{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ALLEN BARLOW","gend":0,"add":"1358 CLARKE AVE APT D","city":"ROANOKE","state":"VA","zip":"24016-9998","dob":"1960-04-05","age":"","mstatus":"","insh":"20050167*01","cliId":"","pno":5408192887,"cno":5408192887,"email":"","ename":"","eno":"","pphy":"MITCHELL, WILLIAM CRAIG MD","ppno":5403443020,"pcpadd":"1315 2ND ST SW SUITE 202,","pcpcity":"ROANOKE","pcpstate":"VA","pcpzip":"24016-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":5403444394,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.1","F25.0","Z63.4","Z62.810","Z65.8","Z56.9","K42.9","F41.1","G47.9","I25.10","I10.","NO DATA","E11.9","K42.0","I25.811","E78.2","I25.2","E78.00","K21.9","Z86.73","F17.210","Z95.5","Z79.84","Z79.85","Z79.82","Z01.810"],"date":["2023-04-04","2021-03-18","2022-07-05","2022-07-05","2022-07-05","2022-07-05","2022-10-27","2023-04-04","2023-04-04","2022-10-27","2023-05-16","2023-05-16","2023-05-16","2022-10-27","2023-05-16","2021-10-28","2022-10-27","2022-10-27","2022-10-27","2022-10-27","2022-10-27","2022-10-27","2022-10-27","2022-10-27","2022-10-27","2022-10-27"],"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":[["","00310653004","BYDUREON PEN","INJ 2MG","4","Select","Select",""],["","13107003205","MIRTAZAPINE","45 MG","85","Select","Select",""],["","23155050201","HYDROXYZ HCL","TAB 50MG","60","Select","Select",""],["","60505265501","TRAZODONE","TAB 150MG","90","Select","Select",""],["","68180035302","SERTRALINE","TAB 100MG","90","Select","Select",""],["","00168009930","KETOCONAZOLE","CRE 0.02","30","Select","Select",""],["","68462016505","CARVEDILOL","25 MG","180","Select","Select",""],["","55111032101","GLIMEPIRIDE","2 MG","180","Select","Select",""],["","65862035705","CLOPIDOGREL","TAB 75MG","90","Select","Select",""],["","68382050010","OMEPRAZOLE","40 MG","90","Select","Select",""],["","68180072003","AMLODIPINE","TAB 5MG","90","Select","Select",""],["","00310654004","BYDUREON BC","INJ 2\/0.85ML","3","Select","Select",""],["","00169406013","VICTOZA","3-PAK 0.6 MG\/0.1","9","Select","Select",""],["","31722088530","ROSUVASTATIN","TAB 40MG","90","Select","Select",""],["","08290320550","BD PEN NEEDL","MIS 32GX4MM","100","Select","Select",""],["","68180051902","LISINOP\/HCTZ","TAB 20-12.5","90","Select","Select",""],["","00363041414","ASPIRIN","TAB 81MG EC","90","Select","Select",""],["","00904678370","ASPIRIN LOW","TAB 81MG EC","30","Select","Select",""],["","00781569031","EZETIMIBE","10 MG","90","Select","Select",""],["","69097052444","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","00168000215","TRIAMCINOLON","CRE 0.005","30","Select","Select",""],["","00406012305","HYDROCO\/APAP","TAB 5-325MG","25","Select","Select",""],["","65862042005","SMZ\/TMP DS","TAB 800-160","20","Select","Select",""],["","27808023302","DOXYCYCL HYC","CAP 100MG","60","Select","Select",""],["","00904678370","ASPIRIN EC","81 MG","90","Select","Select",""],["","68462026430","ROSUVASTATIN CALCIUM","40 MG","90","Select","Select",""],["","23155050201","HYDROXYZINE HCL","50 MG","180","Select","Select",""],["","68180051902","LISINOPRIL-HYDROCHLOROTHIAZIDE","20-12.5 MG","90","Select","Select",""],["","08290320550","NANO","2ND GEN PEN NEEDLE 32GX 5\/32\"","100","Select","Select",""],["","68180035302","SERTRALINE HCL","100 MG","90","Select","Select",""],["","60505265501","TRAZODONE HCL","150 MG","90","Select","Select",""],["","29300039710","AMLODIPINE BESYLATE","5 MG","90","Select","Select",""],["","69097052444","DICLOFENAC GEL","1%","100","Select","Select",""],["","00169406012","VICTOZA INJ","18MG\/3ML","9","Select","Select",""],["","68180035302","SERTRALINE TAB","100MG","90","Select","Select",""],["","23155050201","HYDROXYZ HCL TAB","50MG","60","Select","Select",""],["","60505265501","TRAZODONE TAB","150MG","90","Select","Select",""],["","55111032101","GLIMEPIRIDE TAB","2MG","44","Select","Select",""],["","00904678370","ASPIRIN LOW TAB","81MG EC","30","Select","Select",""],["","00781569031","EZETIMIBE TAB","10MG","90","Select","Select",""],["","68462016505","CARVEDILOL TAB","25MG","180","Select","Select",""],["","08290320550","BD PEN NEEDL MIS","32GX4MM","100","Select","Select",""],["","68382050010","OMEPRAZOLE CAP","40MG","90","Select","Select",""],["","65862035705","CLOPIDOGREL TAB","75MG","90","Select","Select",""],["","68180072003","AMLODIPINE TAB","5MG","90","Select","Select",""],["","31722088530","ROSUVASTATIN TAB","40MG","90","Select","Select",""],["","68180051902","LISINOP\/HCTZ TAB","20-12.5","90","Select","Select",""],["","13107003234","MIRTAZAPINE TAB","45MG","90","Select","Select",""],["","00168000215","TRIAMCINOLON CRE","0.5%","30","Select","Select",""],["","00093321930","KETOCONAZOLE CRE","2%","30","Select","Select",""],["","00363041414","ASPIRIN TAB","81MG EC","90","Select","Select",""],["","27808023302","DOXYCYCL HYC CAP","100MG","60","Select","Select",""],["","65862042005","SMZ\/TMP DS TAB","800-160","20","Select","Select",""],["","43386035610","HYDROCO\/APAP TAB","5-325MG","25","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":""}]}]}