{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LENAE KING","gend":1,"add":"2049 TWIN LAKES DR","city":"BEDFORD","state":"VA","zip":"24523-9998","dob":"1991-04-09","age":"","mstatus":"","insh":"1716396*01","cliId":"","pno":5403094587,"cno":5403094587,"email":"","ename":"","eno":"","pphy":"CHEWNING, MARK W MD","ppno":5409828881,"pcpadd":"21 HIGHLAND AVE SE SUITE 200,","pcpcity":"ROANOKE","pcpstate":"VA","pcpzip":"24013-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":5409820612,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["O99.891","M79.675","Z3A.30","Z88.5","F41.1","F32.9","K76.0","M54.41","J45.20","L30.9","G89.29","J45.41","Z20.822","R00.0","Z53.29","Z87.891","R06.02","R05.9","F41.9","R39.9","N12.","F33.2","O36.63X0","Z37.0","NO DATA","M89.9","M62.838","M62.81","R10.2","R07.89","U07.1","J20.9","Z84.89","O36.0930","Z23.","Z3A.27","O23.03","O26.613","O99.513","J45.909","O99.343","F31.9","Z3A.31","Z88.2","O36.8130","Z3A.38","O99.344","Z3A.39","O99.52","O32.0XX0","O66.0","O70.0","R35.0","R10.9","R94.31","M51.16","M51.26","R07.9","R06.9","R06.89","Z15.89","O99.519","O26.891","J06.9","Z3A.00","R50.9","O36.60X0","F33.41","M54.2","J02.9","J45.990","Z86.16","B34.9","M54.16","Z01.419","N94.9","R09.81","R09.89","F90.9","J45.21","R05.1","H54.3","Z3A.35","R10.32","Z32.01","O20.0","R10.13","N81.84","N94.10","M54.40","R39.15","R15.9","M51.36","F98.8","F43.12","V23.87","Z3A.01","O99.611","O99.281","R11.0","E86.0","K52.9","Z86.59","Z3A.14","O21.9"],"date":["2021-07-17","2021-07-17","2021-07-17","2021-07-17","2023-03-14","2023-03-14","2022-09-15","2022-06-06","2023-02-27","2022-06-06","2022-06-06","2022-08-25","2023-09-13","2022-08-25","2022-08-25","2022-08-25","2022-08-29","2023-01-30","2023-01-25","2021-07-19","2021-08-04","2023-02-27","2021-09-23","2021-09-23","2023-06-06","2021-12-06","2021-12-06","2022-08-19","2022-08-19","2022-08-25","2022-08-29","2022-10-18","2023-02-13","2021-08-03","2021-07-06","2021-07-06","2021-08-03","2021-08-03","2021-08-03","2022-08-29","2021-08-03","2022-08-29","2021-08-03","2021-08-03","2021-09-21","2021-09-21","2021-09-22","2021-09-23","2021-09-22","2021-09-22","2021-09-22","2021-09-22","2022-07-29","2022-07-29","2022-08-25","2022-04-04","2023-06-08","2022-08-29","2022-08-25","2022-08-25","2023-03-09","2021-01-02","2021-01-02","2021-01-02","2021-01-02","2022-11-21","2021-09-23","2021-11-03","2022-07-06","2022-11-21","2023-01-30","2023-01-30","2021-01-02","2023-06-06","2022-04-04","2022-04-04","2023-01-13","2022-08-29","2022-08-29","2022-09-15","2023-01-13","2023-03-13","2021-08-26","2021-01-14","2021-01-14","2023-07-17","2021-06-30","2022-08-19","2022-08-19","2022-08-19","2022-08-19","2022-08-19","2022-08-19","2023-05-31","2023-06-16","2023-08-01","2023-08-01","2023-09-13","2023-09-13","2023-09-13","2023-09-13","2023-09-13","2023-09-13","2023-09-13","2023-09-13"],"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":[["","68462030529","NORETHINDRON","TAB 0.35MG","28","Select","Select",""],["","45802071708","TERCONAZOLE","SUP 80MG","3","Select","Select",""],["","68682045570","METRONIDAZOL","GEL 0.75%VAG","70","Select","Select",""],["","70710113908","FLUCONAZOLE","TAB 