{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BRUCE W REID","gend":0,"add":"450A WALNUT AVE","city":"ROANOKE","state":"VA","zip":"24014-9998","dob":"1958-07-23","age":"","mstatus":"","insh":"20033871*01","cliId":"","pno":5402789593,"cno":5402789593,"email":"","ename":"","eno":"","pphy":"KIDD, JOSEPH H DO","ppno":5404279200,"pcpadd":"2145 MT PLEASANT BLVD","pcpcity":"ROANOKE","pcpstate":"VA","pcpzip":"24014-9998","pcpcounty":"","pcpid":"","pcpname":"Carilion Medical Center","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":5404273237,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z01.812","R06.89","J44.9","D72.829","J45.909","J18.9","Z09.","F33.3","F33.0","F43.29","F43.10","F33.41","J45.30","F17.210","J44.1","I50.22","Z12.2","Z79.899","M79.89","I10.","J96.01","J44.0","J15.9","I11.0","I50.30","I25.10","D64.9","F41.9","NO DATA","M51.36","M50.30","R94.39","I25.119","M79.672","M16.0","Z87.891","R00.0","I51.7","R94.31","M79.81","J01.90","M25.551","M25.851","M25.552","R60.9","Z86.79","Z66.","G57.62","M77.42","M67.02","M54.32","M47.816","M47.22","R53.81","A41.9","Z20.822","R06.00","I25.118","F10.21","R06.09","R06.02","Z95.5","I51.89","R10.9","S30.1XXA","F17.200","I25.83","I50.42","R04.2","K59.00","M47.812"],"date":["2021-05-06","2022-07-28","2022-09-01","2022-08-08","2022-08-08","2022-08-08","2022-08-08","2021-01-06","2021-04-29","2021-04-29","2022-07-28","2021-04-29","2021-05-25","2023-02-09","2023-02-09","2022-09-15","2022-07-11","2022-07-11","2022-07-11","2022-07-11","2022-09-15","2022-09-15","2022-09-15","2022-09-15","2022-09-15","2022-09-15","2022-09-15","2022-09-15","2022-09-15","2022-09-15","2022-09-15","2021-05-12","2021-05-12","2021-06-01","2021-12-23","2021-12-23","2022-07-28","2022-07-28","2022-07-28","2022-08-01","2023-02-09","2021-11-09","2021-11-09","2021-11-09","2022-08-01","2022-08-01","2022-08-01","2021-06-01","2021-06-01","2021-06-01","2021-06-21","2021-06-21","2021-06-21","2021-06-21","2022-07-28","2022-07-28","2021-03-30","2021-03-30","2021-03-30","2021-05-11","2021-06-04","2022-07-28","2022-07-28","2022-08-01","2022-08-01","2021-01-12","2021-01-12","2022-07-28","2022-07-28","2022-07-28","2022-07-28"],"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":[["","00186037020","SYMBICORT","160-4.5MCG","10.2","Select","Select",""],["","00085113204","PROVENTIL","AER HFA","7","Select","Select",""],["","68382009205","CARVEDILOL","TAB 3.125MG","180","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","300","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","00173068220","VENTOLIN HFA","90 MCG","18","Select","Select",""],["","50111078710","AZITHROMYCIN","250 MG","6","Select","Select",""],["","50228018010","GABAPENTIN","300 MG","60","Select","Select",""],["","00093505798","ATORVASTATIN","TAB 80MG","30","Select","Select",""],["","00069047103","CHANTIX","PAK 0.5& 1MG","53","Select","Select",""],["","27241009903","DULOXETINE","CAP 60MG","60","Select","Select",""],["","68645059090","CLOPIDOGREL","75 MG","30","Select","Select",""],["","68180044801","QUETIAPINE","TAB 200MG","30","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","00597007541","SPIRIVA","CAP HANDIHLR","30","Select","Select",""],["","70010016305","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","80777027399","MODERNA VAC","INJ COVID-19","0","Select","Select",""],["","49035045875","ALLERGY REL","TAB 10MG","90","Select","Select",""],["","59746017509","PREDNISONE","20 MG","14","Select","Select",""],["","00143924920","AMOX\/K CLAV","TAB 875-125","10","Select","Select",""],["","68645055054","LISINOPRIL","2.5 MG","90","Select","Select",""],["","49884015576","VARENICLINE","TAB 0.5MG","56","Select","Select",""],["","57664050658","METOPROL TAR","TAB 25MG","30","Select","Select",""],["","16714039102","CEFDINIR","CAP 300MG","5","Select","Select",""],["","42806071401","BENZONATATE","CAP 100MG","30","Select","Select",""],["","43547040111","FUROSEMIDE","TAB 20MG","7","Select","Select",""],["","16714052601","IPRATROPIUM BROMIDE","21 MCG","30","Select","Select",""],["","57664050658","METOPROLOL TARTRATE","25 MG","60","Select","Select",""],["","16714079904","CETIRIZINE HCL","10 MG","30","Select","Select",""],["","00597007547","SPIRIVA HANDIHALER","18 MCG","90","Select","Select",""],["","27241009903","DULOXETINE HCL","60 MG","60","Select","Select",""],["","00093505798","ATORVASTATIN CALCIUM","80 MG","30","Select","Select",""],["","70010016305",""," ","30","Select","Select",""],["","00093598627","EPINEPHRINE","0.3MG\/0.3","2","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":""}]}]}