{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CARL D AUSTIN","gend":0,"add":"3725 SANDLEWOOD ROAD","city":"ROANOKE","state":"VA","zip":"24018-9998","dob":"1963-11-01","age":"","mstatus":"","insh":"20086717*01","cliId":"","pno":5407740907,"cno":5407740907,"email":"","ename":"","eno":"","pphy":"JAMES, COLLEEN DO","ppno":5407257800,"pcpadd":"SUITE 2 3707 BRAMBLETON AVE SW,","pcpcity":"ROANOKE","pcpstate":"VA","pcpzip":"24018-9998","pcpcounty":"","pcpid":"","pcpname":"Carilion Healthcare Corp","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":5409896752,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z23.","Z94.4","E10.9","R18.8","R16.1","C22.0","E11.3313","E11.3312","T86.49","E11.65","J06.9","K75.81","I10.","I25.10","Z95.5","E78.5","K74.60","Z79.4","J30.2","D35.2","E27.40","G47.33","NO DATA","E66.9","Z79.82","Z79.84","Z79.52","Z79.899","Z87.891","H59.033","H18.232","H52.223","H52.4"],"date":["2022-11-28","2023-08-03","2022-11-28","2022-10-03","2022-10-03","2023-06-19","2023-07-10","2023-05-01","2023-06-19","2023-08-27","2023-06-05","2023-06-08","2023-06-26","2023-06-26","2023-06-08","2023-06-26","2023-06-08","2023-06-26","2023-06-28","2023-08-03","2023-06-26","2023-06-26","2023-06-26","2023-06-26","2023-06-26","2023-06-26","2023-06-26","2023-06-26","2023-06-26","2023-08-08","2023-08-08","2023-08-08","2023-08-08"],"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":[["","16729026129","MYCOPHENOLIC","TAB 180MG DR","120","Select","Select",""],["","68382009305","CARVEDILOL","6.25 MG","60","Select","Select",""],["","00054429731","FUROSEMIDE","20 MG","30","Select","Select",""],["","65862029490","ROSUVASTATIN","TAB 10MG","30","Select","Select",""],["","00603020922","MAG OXIDE","TAB 400MG","60","Select","Select",""],["","00088221905","LANTUS SOLOS","INJ 100\/ML","15","Select","Select",""],["","64380097025","HYDROCORT","TAB 5MG","120","Select","Select",""],["","16729004201","TACROLIMUS","1 MG","90","Select","Select",""],["","69097083412","SERTRALINE","TAB 50MG","30","Select","Select",""],["","59746017210","PREDNISONE","5 MG","30","Select","Select",""],["","70377000712","ROSUVASTATIN CALCIUM","10 MG","30","Select","Select",""],["","64980033912","MAGNESIUM OXIDE","400 MG","30","Select","Select",""],["","31722071390","PANTOPRAZOLE SODIUM","40 MG","30","Select","Select",""],["","16729026129","MYCOPHENOLIC ACID","180 MG","120","Select","Select",""],["","00002143480","TRULICITY","1.5 MG\/0.5","2","Select","Select",""],["","00002879959","HUMALOG KWIKPEN U-","100 100\/ML","15","Select","Select",""],["","68645052254","SERTRALINE HCL","50 MG","30","Select","Select",""],["","00597015330","JARDIANCE","25 MG","90","Select","Select",""],["","00002822259","INSULIN LISPRO KWIKPEN U-","100 100\/ML","30","Select","Select",""],["","42806031250","DOXYCYCLINE HYCLATE","100 MG","14","Select","Select",""],["","49502039475","INSULIN GLARGINE-YFGN","100\/ML (3)","15","Select","Select",""],["","69097014260","ALBUTEROL SULFATE HFA","90 MCG","6.7","Select","Select",""],["","69315011801","FUROSEMIDE TAB","80MG","90","Select","Select",""],["","70954005820","PREDNISONE TAB","5MG","30","Select","Select",""],["","16729026129","MYCOPHENOLIC TAB","180MG DR","120","Select","Select",""],["","00603020922","MAG OXIDE TAB","400MG","30","Select","Select",""],["","00088221905","LANTUS SOLOS INJ","100\/ML","15","Select","Select",""],["","16729004201","TACROLIMUS CAP","1MG","180","Select","Select",""],["","64380097025","HYDROCORT TAB","5MG","120","Select","Select",""],["","65862029490","ROSUVASTATIN TAB","10MG","30","Select","Select",""],["","68645035059","CARVEDILOL TAB","6.25MG","120","Select","Select",""],["","69097083412","SERTRALINE TAB","50MG","30","Select","Select",""],["","00172392760","DIAZEPAM","10 MG","1","Select","Select",""],["","00904679480","ASPIRIN","81 MG","30","Select","Select",""],["","00088221905","LANTUS SOLOSTAR","100\/ML (3)","45","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":""}]}]}