{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TYLER COOK","gend":0,"add":"5982 OLD ROUTE 11 LOT 26","city":"DUBLIN","state":"VA","zip":"24084-9998","dob":"1996-08-02","age":"","mstatus":"","insh":"2274543*01","cliId":"","pno":5403155181,"cno":5403155181,"email":"","ename":"","eno":"","pphy":"STEWART, KNOTRESHA F MD","ppno":5408350500,"pcpadd":"28 TOWN CENTER DRIVE,","pcpcity":"DUBLIN","pcpstate":"VA","pcpzip":"24084-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":5403075070,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H61.23","E11.65","R19.00","G62.9","R11.2","R10.13","R10.11","K21.9","K82.8","K44.9","NO DATA","K31.89","K29.50","E78.5","I10.","F17.210","E11.40","Z79.899","Z20.822","Z79.4","Z79.84","K81.1","K29.30","L03.90","S90.02XA","R04.0","E11.9","F17.200","S90.32XA","W20.8XXA","E66.9","Z79.85","Z68.34","T22.20XA","H61.21","Z71.89","R21.","K75.81","F41.9","G47.00","M79.673","M79.606","H52.03","H52.223","H47.333","M25.519","R05.","R52.","R09.81","J02.9","K59.00","R30.0","F31.9","F90.9","K76.0","D13.2","K22.2","K29.70","M25.511","S43.491A","L03.317","R10.9","R11.0","K82.9","R73.9","R53.83","E55.9","J01.90","H52.523","R05.9","T22.131A","T22.132A","T22.231A","T22.232A","K83.9","Z11.52","H92.02","R05.1","R50.9","R06.89","K52.9","R19.7","R07.9","R06.02","E78.00"],"date":["2022-06-02","2022-10-17","2022-10-17","2022-08-15","2023-08-22","2022-08-24","2022-09-20","2022-08-24","2022-12-14","2022-12-14","2022-12-14","2022-09-20","2022-09-20","2022-10-27","2022-10-27","2022-10-27","2022-10-27","2023-05-22","2023-08-22","2022-12-15","2022-12-15","2022-12-14","2022-12-14","2021-12-17","2022-03-30","2022-03-30","2023-09-14","2022-12-15","2022-03-30","2022-03-30","2022-10-27","2022-10-27","2022-10-27","2022-12-15","2021-01-22","2021-01-22","2021-10-04","2022-08-15","2022-08-15","2022-08-15","2022-04-05","2022-04-05","2022-08-08","2022-08-08","2022-08-08","2021-10-12","2021-09-23","2021-09-23","2021-09-23","2023-04-23","2022-07-21","2022-07-21","2022-08-15","2022-09-08","2022-08-15","2022-09-20","2022-09-20","2022-09-20","2021-02-17","2021-02-17","2021-12-15","2022-07-15","2022-08-05","2022-10-17","2022-10-17","2023-04-23","2022-10-17","2022-06-02","2022-08-08","2022-09-08","2022-12-15","2022-12-15","2022-12-15","2022-12-15","2022-10-27","2023-01-16","2023-01-16","2023-04-23","2023-04-23","2023-04-23","2023-08-22","2023-08-22","2023-09-14","2023-09-14","2023-09-14"],"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":[["","00006011254","JANUVIA","TAB 50MG","30","Select","Select",""],["","72733590102","PRALUENT","INJ 75MG\/ML","2","Select","Select",""],["","72205000530","ROSUVASTATIN","TAB 40MG","30","Select","Select",""],["","00088221905","LANTUS SOLOS","INJ 100\/ML","15","Select","Select",""],["","72205001590","PREGABALIN","150 MG","60","Select","Select",""],["","43598065530","BUPROPN HCL","TAB 150MG XL","30","Select","Select",""],["","68180044501","QUETIAPINE","TAB 25MG","20","Select","Select",""],["","00002143380","TRULICITY","0.75MG\/0.5","2","Select","Select",""],["","55505019140","NIZORAL A-D","SHA 0.01","400","Select","Select",""],["","61874011530","VRAYLAR","CAP 1.5MG","30","Select","Select",""],["","31722099601","HYDROCO\/APAP","TAB 5-325MG","20","Select","Select",""],["","65162019011","NAPROXEN","TAB 500MG","20","Select","Select",""],["","68462029817","CLOTRIM\/BETA","CRE DIPROP","45","Select","Select",""],["","29033000305","SUCRALFATE","TAB 1GM","120","Select","Select",""],["","42571012290","LEVOCETIRIZI","TAB 5MG","30","Select","Select",""],["","00597015330","JARDIANCE","TAB 25MG","30","Select","Select",""],["","67877021905","CEPHALEXIN","CAP 500MG","20","Select","Select",""],["","00310652401","BYETTA","INJ 10MCG","2","Select","Select",""],["","31722071390","PANTOPRAZOLE","TAB 40MG","60","Select","Select",""],["","10702000709","CYCLOBENZAPR","TAB 10MG","60","Select","Select",""],["","59267100001","PFIZER VACC","INJ COVID-19","0","Select","Select",""],["","59746017310","PREDNISONE","TAB 10MG","10","Select","Select",""],["","42571016142","AMOX\/K CLAV","TAB 500-125","14","Select","Select",""],["","49100040051","CULTR ULTIMA","CAP STRENGTH","30","Select","Select",""],["","68382080601","TRAZODONE","TAB 