{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BOBBY L HALE","gend":0,"add":"1560 UNION CHURCH ROAD","city":"FERRUM","state":"VA","zip":"24088-9998","dob":"1959-05-23","age":"","mstatus":"","insh":"2175680*01","cliId":"","pno":2769301227,"cno":2769301227,"email":"","ename":"","eno":"","pphy":"COLE, RICHARD C MD","ppno":2766944466,"pcpadd":"18877 JEB STUART HWY,","pcpcity":"STUART","pcpstate":"VA","pcpzip":"24171-9998","pcpcounty":"","pcpid":"","pcpname":"Patrick County Family Practice, PC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":2766942909,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I21.4","I12.9","N18.2","R06.02","R05.9","Z20.822","N17.0","E87.1","D64.9","N18.6","N17.9","R73.9","I50.20","I25.10","D62.","I50.9","E87.8","I46.9","Z95.1","I48.91","I95.1","K21.9","I96.","E89.1","I08.2","D65.","J96.01","R57.0","NO DATA","J95.1","B35.1","I48.0","I50.43","J95.2","I07.1","E83.51","F10.10","Z01.810","J90.","I25.5","D50.0","E55.9","K76.0","R74.8","I73.9","Z72.0","I25.110","I31.3","F17.200","R93.1","R53.81","Z48.812","I50.22","E11.51","E11.52","Z23.","Z86.74","Z99.2","I25.2","Z79.899","I95.9","F17.210","E78.5","I25.799","R53.82","R20.0","D38.2","J44.9","I51.89","F43.20","H61.23","L89.612","L89.613","I70.245","M79.671","M79.672","R94.31","Z01.818","I20.9","V58.89","I45.10","I21.19","I49.3","I25.84","Z51.81","M62.261","S91.101A","H25.813","H04.123","E11.65","I97.611","I10.","E87.5","S91.105A","Z68.25","R06.00","Z86.79"],"date":["2022-03-07","2022-01-24","2022-01-24","2022-01-24","2022-01-24","2022-01-25","2022-02-23","2022-02-13","2022-02-23","2022-03-07","2022-03-07","2022-02-26","2022-02-26","2022-07-11","2022-02-24","2022-02-24","2022-02-26","2022-03-07","2022-07-11","2023-06-13","2022-03-07","2022-02-28","2022-03-07","2022-03-07","2022-06-17","2022-01-25","2022-01-25","2022-01-25","2022-07-07","2022-01-25","2022-07-05","2022-01-25","2022-01-25","2022-01-25","2022-02-10","2022-01-25","2022-02-26","2022-01-25","2022-05-06","2023-06-13","2022-02-26","2022-05-20","2022-02-23","2022-01-28","2022-01-28","2022-06-07","2022-02-01","2022-02-01","2022-02-01","2022-02-07","2022-03-07","2022-02-23","2023-06-13","2022-02-23","2022-02-23","2022-02-23","2022-02-23","2022-02-23","2022-07-11","2022-03-10","2022-04-04","2022-07-11","2022-05-20","2022-05-20","2022-05-20","2022-05-20","2022-10-07","2023-06-13","2022-01-25","2022-02-28","2022-06-09","2022-07-07","2022-08-25","2022-01-27","2022-01-27","2022-01-27","2022-03-10","2022-05-01","2022-07-07","2022-03-07","2022-01-24","2022-01-24","2022-01-24","2022-01-25","2022-02-11","2022-02-12","2022-02-28","2022-11-02","2022-11-02","2022-02-05","2022-02-02","2022-02-27","2022-02-27","2022-02-28","2022-03-07","2022-07-11","2022-07-11"],"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":[["","45802086803","POLYETH GLYC","POW 3350 NF","510","Select","Select",""],["","68382032010","POT CHLORIDE","TAB 10MEQ ER","30","Select","Select",""],["","10006073038","MAG OXIDE","TAB 400MG","30","Select","Select",""],["","00093321930","KETOCONAZOLE","CRE 0.02","30","Select","Select",""],["","59651024801","MIDODRINE","TAB 10MG","90","Select","Select",""],["","31604001870","VITAMIN D","TAB 1000UNIT","60","Select","Select",""],["","43598043611","NITROGLYCERN","SUB 0.4MG","25","Select","Select",""],["","50428034583","GENTLE LAXAT","SUP 10MG","16","Select","Select",""],["","49483034010","ACETAMIN","TAB 