{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MEL PEARSON","gend":1,"add":"PO BOX 231","city":"LEBANON","state":"VA","zip":"24266-9998","dob":"1991-08-12","age":"","mstatus":"","insh":"2266899*01","cliId":"","pno":2768831290,"cno":2768831290,"email":"","ename":"","eno":"","pphy":"LOUTHAN, JAMES D MD","ppno":4238572800,"pcpadd":"STE 200 2033 MEADOWVIEW LN","pcpcity":"KINGSPORT","pcpstate":"TN","pcpzip":"37660-9998","pcpcounty":"","pcpid":"","pcpname":"Holston Medical Group PC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"SOUTHWEST","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4238572801,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["L50.5","L50.3","M19.90","M25.50","F33.8","J45.909","R79.89","Z87.891","R10.11","M25.561","M25.571","M79.671","R07.9","Z90.13","F41.1","K21.9","NO DATA","Z23.","J06.9","Z20.828","L03.211","L02.01","F64.9","K20.0","L50.8","J45.20","J30.1","R21.","G56.02","Z48.811","G56.01","N64.89","L02.213","L76.82","F17.290","Z82.49","Z88.1","Z88.2","Z88.8","S60.051A","W22.8XXA","S64.491A","R07.89","R10.13","S96.911A","X58.XXXA","M54.6","Z79.51","M54.9","S83.62XA","Z91.018","S63.502A","S83.92XA","R11.10","Z20.822","F90.1","M25.562","Z78.9","Z72.0","Z79.899","M23.90","R55.","R42.","R41.0","R51.9","R00.2","R11.0","R53.83","L70.0","L98.8","L50.9","S61.211A","R13.14","Z87.19","R10.12","R29.898","R93.7","B34.9","S89.92XA","G56.03","R20.0","Z11.52","V58.89","M76.71","G57.61","M21.41","R10.9","R07.81","C50.919","R60.9","F32.1","R05.9","J01.41","R50.9","G89.18","M79.645","F64.0","N39.0","R39.11","R34.","R11.2","R19.7","M62.81","L02.424","L02.423","B07.8","Z48.02","F17.210","S83.8X2A","Z90.49","S80.02XA","M23.92","R20.2","Z11.1","E78.49","G47.00","R13.10","M22.2X2","E88.81","Z90.10","W18.42XA","X50.1XXA","L02.426","L02.425","R00.0","M79.644","M51.36"],"date":["2022-10-31","2022-12-07","2021-06-16","2021-06-16","2022-04-06","2022-04-14","2021-09-22","2023-05-08","2021-09-22","2021-11-18","2021-09-22","2021-09-22","2022-12-07","2022-12-07","2023-05-08","2022-12-14","2023-05-08","2021-10-20","2023-01-16","2022-01-25","2022-03-20","2022-03-20","2022-11-28","2022-11-02","2022-06-03","2023-01-16","2023-05-08","2022-07-01","2022-09-19","2022-08-24","2022-08-24","2022-12-06","2022-12-07","2022-12-07","2022-12-07","2022-12-07","2022-12-07","2022-12-07","2022-12-07","2023-01-17","2023-01-17","2021-03-04","2021-04-19","2021-04-19","2021-08-20","2021-08-20","2022-01-19","2021-10-29","2021-10-29","2022-01-06","2021-11-30","2022-01-27","2022-01-27","2022-01-27","2023-01-16","2023-05-08","2022-04-20","2023-03-07","2022-04-14","2022-04-14","2022-04-20","2022-07-06","2022-07-06","2022-07-06","2022-08-08","2022-07-20","2022-07-06","2022-07-06","2023-03-07","2023-03-07","2021-02-28","2021-03-04","2021-09-24","2021-07-29","2021-11-18","2022-01-18","2022-01-18","2022-01-27","2022-01-27","2022-08-03","2022-06-16","2022-09-12","2021-09-03","2021-07-06","2021-09-03","2021-09-03","2021-11-15","2022-01-05","2022-01-05","2022-03-20","2023-05-08","2023-01-16","2023-03-25","2023-03-25","2021-03-04","2021-03-04","2021-03-24","2021-03-24","2021-11-03","2021-11-03","2022-04-07","2022-04-07","2022-02-09","2022-09-07","2022-09-07","2023-03-07","2021-01-06","2021-01-06","2021-10-03","2021-10-03","2022-04-16","2022-04-20","2022-07-19","2022-10-26","2021-06-23","2021-06-23","2021-08-25","2021-10-21","2022-02-06","2022-03-02","2022-04-20","2021-10-03","2022-09-07","2022-09-07","2023-01-17","2023-01-17","2023-05-04"],"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":[["","62756001540","TESTOST CYP","INJ 200MG\/ML","10","Select","Select",""],["","31722099601","HYDROCO\/APAP","TAB 5-325MG","28","Select","Select",""],["","66993059602","AMPHET\/DEXTR","CAP 15MG ER","30","Select","Select",""],["","54092038501","ADDERALL XR","CAP 15MG","30","Select","Select",""],["","49035078443","ALLERGY RELF","TAB 180MG","60","Select","Select",""],["","00591352530","LIDOCAINE","5 %","15","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","55111078401","FEXOFENADINE","TAB 