{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DEBORAH  L NEDEAU","gend":1,"add":"2295 TIMBER RIDGE ROAD","city":"BEDFORD","state":"VA","zip":"24523-9998","dob":"1980-05-20","age":"","mstatus":"","insh":"20055546*01","cliId":"","pno":5408759196,"cno":5408759196,"email":"","ename":"","eno":"","pphy":"COHEN, LEONARD J MD","ppno":5404257910,"pcpadd":"582 BLUE RIDGE AVE,","pcpcity":"BEDFORD","pcpstate":"VA","pcpzip":"24523-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":5405835149,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J45.901","I10.","G47.33","E11.65","E88.81","J45.909","E66.01","K21.9","F41.8","F31.9","Z88.0","Z79.51","Z79.899","R73.9","E11.9","Z79.4","F33.2","G89.4","G43.101","Z72.89","F41.9","K59.01","K92.1","U07.1","R51.9","R11.10","NO DATA","E87.6","K31.89","R10.84","S46.011A","M25.511","H53.8","Z79.1","Z88.2","E78.2","M19.011","R42.","E11.42","E11.59","E78.5","I15.2","R05.2","R07.89","R09.89","Z20.822","J02.9","M51.37","M43.26","M54.31","M79.7","M51.36","M47.896","M62.830","Z79.891","Z87.891","F51.04","G43.009","F30.9","F31.12","R13.10","S49.91XA","L60.0","B35.1","L60.8","M79.674","M79.675","Z98.890","Z12.31","M54.41","M54.42","Z23.","R81.","R30.0","E11.40","J34.89","R14.0","K64.5","R19.7","Z90.49","Z71.9","M47.816","E11.51","S90.31XA","K64.9","J01.00","J20.9","Z68.41","M79.671","N30.00","V58.89","N39.0","R10.9","Z87.442","R05.9","G43.709","K05.219","K08.9","R68.84"],"date":["2021-05-06","2022-11-01","2023-04-29","2022-03-17","2021-09-24","2023-04-27","2021-09-26","2022-05-27","2021-09-24","2021-09-24","2021-09-26","2021-09-26","2021-09-24","2021-09-24","2022-05-27","2021-12-14","2021-12-14","2022-08-17","2021-12-14","2021-11-04","2021-12-14","2021-12-14","2021-12-14","2022-09-14","2022-09-14","2022-09-14","2023-06-05","2022-09-14","2021-02-09","2021-02-09","2021-06-04","2021-06-29","2021-09-26","2021-09-26","2021-09-26","2022-03-03","2021-09-02","2021-09-26","2021-10-20","2021-10-20","2021-10-20","2021-10-20","2022-02-01","2022-02-01","2022-02-01","2022-06-23","2022-06-23","2022-08-11","2022-08-11","2022-08-11","2022-08-11","2023-03-31","2023-06-05","2023-06-05","2023-06-05","2023-04-27","2021-07-06","2021-07-06","2021-07-06","2021-07-06","2021-07-06","2021-07-06","2023-02-27","2023-02-27","2023-02-27","2023-02-27","2023-02-27","2021-09-02","2022-03-17","2022-11-01","2022-08-29","2022-11-03","2021-06-10","2021-09-17","2023-02-27","2022-04-25","2022-05-27","2022-05-27","2022-05-27","2022-05-27","2022-05-27","2022-12-12","2021-04-20","2021-09-09","2022-07-06","2021-01-21","2021-01-21","2021-03-23","2021-09-21","2021-09-17","2021-09-21","2021-10-14","2021-10-14","2021-10-14","2022-04-06","2022-11-01","2023-06-03","2023-06-13","2023-06-13"],"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":[["","50742025290","DILTIAZEM","CAP 360MG ER","30","Select","Select",""],["","42858000201","OXYCODONE","TAB 10MG","120","Select","Select",""],["","00121174410","GUAIFENESIN","SOL 100\/5ML","600","Select","Select",""],["","65862056099","PANTOPRAZOLE","TAB 40MG","180","Select","Select",""],["","59746017310","PREDNISONE","TAB 10MG","14","Select","Select",""],["","00143988750","AMOXICILLIN","SUS 400\/5ML","200","Select","Select",""],["","49348013537","MUCUS+CHST","LIQ 100\/5ML","237","Select","Select",""],["","00186037020","SYMBICORT","160-4.5MCG","10.2","Select","Select",""],["","53885024510","ONETOUCH","TES ULTRA","200","Select","Select",""],["","00472037945","CLOTRIM\/BETA","CRE