325MG","30","Select","Select",""],["","00054429931","FUROSEMIDE","40 MG","30","Select","Select",""],["","59779027408","ASPIRIN LOW","CHW 81MG","100","Select","Select",""],["","50428048545","CVS B-1","TAB 100MG","30","Select","Select",""],["","37864000052","THERA-M","TAB ","30","Select","Select",""],["","00093505798","ATORVASTATIN","TAB 80MG","90","Select","Select",""],["","69315012710","FOLIC ACID","TAB 1000MCG","30","Select","Select",""],["","51862024160","AMIODARONE","TAB 200MG","60","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","60","Select","Select",""],["","67877021905","CEPHALEXIN","CAP 500MG","21","Select","Select",""],["","80681009800","VITAMIN B-1","TAB 100MG","30","Select","Select",""],["","50428062110","MELATONIN","TAB 3MG","30","Select","Select",""],["","00536124701","SENEXON-S","TAB 8.6-50MG","60","Select","Select",""],["","74312001380","VITAMIN B-12","TAB 1000MCG","90","Select","Select",""],["","68645055054","LISINOPRIL","2.5 MG","90","Select","Select",""],["","59746017310","PREDNISONE","TAB 10MG","20","Select","Select",""],["","60219175103","SILDENAFIL","TAB 25MG","10","Select","Select",""],["","31604040383",""," ","30","Select","Select",""],["","00093505798","ATORVASTATIN TAB","80MG","90","Select","Select",""],["","43598043611","NITROGLYCERN SUB","0.4MG","25","Select","Select",""],["","59651024801","MIDODRINE TAB","10MG","90","Select","Select",""],["","43547040111","FUROSEMIDE TAB","20MG","30","Select","Select",""],["","10006073038","MAG OXIDE TAB","400MG","30","Select","Select",""],["","50428048545","CVS B-","1 TAB 100MG","30","Select","Select",""],["","69315012710","FOLIC ACID TAB","1000MCG","30","Select","Select",""],["","59779027408","ASPIRIN LOW CHW","81MG","100","Select","Select",""],["","65862085901","FAMOTIDINE TAB","20MG","30","Select","Select",""],["","50428062110","MELATONIN TAB","3MG","30","Select","Select",""],["","31604001870","VITAMIN D TAB","1000UNIT","60","Select","Select",""],["","00536124701","SENEXON-S TAB","8.6-50MG","60","Select","Select",""],["","53746054201","POT CHLORIDE CAP","10MEQ ER","60","Select","Select",""],["","00093321930","KETOCONAZOLE CRE","2%","30","Select","Select",""],["","11845069305","VITAMIN B-","12 TAB 1000MCG","30","Select","Select",""],["","50428034583","GENTLE LAXAT SUP","10MG","16","Select","Select",""],["","68645055054","LISINOPRIL TAB","2.5MG","90","Select","Select",""],["","45802086803","POLYETH GLYC POW","3350 NF","510","Select","Select",""],["","37864000052","THERA-M TAB","","30","Select","Select",""],["","51862024160","AMIODARONE TAB","200MG","60","Select","Select",""],["","49483034010","ACETAMIN TAB","325MG","30","Select","Select",""],["","69680013393","POT CHLORIDE TAB","10MEQ ER","30","Select","Select",""],["","59746017310","PREDNISONE TAB","10MG","20","Select","Select",""],["","67877021905","CEPHALEXIN CAP","500MG","21","Select","Select",""],["","60219175103","SILDENAFIL TAB","25MG","10","Select","Select",""],["","68180096301","ALBUTEROL SULFATE HFA","90 MCG","8.5","Select","Select",""],["","00093505798","ATORVASTATIN CALCIUM","80 MG","90","Select","Select",""],["","49035056317","ASPIRIN EC","81 MG","30","Select","Select",""],["","68382009305","CARVEDILOL","6.25 MG","60","Select","Select",""],["","00143924920","AMOXICILLIN-CLAVULANATE POTASS","875-125 MG","14","Select","Select",""],["","53746051101","SPIRONOLACTONE","25 MG","30","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":""}]}]}