150MG","30","Select","Select",""],["","50111064801","FLUOXETINE","CAP 20MG","30","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","15","Select","Select",""],["","68180012202","CEPHALEXIN","500 MG","15","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","10","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","00093342210","CYCLOBENZAPR","TAB 10MG","30","Select","Select",""],["","69097014260","ALBUTEROL","AER HFA","20","Select","Select",""],["","00168029330","CLOBETASOL","GEL 0.0005","30","Select","Select",""],["","71205026260","FLUTIC\/SALME","AER 250\/50","60","Select","Select",""],["","00173069600","ADVAIR DISKU","AER 250\/50","60","Select","Select",""],["","00054001825","PREDNISONE","20 MG","10","Select","Select",""],["","42806071505","BENZONATATE","200 MG","30","Select","Select",""],["","00186037020","SYMBICORT","160-4.5MCG","10.2","Select","Select",""],["","59651000305","OMEPRAZOLE","CAP 40MG","30","Select","Select",""],["","00310737020","BUDES\/FORMOT","AER 160-4.5","10","Select","Select",""],["","00093415573","AMOXICILLIN","SUS 250\/5ML","240","Select","Select",""],["","68180016011","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","00173086910","ANORO ELLIPTA","62.5-25MCG","60","Select","Select",""],["","24208031510","POLYMYXIN B SUL-TRIMETHOPRIM","10000-1\/ML","10","Select","Select",""],["","68180059206","DESVENLAFAXINE SUCCINATE ER","50 MG","90","Select","Select",""],["","78206012601","DULERA","200-5 MCG","13","Select","Select",""],["","00310737020","BUDESONIDE-FORMOTEROL FUMARATE","160-4.5MCG","10.2","Select","Select",""],["","65862050320","AMOXICILLIN-CLAVULANATE POTASS","875-125 MG","20","Select","Select",""],["","00228306311","DEXTROAMPHETAMINE-AMPHET ER","15 MG","14","Select","Select",""],["","54092038501","ADDERALL XR","15 MG","14","Select","Select",""],["","69097014260","ALBUTEROL AER HFA","","20","Select","Select",""],["","00168029330","CLOBETASOL GEL","0.05%","30","Select","Select",""],["","68180012202","CEPHALEXIN CAP","500MG","10","Select","Select",""],["","71205026260","FLUTIC\/SALME AER","250\/50","60","Select","Select",""],["","59651000305","OMEPRAZOLE CAP","40MG","30","Select","Select",""],["","64380071307","BENZONATATE CAP","200MG","30","Select","Select",""],["","00186037020","SYMBICORT AER","160-4.5","10","Select","Select",""],["","00310737020","BUDES\/FORMOT AER","160-4.5","10","Select","Select",""],["","00173069600","ADVAIR DISKU AER","250\/50","60","Select","Select",""],["","00378064110","PREDNISONE TAB","10MG","24","Select","Select",""],["","00093415573","AMOXICILLIN SUS","250\/5ML","300","Select","Select",""],["","00781261305","AMOXICILLIN CAP","500MG","21","Select","Select",""],["","68180016011","AZITHROMYCIN TAB","250MG","6","Select","Select",""],["","00093342210","CYCLOBENZAPRINE HCL","10 MG","30","Select","Select",""],["","16571020210","DICLOFENAC SODIUM","50 MG","60","Select","Select",""],["","58980060530","UREA","10 %","85","Select","Select",""],["","00093321992","KETOCONAZOLE","2 %","60","Select","Select",""],["","65862039010","ONDANSETRON ODT","4 MG","10","Select","Select",""],["","65862085901","FAMOTIDINE","20 MG","180","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":""}]}]}