{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"PATRICK S OBRIEN","gend":0,"add":"608 HARRISON AVE APT 323","city":"ROANOKE","state":"VA","zip":"24016-9998","dob":"1960-01-30","age":"","mstatus":"","insh":"20052775*01","cliId":"","pno":5714589024,"cno":5714589024,"email":"","ename":"","eno":"","pphy":"ISSA, MAYADA H MD","ppno":5402245170,"pcpadd":"3 RIVERSIDE CIR,","pcpcity":"ROANOKE","pcpstate":"VA","pcpzip":"24016-9998","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":5409838229,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F41.9","F39.","I10.","I42.6","R09.81","F32.9","T18.128A","T78.40XA","E87.6","F10.129","Z20.822","F10.231","F10.20","Z87.891","R61.","F10.94","F10.929","F33.1","F11.90","Z12.11","D12.0","K64.8","R09.02","V62.84","J06.9","M25.532","K52.9","M19.032","Z47.89","K57.30","F33.0","F29.","R30.0","R39.12","F42.9","Z72.0","Z12.2","Z12.5","Z87.898","Z23.","G25.81","Z86.79","E78.5","Z01.810","M11.232","M65.9","G56.22","M19.042","T18.108A","A39.9","R06.02","F10.10","R07.9","J34.89","R51.9","R05.1","R94.31","R40.1","R40.0","F41.1","R52.","Z11.52","K22.10","K26.9","I42.9","K80.20","K76.0","F17.200","Z79.899","R44.1","NO DATA","Z59.00","Z56.0","R68.83","F17.210","I25.10","I25.84","F17.290","K27.9","M25.632","Z98.890","R13.19","Z87.19","R91.8"],"date":["2023-06-12","2021-05-03","2023-08-31","2022-02-07","2022-04-04","2022-01-04","2021-05-15","2021-05-15","2021-12-31","2021-12-28","2021-11-24","2021-10-26","2022-02-26","2021-10-26","2021-10-26","2022-01-02","2022-01-02","2023-01-23","2021-11-22","2022-10-04","2022-10-04","2022-10-04","2021-12-31","2021-12-31","2021-12-31","2022-08-09","2022-07-05","2023-06-01","2023-06-01","2022-10-04","2021-10-26","2021-11-13","2022-03-14","2022-03-14","2022-03-14","2023-01-23","2022-03-22","2022-03-14","2022-06-27","2023-01-23","2023-06-12","2023-06-12","2023-06-12","2023-03-27","2023-04-03","2023-04-03","2023-04-03","2023-04-03","2021-05-15","2021-10-26","2021-10-26","2021-12-29","2021-05-15","2022-04-04","2022-04-04","2022-04-04","2021-10-24","2021-10-24","2021-10-24","2022-01-04","2022-03-25","2022-03-25","2021-05-15","2021-05-15","2021-05-15","2021-05-15","2021-05-15","2021-11-12","2021-05-15","2021-11-12","2022-10-04","2021-11-12","2021-11-12","2021-11-12","2023-08-31","2022-03-22","2022-03-22","2022-10-04","2022-10-04","2023-06-01","2023-06-01","2023-08-31","2023-08-31","2023-08-31"],"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":[["","57664049983","MIRTAZAPINE","15 MG","30","Select","Select",""],["","00115180301","HYDROXYZ PAM","CAP 25MG","60","Select","Select",""],["","70436001002","BUPROPN HCL","TAB 150MG XL","30","Select","Select",""],["","68180044701","QUETIAPINE","TAB 100MG","90","Select","Select",""],["","00378018201","PROPRANOLOL","TAB 10MG","30","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","43598075360","BUPROPION","TAB 200MG SR","90","Select","Select",""],["","96295013576","MULTIVITAMIN","TAB ADLT 50+","30","Select","Select",""],["","10135013210","THIAMINE HCL","TAB 100MG","30","Select","Select",""],["","47335058481","ROSUVASTATIN","TAB 20MG","30","Select","Select",""],["","10135018210","FOLIC ACID","TAB 1MG","30","Select","Select",""],["","68382013201","TAMSULOSIN","CAP 0.4MG","30","Select","Select",""],["","68180098103","LISINOPRIL","20 MG","30","Select","Select",""],["","40985022368","THERAPEUTIC-","TAB M\/LUTEIN","30","Select","Select",""],["","10006073021","VITAMIN B1","TAB 100MG","30","Select","Select",""],["","42806016005","HYDROXYZ HCL","TAB 25MG","90","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","00536468010","VITAMIN B-1","TAB 100MG","30","Select","Select",""],["","65862001501","AMOXICILLIN","TAB 