{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DAVID L WEAVER","gend":0,"add":"1224 UPPER POORE VALLEY ROAD","city":"SALTVILLE","state":"VA","zip":"24370-9998","dob":"1966-01-28","age":"","mstatus":"","insh":"20055744*01","cliId":"","pno":2766446126,"cno":2766446126,"email":"","ename":"","eno":"","pphy":"CAMARGO, EDGAR MD","ppno":2764964433,"pcpadd":"308 W MAIN ST,","pcpcity":"SALTVILLE","pcpstate":"VA","pcpzip":"24370-9998","pcpcounty":"","pcpid":"","pcpname":"Saltville Medical Center","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"SOUTHWEST","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":2764965923,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J18.9","R91.8","NO DATA","M79.671","I75.021","F11.20","J98.4","I70.203","I21.4","I42.9","I73.9","F19.10","F17.210","I49.8","J85.0","R79.89","R63.4","E46.","D64.9","F17.200","I40.1","B33.24","I70.0","I71.4","I70.8","R94.31","J44.9","I99.9","I99.8","B18.2","I26.99","J96.01","J10.1","I70.223","I21.3","R06.02","R94.39","R59.0","Z72.0","J43.2","J47.1","I70.229","I75.029","Z78.9","J15.9","R64.","I74.5","R18.8","E87.1","I10.","Z79.899","F11.90","Z20.822","M89.9","A41.9","J10.08","J69.0","E87.2","D72.821","E78.5","E87.6","E88.09","I11.9","I25.2","R77.8","R09.02","I51.7","I74.09","Z01.810","F17.290","R00.0","R06.82","R07.89","J47.9","B49.","R06.03","J44.1","D69.6","Z01.812","B19.20"],"date":["2022-03-14","2022-07-11","2022-03-14","2021-01-26","2021-01-06","2023-09-17","2022-07-11","2021-04-09","2023-02-20","2022-03-14","2023-09-12","2022-03-14","2023-09-05","2022-03-14","2021-01-06","2021-01-06","2021-01-06","2021-01-06","2021-01-06","2023-09-12","2023-02-20","2023-02-20","2021-04-09","2021-04-09","2021-04-09","2022-03-14","2023-01-30","2021-01-05","2021-09-01","2023-09-10","2022-07-11","2023-09-12","2022-03-14","2022-12-12","2022-03-11","2022-03-11","2022-03-16","2022-07-11","2023-09-04","2022-07-11","2022-07-11","2021-01-02","2021-01-03","2021-01-05","2021-01-01","2022-03-11","2021-01-01","2021-01-01","2021-01-01","2023-09-12","2022-03-11","2021-01-01","2022-03-11","2021-01-02","2022-03-11","2022-03-11","2022-03-14","2022-03-14","2022-03-11","2023-09-12","2022-03-11","2022-03-11","2022-03-11","2022-03-11","2022-03-11","2023-09-04","2022-03-13","2023-09-12","2023-08-31","2022-03-11","2022-03-11","2022-03-11","2022-03-11","2022-03-13","2022-03-14","2023-09-04","2023-09-12","2023-09-07","2023-08-31","2023-09-12"],"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":[["","16729013616","CLONAZEPAM","TAB 0.5MG","28","Select","Select",""],["","00093227534","AMOX\/K CLAV","TAB 875-125","4","Select","Select",""],["","31722094905","OXYCOD\/APAP","TAB 5-325MG","10","Select","Select",""],["","65862053820","LEVOFLOXACIN","TAB 750MG","20","Select","Select",""],["","16103035611","ASPIRIN","TAB 81MG EC","30","Select","Select",""],["","16729004617","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","55111068405","IBU","TAB 800MG","60","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","63868036320","ASPIRIN LOW","TAB 81MG EC","30","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8","Select","Select",""],["","16729021816","CLOPIDOGREL","75 MG","30","Select","Select",""],["","00172392670","DIAZEPAM","5 MG","5","Select","Select",""],["","00597015561","STIOLTO","AER 2.5-2.5","4","Select","Select",""],["","00591544221","PREDNISONE","PAK 10MG","21","Select","Select",""],["","00172572880","FAMOTIDINE","TAB 20MG","60","Select","Select",""],["","57237010099","METOPROL TAR","TAB 25MG","30","Select","Select",""],["","43547035150","LISINOPRIL","2.5 MG","30","Select","Select",""],["","00003089421","ELIQUIS","5 MG","60","Select","Select",""],["","00781717612","NALOXONE","SPR ","2","Select","Select",""],["","00143980305","DOXYCYCL HYC","CAP 100MG","20","Select","Select",""],["","68180096301","ALBUTEROL SULFATE HFA","90 MCG","8.5","Select","Select",""],["","67877051305","ATORVASTATIN CALCIUM","40 MG","30","Select","Select",""],["","00597015561","STIOLTO RESPIMAT","2.5-2.5MCG","4","Select","Select",""],["","00378827052","ALBUTEROL SULFATE","2.5 MG\/3ML","8.5","Select","Select",""],["","00536123441","ASPIRIN EC","81 MG","30","Select","Select",""],["","68382056410","METOPROLOL SUCCINATE","25 MG","30","Select","Select",""],["","59310057922","PROAIR HFA AER","","8","Select","Select",""],["","00003089421","ELIQUIS TAB","5MG","60","Select","Select",""],["","16729021816","CLOPIDOGREL TAB","75MG","30","Select","Select",""],["","57237010099","METOPROL TAR TAB","25MG","30","Select","Select",""],["","00172392670","DIAZEPAM TAB","5MG","3","Select","Select",""],["","43547035150","LISINOPRIL TAB","2.5MG","30","Select","Select",""],["","00172572880","FAMOTIDINE TAB","20MG","60","Select","Select",""],["","00093227534","AMOX\/K CLAV TAB","875-125","4","Select","Select",""],["","00591544221","PREDNISONE PAK","10MG","21","Select","Select",""],["","00781717612","NALOXONE SPR","","2","Select","Select",""],["","16103035611","ASPIRIN TAB","81MG EC","30","Select","Select",""],["","16729004617","ATORVASTATIN TAB","40MG","30","Select","Select",""],["","00597015561","STIOLTO AER","2.5-2.5","4","Select","Select",""],["","00143980305","DOXYCYCL HYC CAP","100MG","20","Select","Select",""],["","68180096301","ALBUTEROL AER HFA","","8","Select","Select",""],["","00536589671","NICOTINE PATCH","21 MG\/24HR","28","Select","Select",""],["","59746000103","METHYLPREDNISOLONE","4 MG","21","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":""}]}]}