180MG","60","Select","Select",""],["","68382080601","TRAZODONE","TAB 100MG","30","Select","Select",""],["","00173068224","VENTOLIN HFA","AER ","8","Select","Select",""],["","08290309572","3ML LL SYRNG","MIS 22GX1\"","2","Select","Select",""],["","31722071390","PANTOPRAZOLE","TAB 40MG","60","Select","Select",""],["","50742019001","CYPROHEPTAD","TAB 4MG","120","Select","Select",""],["","68382004101","PROMETHAZINE","TAB 25MG","20","Select","Select",""],["","29300022019","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","13668001101","CITALOPRAM","TAB 40MG","30","Select","Select",""],["","69238110002","DOXYCYCL HYC","CAP 100MG","60","Select","Select",""],["","51672140004","CLINDAMYCIN","LOT 0.01","60","Select","Select",""],["","67405082505","BENZOYL PER","LIQ 5% WASH","296","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","20","Select","Select",""],["","00472011745","TRETINOIN","0.025 %","45","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","68645056354","IBUPROFEN","800 MG","60","Select","Select",""],["","68462015713","ONDANSETRON","TAB 4MG ODT","20","Select","Select",""],["","00173072020","FLOVENT HFA","220 MCG","12","Select","Select",""],["","63646001004","KETOCONAZOLE","SHA 0.02","120","Select","Select",""],["","68382091634","METHYLPRED","TAB 4MG","21","Select","Select",""],["","49035036659",""," ","60","Select","Select",""],["","00093598627","EPINEPHRINE","INJ 0.3MG","2","Select","Select",""],["","55111014601","FLUCONAZOLE","TAB 200MG","4","Select","Select",""],["","63304007601","POT CHLORIDE","TAB 10MEQ ER","20","Select","Select",""],["","47335099436","WINLEVI","1 %","60","Select","Select",""],["","62332014231","CELECOXIB","200 MG","180","Select","Select",""],["","59762040101","SUCRALFATE","TAB 1GM","56","Select","Select",""],["","49281042250","FLUZONE QUAD","INJ 2022-23","0","Select","Select",""],["","00172572960","FAMOTIDINE","TAB 40MG","14","Select","Select",""],["","65162062711","TRAMADOL HCL","TAB 50MG","3","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","15","Select","Select",""],["","16729044310","BUPROPN HCL","TAB 150MG XL","30","Select","Select",""],["","59267030402","PFIZER BIVAL","INJ BA4\/BA5","0","Select","Select",""],["","52817033200","CYCLOBENZAPR","TAB 10MG","21","Select","Select",""],["","80777028299","MODERNA BIVA","INJ BA4\/BA5","0","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","28","Select","Select",""],["","00054327099","FLUTICASONE PROPIONATE","50 MCG","16","Select","Select",""],["","66993001968","ALBUTEROL SULFATE HFA","90 MCG","18","Select","Select",""],["","29300022019","MONTELUKAST SODIUM","10 MG","90","Select","Select",""],["","16729044310","BUPROPION XL","150 MG","90","Select","Select",""],["","68382080601","TRAZODONE HCL","100 MG","90","Select","Select",""],["","00143924920","AMOXICILLIN-CLAVULANATE POTASS","875-125 MG","20","Select","Select",""],["","00024591502","DUPIXENT PEN","300 MG\/2ML","8","Select","Select",""],["","31722071390","PANTOPRAZOLE SODIUM","40 MG","90","Select","Select",""],["","13668001101","CITALOPRAM HBR","40 MG","90","Select","Select",""],["","29300041519","CYCLOBENZAPRINE HCL","10 MG","30","Select","Select",""],["","55111078401","FEXOFENADINE HCL","180 MG","180","Select","Select",""],["","35573045391","BENZOYL PEROXIDE","5 %","296","Select","Select",""],["","65162083366","DICLOFENAC SODIUM","1 %","100","Select","Select",""],["","49035078443","ALLERGY RELIEF","180 MG","60","Select","Select",""],["","70710111001","CYPROHEPTADINE HCL","4 MG","180","Select","Select",""],["","69238110002","DOXYCYCLINE HYCLATE","100 MG","20","Select","Select",""],["","68382005105","MELOXICAM","15 MG","12","Select","Select",""],["","65162047810","NITROFURANTOIN MONO-MACRO","100 MG","14","Select","Select",""],["","66993059602","DEXTROAMPHETAMINE-AMPHET ER","15 MG","30","Select","Select",""],["","51672140004","CLINDAMYCIN PHOSPHATE","1 %","60","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":""}]}]}