DIPROP","90","Select","Select",""],["","00378395377","ATORVASTATIN","TAB 80MG","30","Select","Select",""],["","00527169501","BUT\/APAP\/CAF","TAB ","90","Select","Select",""],["","57237016199","OMEPRAZOLE","CAP 20MG","90","Select","Select",""],["","00169255013","TRESIBA FLEX","INJ 200UNIT","45","Select","Select",""],["","00002318280","TRULICITY","4.5 MG\/0.5","2","Select","Select",""],["","68180052001","LISINOP\/HCTZ","TAB 20-25MG","30","Select","Select",""],["","45802075930","PROMETHAZINE","SUP 25MG","6","Select","Select",""],["","00002237711","EMGALITY","INJ 120MG\/ML","1","Select","Select",""],["","53885000810","ONETOUCH DEL","MIS PLUS 33G","200","Select","Select",""],["","69238208105","PROPRANOLOL","TAB 80MG","180","Select","Select",""],["","47335027641","SUMATRIPTAN","INJ 6MG\/0.5","1","Select","Select",""],["","00002882427","HUMULIN R","INJ U-500","18","Select","Select",""],["","52817018010","CLONIDINE","TAB 0.1MG","30","Select","Select",""],["","67877054360","CEFDINIR","CAP 300MG","20","Select","Select",""],["","49884046667","CHOLESTYRAM","POW 4GM LITE","630","Select","Select",""],["","64380071207","BENZONATATE","CAP 100MG","42","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","8","Select","Select",""],["","00904699880","DOCUSATE SOD","CAP 100MG","120","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","00310737020","BUDES\/FORMOT","AER 160-4.5","10","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","12","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","60","Select","Select",""],["","68180098103","LISINOPRIL","TAB 20MG","30","Select","Select",""],["","67877019910","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","52817036100","METOPROL TAR","TAB 50MG","60","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8","Select","Select",""],["","00093220401","METOCLOPRAM","TAB 5MG","28","Select","Select",""],["","08290320122","BD PEN NEEDL","MIS 32GX4MM","200","Select","Select",""],["","16729017501","AMITRIPTYLIN","TAB 100MG","90","Select","Select",""],["","33342008841","RIZATRIPTAN","10 MG","9","Select","Select",""],["","00169255013","TRESIBA FLEXTOUCH U-","200 200\/ML (3)","72","Select","Select",""],["","08290320122","ULTRA-FINE NANO PEN NEEDLE","32GX 5\/32\"","200","Select","Select",""],["","43547028111","ESCITALOPRAM OXALATE","10 MG","30","Select","Select",""],["","53885000810","ONETOUCH DELICA PLUS LANCET","33 GAUGE","200","Select","Select",""],["","00002882427","HUMULIN R U-","500 KWIKPEN 500\/ML (3)","42","Select","Select",""],["","67877019910","AMLODIPINE BESYLATE","10 MG","30","Select","Select",""],["","52817036100","METOPROLOL TARTRATE","50 MG","60","Select","Select",""],["","00002237711","EMGALITY SYRINGE","120 MG\/ML","1","Select","Select",""],["","10702005601","OXYCODONE HCL","10 MG","120","Select","Select",""],["","00185067405","HYDROXYZINE PAMOATE","25 MG","120","Select","Select",""],["","65862050320","AMOXICILLIN-CLAVULANATE POTASS","875-125 MG","20","Select","Select",""],["","53885024510","ONETOUCH ULTRA TEST STRIP","","200","Select","Select",""],["","00378395377","ATORVASTATIN CALCIUM","80 MG","30","Select","Select",""],["","11877001140","BINAXNOW COVID-","19 AG SELF TEST ","8","Select","Select",""],["","68180096301","ALBUTEROL SULFATE HFA","90 MCG","8.5","Select","Select",""],["","70710122901","AMITRIPTYLINE HCL","100 MG","30","Select","Select",""],["","16571020106","DICLOFENAC SODIUM","75 MG","60","Select","Select",""],["","69547035302","NARCAN","4 