{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"RANDI  N WALTON","gend":1,"add":"125 SOPHIA LN SE APT H82","city":"CHRISTIANSBURG","state":"VA","zip":"24073-9998","dob":"1988-05-05","age":"","mstatus":"","insh":"1959461*01","cliId":"","pno":5402395293,"cno":5402395293,"email":"","ename":"","eno":"","pphy":"HEMPHILL, JULIA MD","ppno":5402681400,"pcpadd":"6920 ROANOKE RD","pcpcity":"SHAWSVILLE","pcpstate":"VA","pcpzip":"24162-9998","pcpcounty":"","pcpid":"","pcpname":"Carilion Healthcare Corp","plan":"OHP","program":"MEDICAID","lob":"M4","region":"ROANOKE ALLEGHANY","aligned":"","ano":"5408181937, 5403208765","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":5402681300,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F11.20","J45.40","F17.210","G47.33","K29.90","NO DATA","Z83.49","B19.20","R06.81","F41.9","Z12.4","F32.9","M46.1","N30.01","R11.0","R05.9","Z79.899","R10.31","J44.9","K21.9","R25.2","Z72.0","Z23.","E66.9","G89.29","N39.0","E87.6","R11.2","R50.9","R10.9","Z20.822","R10.13","K31.9","K29.80","K44.9","K22.10","K29.70","K58.1","M41.9","Z86.19","Z90.49","I95.9","G47.10","Z68.30","F31.9","Z01.818","F41.8","T78.1XXA","R94.31","K59.00","R10.84","E73.9","D72.829","Z87.442","Z87.19","S61.411A","M79.671","M72.2","R68.84","R19.7","S99.921A","M19.071","S90.934A","M79.674","R11.14","R10.11","R13.10","K59.09","K83.8","F29.","R06.9","R18.8","R11.10"],"date":["2023-04-26","2023-02-08","2023-02-08","2023-02-08","2023-02-08","2023-02-21","2021-08-23","2022-09-07","2021-10-05","2023-02-21","2021-08-23","2021-10-05","2022-07-15","2022-07-15","2023-02-11","2022-07-15","2023-02-11","2022-07-15","2023-02-10","2023-02-08","2023-02-21","2022-11-02","2023-02-10","2022-11-02","2022-11-02","2022-11-15","2022-11-15","2023-02-11","2022-11-15","2022-11-15","2022-11-15","2023-02-23","2023-02-08","2023-02-08","2023-02-08","2023-02-21","2023-02-08","2023-02-08","2023-02-08","2023-02-08","2023-02-08","2023-02-10","2021-10-05","2021-10-05","2023-02-21","2021-09-15","2021-10-05","2022-01-23","2022-01-23","2023-02-21","2023-02-11","2022-01-23","2022-11-15","2022-11-15","2023-02-11","2021-01-19","2022-04-10","2021-11-09","2022-02-28","2022-01-28","2022-04-10","2022-04-10","2022-04-10","2022-04-10","2023-02-23","2023-02-23","2023-02-06","2023-02-06","2023-02-23","2023-02-11","2023-02-11","2023-02-11","2023-02-11"],"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":[["","00054074287","ALBUTEROL","AER HFA","7","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","59267100001","PFIZER VACC","INJ COVID-19","0","Select","Select",""],["","00536589588","NICOTINE TD","DIS 14MG\/24H","14","Select","Select",""],["","31722001710","FAMOTIDINE","TAB 20MG","60","Select","Select",""],["","00597007541","SPIRIVA","CAP HANDIHLR","30","Select","Select",""],["","13668013710","ESCITALOPRAM","TAB 20MG","90","Select","Select",""],["","68382050010","OMEPRAZOLE","40 MG","60","Select","Select",""],["","57237007530","ONDANSETRON","TAB 4MG","20","Select","Select",""],["","60219170705","PREDNISONE","TAB 10MG","21","Select","Select",""],["","16571020150","DICLOFENAC","TAB 75MG DR","60","Select","Select",""],["","00781185220","AMOX\/K CLAV","TAB 875-125","10","Select","Select",""],["","42806008405","BUSPIRONE","TAB 10MG","90","Select","Select",""],["","00173086910","ANORO ELLIPT","AER 62.5-25","60","Select","Select",""],["","52817033010","CYCLOBENZAPR","TAB 5MG","30","Select","Select",""],["","29300035505","TRAMADOL HCL","TAB 50MG","5","Select","Select",""],["","67877032005","IBUPROFEN","TAB 600MG","15","Select","Select",""],["","67877021905","CEPHALEXIN","CAP 500MG","20","Select","Select",""],["","00169413212","OZEMPIC","INJ 2\/1.5ML","2","Select","Select",""],["","66993058597","FLUTIC\/SALME","AER 250\/50","120","Select","Select",""],["","00173069600","ADVAIR DISKU","AER 250\/50","120","Select","Select",""],["","00002143480","TRULICITY","1.5 MG\/0.5","2","Select","Select",""],["","61442010310","DICLOFENAC SODIUM","75 MG","60","Select","Select",""],["","43547028211","ESCITALOPRAM OXALATE","20 MG","30","Select","Select",""],["","29033000305","SUCRALFATE","1 G","60","Select","Select",""],["","29300024505","BUSPIRONE HCL","10 MG","90","Select","Select",""],["","65862018730","ONDANSETRON HCL","4 MG","20","Select","Select",""],["","68180096301","ALBUTEROL SULFATE HFA","90 MCG","8.5","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":""}]}]}