAB","20MG","4","Select","Select",""],["","65862014636","SUMATRIPTAN TAB","25MG","9","Select","Select",""],["","00603548221","PROPRANOLOL TAB","10MG","60","Select","Select",""],["","45802005935","NYSTATIN CRE","100000","15","Select","Select",""],["","00143924920","AMOX\/K CLAV TAB","875-125","20","Select","Select",""],["","68180087673","NORETHINDRON TAB","0.35MG","28","Select","Select",""],["","62332041510","OSELTAMIVIR CAP","75MG","10","Select","Select",""],["","82607066026","FLOWFLEX KIT TEST","","4","Select","Select",""],["","65162019011","NAPROXEN","500 MG","30","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":""}]}]}