MG","2","Select","Select",""],["","65862056099","PANTOPRAZOLE SODIUM","40 MG","180","Select","Select",""],["","50742025290","DILTIAZEM CAP","360MG ER","30","Select","Select",""],["","42858000201","OXYCODONE TAB","10MG","120","Select","Select",""],["","65862056099","PANTOPRAZOLE TAB","40MG","180","Select","Select",""],["","00143988750","AMOXICILLIN SUS","400\/5ML","200","Select","Select",""],["","59746017310","PREDNISONE TAB","10MG","14","Select","Select",""],["","00121174410","GUAIFENESIN SOL","100\/5ML","600","Select","Select",""],["","70000029902","MUCUS+CHST LIQ","100\/5ML","237","Select","Select",""],["","00121148800","GUAIFENESIN LIQ","100\/5ML","600","Select","Select",""],["","00186037020","SYMBICORT AER","160-4.5","10","Select","Select",""],["","16714079801","SUMATRIPTAN TAB","100MG","9","Select","Select",""],["","00002882427","HUMULIN R INJ U-","500","18","Select","Select",""],["","59762015801","ATORVASTATIN TAB","80MG","30","Select","Select",""],["","00472037945","CLOTRIM\/BETA CRE DIPROP","","90","Select","Select",""],["","69238208105","PROPRANOLOL TAB","80MG","180","Select","Select",""],["","47335027641","SUMATRIPTAN INJ","6MG\/0.5","1","Select","Select",""],["","53885000810","ONETOUCH DEL MIS PLUS","33G","200","Select","Select",""],["","00002237711","EMGALITY INJ","120MG\/ML","1","Select","Select",""],["","52817018010","CLONIDINE TAB","0.1MG","30","Select","Select",""],["","65162068090","PROMETHAZINE SOL DM","","120","Select","Select",""],["","00169255013","TRESIBA FLEX INJ","200UNIT","54","Select","Select",""],["","00002318280","TRULICITY INJ","4.5\/0.5","2","Select","Select",""],["","57237016199","OMEPRAZOLE CAP","20MG","90","Select","Select",""],["","64380071207","BENZONATATE CAP","100MG","42","Select","Select",""],["","00527169501","BUT\/APAP\/CAF TAB","","90","Select","Select",""],["","53885024510","ONETOUCH TES ULTRA","","200","Select","Select",""],["","49884046667","CHOLESTYRAM POW","4GM LITE","210","Select","Select",""],["","42858010201","OXYCOD\/APAP TAB","5-325MG","8","Select","Select",""],["","68180052001","LISINOP\/HCTZ TAB","20-25MG","30","Select","Select",""],["","67877054360","CEFDINIR CAP","300MG","20","Select","Select",""],["","00310737020","BUDES\/FORMOT AER","160-4.5","10","Select","Select",""],["","53746010901","HYDROCO\/APAP TAB","5-325MG","12","Select","Select",""],["","68462019005","NAPROXEN TAB","500MG","60","Select","Select",""],["","00487950103","ALBUTEROL NEB","0.083%","360","Select","Select",""],["","00054327099","FLUTICASONE SPR","50MCG","16","Select","Select",""],["","67877019910","AMLODIPINE TAB","10MG","30","Select","Select",""],["","52817036100","METOPROL TAR TAB","50MG","60","Select","Select",""],["","00904699880","DOCUSATE SOD CAP","100MG","120","Select","Select",""],["","68180096301","ALBUTEROL AER HFA","","8","Select","Select",""],["","68180098103","LISINOPRIL TAB","20MG","30","Select","Select",""],["","45802075930","PROMETHAZINE SUP","25MG","12","Select","Select",""],["","16729017301","AMITRIPTYLIN TAB","50MG","30","Select","Select",""],["","00093220401","METOCLOPRAM TAB","5MG","28","Select","Select",""],["","08290320122","BD PEN NEEDL MIS","32GX4MM","200","Select","Select",""],["","33342008841","RIZATRIPTAN TAB","10MG","9","Select","Select",""],["","65162046650","IBUPROFEN","800 MG","15","Select","Select",""],["","00093117410","PENICILLIN V POTASSIUM","500 MG","28","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":""}]}]}