875MG","20","Select","Select",""],["","70436015542","PROMETHAZINE","SOL DM","120","Select","Select",""],["","00904548652","CERTAVITE","TAB SENIOR","30","Select","Select",""],["","31722095801","BENZONATATE","CAP 200MG","30","Select","Select",""],["","16571040210","CETIRIZINE","TAB 10MG","20","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","62332003031","ROPINIROLE","TAB 0.25MG","30","Select","Select",""],["","42806054701","VITAMIN D","CAP 1.25MG","4","Select","Select",""],["","57896048930","POLYETH GLYC","POW 3350 NF","510","Select","Select",""],["","59267102503","PFIZER VACC","INJ ADLT RTU","0","Select","Select",""],["","37000002404","METAMUCIL","POW 0.5812","30","Select","Select",""],["","29300039810","AMLODIPINE BESYLATE","10 MG","90","Select","Select",""],["","43547029010","BUPROPION HCL SR","200 MG","90","Select","Select",""],["","68462025301","ROPINIROLE HCL","0.25 MG","90","Select","Select",""],["","59267030402","PFIZER COVID BIVAL (","12Y UP)EUA 30 MCG\/0.3","0.3","Select","Select",""],["","70377000812","ROSUVASTATIN CALCIUM","20 MG","90","Select","Select",""],["","29300014901","QUETIAPINE FUMARATE","100 MG","90","Select","Select",""],["","23155050105","HYDROXYZINE HCL","25 MG","90","Select","Select",""],["","00093031401","KETOROLAC TROMETHAMINE","10 MG","15","Select","Select",""],["","59746000103","METHYLPREDNISOLONE","4 MG","21","Select","Select",""],["","68180044701","QUETIAPINE TAB","100MG","90","Select","Select",""],["","00603548232","PROPRANOLOL TAB","10MG","90","Select","Select",""],["","13107003134","MIRTAZAPINE TAB","15MG","90","Select","Select",""],["","00115180301","HYDROXYZ PAM CAP","25MG","60","Select","Select",""],["","68382013201","TAMSULOSIN CAP","0.4MG","30","Select","Select",""],["","68180072103","AMLODIPINE TAB","10MG","90","Select","Select",""],["","70436001004","BUPROPN HCL TAB","150MG XL","30","Select","Select",""],["","40985022368","THERAPEUTIC- TAB M\/LUTEIN","","30","Select","Select",""],["","10006073021","VITAMIN B","1 TAB 100MG","30","Select","Select",""],["","43598075360","BUPROPION TAB","200MG SR","90","Select","Select",""],["","68180098103","LISINOPRIL TAB","20MG","30","Select","Select",""],["","69315012710","FOLIC ACID TAB","1000MCG","30","Select","Select",""],["","10135013210","THIAMINE HCL TAB","100MG","30","Select","Select",""],["","96295013577","MULTIVITAMIN TAB ADULTS","","30","Select","Select",""],["","70377000812","ROSUVASTATIN TAB","20MG","90","Select","Select",""],["","00093506101","HYDROXYZ HCL TAB","25MG","90","Select","Select",""],["","00536468010","VITAMIN B-","1 TAB 100MG","30","Select","Select",""],["","70436015542","PROMETHAZINE SOL DM","","120","Select","Select",""],["","60505082901","FLUTICASONE SPR","50MCG","16","Select","Select",""],["","65162083366","DICLOFENAC GEL","1%","100","Select","Select",""],["","16571040210","CETIRIZINE TAB","10MG","20","Select","Select",""],["","31722095801","BENZONATATE CAP","200MG","30","Select","Select",""],["","00904548652","CERTAVITE TAB SENIOR","","30","Select","Select",""],["","96295013576","MULTIVITAMIN TAB ADLT","50+","30","Select","Select",""],["","65862001501","AMOXICILLIN TAB","875MG","20","Select","Select",""],["","57896048930","POLYETH GLYC POW","3350 NF","510","Select","Select",""],["","69452015120","VITAMIN D CAP","50000UNT","2","Select","Select",""],["","62332003031","ROPINIROLE TAB","0.25MG","30","Select","Select",""],["","59267102503","PFIZER VACC INJ ADLT RTU","","0","Select","Select",""],["","37000002404","METAMUCIL POW","58.12%","30","Select","Select",""],["","43598044674","NICOTINE PATCH","7MG\/24HR","14","Select","Select",""],["","59267030402","PFIZER COVID BIVAL (12Y UP)","EUA","0.3","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":""}]}]}