100MG","30","Select","Select",""],["","65862044830","VALACYCLOVIR","TAB 500MG","10","Select","Select",""],["","42806071401","BENZONATATE","CAP 100MG","28","Select","Select",""],["","62135030901","CIPROFLOXACN","TAB 500MG","14","Select","Select",""],["","63304069301","CLINDAMYCIN","CAP 300MG","21","Select","Select",""],["","68645052354","SERTRALINE","TAB 100MG","30","Select","Select",""],["","16714075601","ATOMOXETINE","CAP 18MG","30","Select","Select",""],["","16714068403","SIMVASTATIN","TAB 40MG","30","Select","Select",""],["","57237002801","AMOXICILLIN","TAB 500MG","21","Select","Select",""],["","68645055054","LISINOPRIL","TAB 2.5MG","30","Select","Select",""],["","00169413013","OZEMPIC","INJ 4MG\/3ML","3","Select","Select",""],["","00005200010","PREVNAR 20","INJ ","0","Select","Select",""],["","49035007841","EQ STOOL","CAP SOFTENER","56","Select","Select",""],["","00904699880","DOCUSATE SOD","CAP 100MG","56","Select","Select",""],["","11523726803","MIRALAX","POW 3350 NF","30","Select","Select",""],["","79854007941","VITAMIN D3","TAB 5000UNIT","30","Select","Select",""],["","00093505998","ATORVASTATIN","TAB 20MG","30","Select","Select",""],["","50111078751","AZITHROMYCIN","250 MG","6","Select","Select",""],["","42806054701","VITAMIN D","2 1250 MCG","4","Select","Select",""],["","70710146707","COLESTIPOL","TAB 1GM","360","Select","Select",""],["","42858000101","OXYCODONE","TAB 5MG","10","Select","Select",""],["","00093220301","METOCLOPRAM","TAB 10MG","10","Select","Select",""],["","31722070090","LOSARTAN POTASSIUM","25 MG","30","Select","Select",""],["","65862014736","SUMATRIPTAN SUCCINATE","50 MG","8","Select","Select",""],["","68196085360",""," ","56","Select","Select",""],["","00002149580","MOUNJARO","5 MG\/0.5ML","2","Select","Select",""],["","00597015330","JARDIANCE TAB","25MG","30","Select","Select",""],["","00088221905","LANTUS SOLOS INJ","100\/ML","15","Select","Select",""],["","68180044501","QUETIAPINE TAB","25MG","20","Select","Select",""],["","16714075601","ATOMOXETINE CAP","18MG","30","Select","Select",""],["","43598065530","BUPROPN HCL TAB","150MG XL","30","Select","Select",""],["","62332012390","PREGABALIN CAP","150MG","56","Select","Select",""],["","16714068403","SIMVASTATIN TAB","40MG","30","Select","Select",""],["","00002143380","TRULICITY INJ","0.75\/0.5","2","Select","Select",""],["","65162019011","NAPROXEN TAB","500MG","20","Select","Select",""],["","00005200010","PREVNAR","20 INJ","0","Select","Select",""],["","00169413013","OZEMPIC INJ","4MG\/3ML","3","Select","Select",""],["","11523726803","MIRALAX POW","3350 NF","30","Select","Select",""],["","59746017310","PREDNISONE TAB","10MG","10","Select","Select",""],["","57237002801","AMOXICILLIN TAB","500MG","21","Select","Select",""],["","68645055054","LISINOPRIL TAB","2.5MG","30","Select","Select",""],["","49035007841","EQ STOOL CAP SOFTENER","","56","Select","Select",""],["","00904699880","DOCUSATE SOD CAP","100MG","56","Select","Select",""],["","50111078810","AZITHROMYCIN TAB","500MG","7","Select","Select",""],["","31722071390","PANTOPRAZOLE TAB","40MG","180","Select","Select",""],["","42806071401","BENZONATATE CAP","100MG","28","Select","Select",""],["","42806054701","VITAMIN D CAP","1.25MG","8","Select","Select",""],["","00093505998","ATORVASTATIN TAB","20MG","30","Select","Select",""],["","49100040051","CULTR ULTIMA CAP STRENGTH","","30","Select","Select",""],["","00093220301","METOCLOPRAM TAB","10MG","10","Select","Select",""],["","31722099601","HYDROCO\/APAP TAB","5-325MG","20","Select","Select",""],["","42858000101","OXYCODONE TAB","5MG","10","Select","Select",""],["","59762045001","COLESTIPOL TAB","1GM","360","Select","Select",""],["","31722071390","PANTOPRAZOLE SODIUM","40 MG","180","Select","Select",""],["","00228282011","HYDROCHLOROTHIAZIDE","12.5 MG","5","Select","Select",""],["","00093505998","ATORVASTATIN CALCIUM","20 MG","30","Select","Select",""],["","65862007701","CIPROFLOXACIN HCL","500 MG","14","Select","Select",""],["","00169418113","OZEMPIC .","25 OR 0.5","3","Select","Select",""],["","68462063945","NITROGLYCERIN","0.4 MG","25","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":""}]}]}