{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CLINTON MARSH","gend":0,"add":"1011 REXFORD DR","city":"GOODVIEW","state":"VA","zip":"24095-9998","dob":"1960-03-25","age":"","mstatus":"","insh":"2198626*01","cliId":"","pno":5408901146,"cno":5408901146,"email":"","ename":"","eno":"","pphy":"OLSEN, CHRISTOPHER DO","ppno":5409618040,"pcpadd":"282 WESTLAKE RD,","pcpcity":"HARDY","pcpstate":"VA","pcpzip":"24101-9998","pcpcounty":"","pcpid":"","pcpname":"Carilion Giles Community Hospital","plan":"OHP","program":"MEDICAID","lob":"M4","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":5409619466,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M96.1","M47.816","M47.817","NO DATA","M48.07","M41.86","M43.15","M43.16","M43.17","M51.34","M51.35","M51.37","M51.16","I25.10","R06.02","R07.9","R53.1","R53.83","Z95.5","Z95.1","R94.31","R06.83","E11.9","I10.","E78.2","I51.7","I25.110","I11.0","I50.32","D62.","E11.65","I48.91","E78.00","K21.9","I25.2","Z79.02","Z79.82","Z86.73","Z88.6","U07.1","I20.8","R68.83","E78.5","Z12.11","Z80.0","Z01.810","R00.1","I34.0","R10.9","R10.31","N28.9","E66.3","Z00.00","Z12.5","R07.89","M25.511","M25.512","R00.0","R06.00","R50.9","Z20.822","I25.84","I51.9","I65.23","I25.118","N17.9","Z98.890","Z23.","L57.0","Z79.4","H04.123","H10.9"],"date":["2022-07-13","2022-07-08","2022-07-08","2022-07-13","2022-07-08","2022-07-08","2022-07-08","2022-07-08","2022-07-08","2022-07-08","2022-07-08","2022-07-08","2022-07-13","2023-07-24","2022-08-02","2022-08-02","2022-08-02","2022-08-02","2023-04-11","2023-07-24","2022-08-17","2021-05-20","2023-07-24","2023-07-24","2023-07-24","2022-08-11","2022-08-19","2022-08-19","2022-11-09","2022-08-19","2022-08-22","2022-08-19","2022-08-19","2022-11-09","2022-08-19","2022-08-19","2022-08-19","2023-07-24","2022-08-19","2023-04-13","2021-04-19","2021-04-19","2022-08-10","2022-11-09","2021-05-04","2022-08-17","2022-08-17","2022-08-19","2023-02-03","2023-02-03","2021-03-16","2021-03-16","2021-03-16","2021-03-16","2022-10-28","2022-10-28","2022-10-28","2021-04-19","2021-04-19","2021-04-19","2021-04-19","2022-08-10","2022-08-11","2022-08-17","2021-04-22","2021-04-22","2022-03-03","2022-11-09","2022-11-09","2023-07-24","2023-07-25","2023-07-24"],"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":[["","68382000514","TOPIRAMATE","CAP 25MG","60","Select","Select",""],["","70377003012","ATORVASTATIN","TAB 80MG","45","Select","Select",""],["","67877019805","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","00186077760","BRILINTA","TAB 90MG","180","Select","Select",""],["","70010049110","METFORMIN","TAB 500MG ER","30","Select","Select",""],["","50742061510","METOPROL SUC","TAB 25MG ER","90","Select","Select",""],["","69238115409","EZETIMIBE","10 MG","90","Select","Select",""],["","00378668910","PANTOPRAZOLE","TAB 40MG","90","Select","Select",""],["","59779030603","CVS PURELAX","POW ","510","Select","Select",""],["","00172392770","DIAZEPAM","TAB 10MG","1","Select","Select",""],["","13668010510","ISOSORB MONO","TAB 60MG ER","90","Select","Select",""],["","43598029390","PREGABALIN","CAP 75MG","60","Select","Select",""],["","57664050658","METOPROL TAR","TAB 25MG","180","Select","Select",""],["","43547040211","FUROSEMIDE","TAB 40MG","5","Select","Select",""],["","53746054201","POT CHLORIDE","CAP 10MEQ ER","10","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","28","Select","Select",""],["","69097084507","CYCLOBENZAPR","TAB 5MG","15","Select","Select",""],["","57664050658","METOPROLOL TARTRATE","25 MG","30","Select","Select",""],["","70377002911","ATORVASTATIN CALCIUM","40 MG","90","Select","Select",""],["","70377000812","ROSUVASTATIN CALCIUM","20 MG","90","Select","Select",""],["","45802065078","LORATADINE","10 MG","30","Select","Select",""],["","00378668910","PANTOPRAZOLE SODIUM","40 MG","90","Select","Select",""],["","68180072003","AMLODIPINE BESYLATE","5 MG","90","Select","Select",""],["","00054327099","FLUTICASONE PROPIONATE","50 MCG","16","Select","Select",""],["","70010049110","METFORMIN HCL ER","500 MG","90","Select","Select",""],["","00069034530","PAXLOVID (EUA)","300-100 MG","30","Select","Select",""],["","68382000514","TOPIRAMATE CAP","25MG","60","Select","Select",""],["","70377003012","ATORVASTATIN TAB","80MG","45","Select","Select",""],["","70010049110","METFORMIN TAB","500MG ER","30","Select","Select",""],["","50742061510","METOPROL SUC TAB","25MG ER","90","Select","Select",""],["","68180072003","AMLODIPINE TAB","5MG","90","Select","Select",""],["","00378668910","PANTOPRAZOLE TAB","40MG","90","Select","Select",""],["","69238115409","EZETIMIBE TAB","10MG","90","Select","Select",""],["","00186077760","BRILINTA TAB","90MG","180","Select","Select",""],["","00172392770","DIAZEPAM TAB","10MG","1","Select","Select",""],["","59779030603","CVS PURELAX POW","","510","Select","Select",""],["","13668010510","ISOSORB MONO TAB","60MG ER","90","Select","Select",""],["","43598029390","PREGABALIN CAP","75MG","60","Select","Select",""],["","57664050658","METOPROL TAR TAB","25MG","30","Select","Select",""],["","43547040211","FUROSEMIDE TAB","40MG","5","Select","Select",""],["","10702001801","OXYCODONE TAB","5MG","28","Select","Select",""],["","53746054201","POT CHLORIDE CAP","10MEQ ER","10","Select","Select",""],["","69097084507","CYCLOBENZAPR TAB","5MG","15","Select","Select",""],["","53885092701","ONETOUCH VERIO REFLECT METER","","1","Select","Select",""],["","24208091055","ERYTHROMYCIN","5 MG\/GRAM","3.5","Select","Select",""],["","53885027210","ONETOUCH VERIO TEST STRIP","","100","Select","Select",""],["","53885001110","ONETOUCH DELICA PLUS LANCET","30 GAUGE","200","Select","Select",""],["","00597015230","JARDIANCE","10 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":""}]}]}