{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KAREN ELLIS","gend":1,"add":"7004 LA MARRE DR","city":"ROANOKE","state":"VA","zip":"24019-9998","dob":"1974-01-29","age":"","mstatus":"","insh":"20069240*01","cliId":"","pno":5403536004,"cno":5403536004,"email":"","ename":"","eno":"","pphy":"BIVENS JR, CARL H MD","ppno":5403443276,"pcpadd":"3501 COLONIAL GREEN CIRCLE,","pcpcity":"ROANOKE","pcpstate":"VA","pcpzip":"24018-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":5403424399,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G93.41","A41.9","NO DATA","E87.8","K92.2","T68.XXXA","J18.9","N17.9","R04.89","R74.8","D62.","B37.9","E11.65","R65.21","J69.0","J96.01","F11.20","D72.829","D64.9","E03.9","S22.080A","E87.1","R41.82","E11.21","K31.84","I46.9","E87.5","I49.9","N17.0","N18.4","R41.89","E87.2","R57.9","I07.1","U07.1","R07.9","R73.9","R40.20"],"date":["2022-04-24","2022-05-05","2022-05-04","2022-04-17","2022-04-24","2022-04-24","2022-04-24","2022-05-04","2022-05-18","2022-04-24","2022-04-24","2022-05-18","2022-05-09","2022-05-18","2022-05-05","2022-05-05","2023-07-23","2022-05-18","2022-05-18","2022-05-18","2022-04-28","2022-05-10","2022-05-06","2021-09-27","2021-09-27","2022-05-10","2022-04-15","2022-04-20","2022-05-10","2022-05-10","2022-04-15","2022-04-15","2022-04-15","2022-04-17","2022-04-17","2022-04-22","2022-05-02","2022-04-15"],"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":[["","00781107905","ALPRAZOLAM","1 MG","90","Select","Select",""],["","68382004110","PROMETHAZINE","TAB 25MG","90","Select","Select",""],["","53885027210","ONETOUCH","TES VERIO","200","Select","Select",""],["","65702048110","ACCU-CHEK","KIT FASTCLIX","1","Select","Select",""],["","57599000200","FREESTYLE","MIS READER","1","Select","Select",""],["","00169633910","NOVOLOG","INJ FLEXPEN","15","Select","Select",""],["","00088221905","LANTUS SOLOS","INJ 100\/ML","15","Select","Select",""],["","43598051090","ESOMEPRA MAG","CAP 40MG DR","90","Select","Select",""],["","73070010315","INSULIN ASPA","INJ FLEXPEN","15","Select","Select",""],["","69238183907","LEVOTHYROXIN","TAB 175MCG","90","Select","Select",""],["","55111064505","OMEPRAZOLE","CAP 40MG","90","Select","Select",""],["","50111045001","TRAZODONE","TAB 150MG","90","Select","Select",""],["","55111046701","METOPROL SUC","TAB 50MG ER","90","Select","Select",""],["","00074706990","SYNTHROID","TAB 150MCG","90","Select","Select",""],["","65702028810","FASTCLIX","MIS LANCETS","300","Select","Select",""],["","57599080300","FREESTY LIBR","MIS 2 READER","1","Select","Select",""],["","65862017601","PENICILLN VK","TAB 500MG","29","Select","Select",""],["","08290320119","BD PEN NEEDL","MIS 31GX5MM","200","Select","Select",""],["","00591352530","LIDOCAINE","PAD 0.05","14","Select","Select",""],["","00002803101","GLUCAGON","KIT 1MG","1","Select","Select",""],["","53885000810","ONETOUCH DEL","MIS PLUS 33G","100","Select","Select",""],["","00536124701","SENEXON-S","TAB 8.6-50MG","28","Select","Select",""],["","49483034010","ACETAMIN","TAB 325MG","120","Select","Select",""],["","52817036100","METOPROL TAR","TAB 50MG","60","Select","Select",""],["","00002822259","INSULIN LISP","INJ 100\/ML","15","Select","Select",""],["","00904759180","FEROSUL","TAB 325MG","30","Select","Select",""],["","31722071310","PANTOPRAZOLE","TAB 40MG","90","Select","Select",""],["","69097052444","DICLOFENAC","GEL 0.01","200","Select","Select",""],["","00223176001","SOD CHLORIDE","TAB 1GM","60","Select","Select",""],["","00002879959","HUMALOG KWIK","INJ 100\/ML","15","Select","Select",""],["","00536589588","NICOTINE TD","DIS 14MG\/24H","30","Select","Select",""],["","00406051201","OXYCOD\/APAP","TAB 5-325MG","12","Select","Select",""],["","68462015713","ONDANSETRON","TAB 4MG ODT","56","Select","Select",""],["","00093314705","CEPHALEXIN","500 MG","21","Select","Select",""],["","60258019701","PRENATAL 19","CHW TAB","30","Select","Select",""],["","00378668977","PANTOPRAZOLE SODIUM","40 MG","90","Select","Select",""],["","57664047758","METOPROLOL TARTRATE","50 MG","60","Select","Select",""],["","00088221905","LANTUS SOLOSTAR","100\/ML (3)","12","Select","Select",""],["","00169633910","NOVOLOG INJ FLEXPEN","","15","Select","Select",""],["","31722071310","PANTOPRAZOLE TAB","40MG","30","Select","Select",""],["","53885027210","ONETOUCH TES VERIO","","200","Select","Select",""],["","00088221905","LANTUS SOLOS INJ","100\/ML","15","Select","Select",""],["","51991070605","ALPRAZOLAM TAB","1MG","90","Select","Select",""],["","00536589588","NICOTINE TD DIS","14MG\/24H","30","Select","Select",""],["","00406051201","OXYCOD\/APAP TAB","5-325MG","12","Select","Select",""],["","49483034010","ACETAMIN TAB","325MG","120","Select","Select",""],["","00904759180","FEROSUL TAB","325MG","30","Select","Select",""],["","00223176001","SOD CHLORIDE TAB","1GM","60","Select","Select",""],["","00002879959","HUMALOG KWIK INJ","100\/ML","15","Select","Select",""],["","00002822259","INSULIN LISP INJ","100\/ML","3","Select","Select",""],["","52817036100","METOPROL TAR TAB","50MG","60","Select","Select",""],["","69238183907","LEVOTHYROXIN TAB","175MCG","90","Select","Select",""],["","00591352530","LIDOCAINE PAD","5%","14","Select","Select",""],["","69097052444","DICLOFENAC GEL","1%","200","Select","Select",""],["","00536124701","SENEXON-S TAB","8.6-50MG","28","Select","Select",""],["","68462015713","ONDANSETRON TAB","4MG ODT","56","Select","Select",""],["","68382004110","PROMETHAZINE TAB","25MG","90","Select","Select",""],["","67877021905","CEPHALEXIN CAP","500MG","21","Select","Select",""],["","60258019701","PRENATAL","19 CHW TAB","30","Select","Select",""],["","57599080000","FREESTYLE LIBRE","2 SENSOR","9","Select","Select",""],["","57237007710","ONDANSETRON ODT","4 MG","56","Select","Select",""],["","53885027210","ONETOUCH VERIO TEST STRIP","","300","Select","Select",""],["","69238183901","LEVOTHYROXINE SODIUM","175 MCG","90","Select","Select",""],["","00169633910","NOVOLOG FLEXPEN","100\/ML (3)","15","Select","Select",""],["","00591530701","PROMETHAZINE HCL","25 MG","90","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":""}]}]}