{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ROBERT D SNEAD","gend":0,"add":"2507 FLORALAND DR NW","city":"ROANOKE","state":"VA","zip":"24012-9998","dob":"1973-02-28","age":"","mstatus":"","insh":"2284113*01","cliId":"","pno":5403437227,"cno":5403437227,"email":"","ename":"","eno":"","pphy":"GADDAM, SHRAVAN KUMAR R MD","ppno":5409817653,"pcpadd":"SUITE 302 2001 CRYSTAL SPRG AVE,","pcpcity":"ROANOKE","pcpstate":"VA","pcpzip":"24014-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":5409817469,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R94.31","F10.10","F32.9","F19.94","Z59.00","K21.9","F10.20","R10.13","Z59.02","K70.0","R11.2","J06.9","R09.81","J34.89","R05.9","F10.230","T73.0XXA","F10.129","F10.14","V62.84","R51.9","R00.0","R44.0","F10.229","R56.9","R10.9","F17.200","Z20.822","R07.89","F10.929","G40.201","J40.","J32.9","R42.","Z79.891","Z79.899","F10.120","J45.909","G89.29","R11.0","F33.2","R06.02","R50.9","R07.9","R53.83","Z76.5","Z53.29","Z87.891","E83.42","F33.9","M54.5","Z11.52","W19.XXXD","F10.220","Y90.8","F99.","NO DATA","R11.10","I10.","F10.99","K29.80","B96.81","Z72.0","R44.1","R44.3","F34.1","E87.6","H61.22","R19.7","B19.9","A04.8","E80.6","R80.9","K76.0","E86.0","J30.9","F10.920","R10.84","R78.0","E87.1","M79.671","K29.70","R73.9","I25.10","Z72.89","T14.8XXA","Z79.51","B34.9","R47.81","R52.","W19.XXXA","X50.0XXA","Y92.9","Y90.9","Z59.0","K30.","S39.012A","Z81.1","Z82.49","Z83.3","Z87.19","F29.","V62.85","F10.239","E74.01","F19.939","Z02.9","H35.373","H52.13","H52.223","H52.4"],"date":["2022-04-05","2022-01-12","2021-11-24","2022-04-19","2022-03-09","2023-03-13","2022-09-28","2022-04-03","2021-11-22","2022-04-19","2022-04-03","2023-03-13","2021-12-14","2021-12-14","2022-05-22","2022-04-19","2022-01-07","2022-01-07","2022-02-04","2022-03-09","2022-02-18","2022-02-18","2022-02-18","2022-03-09","2022-03-09","2022-03-09","2022-03-09","2023-03-13","2022-03-09","2022-03-09","2022-03-09","2022-06-20","2022-06-20","2022-06-20","2022-10-12","2022-10-12","2021-12-04","2023-03-13","2021-02-18","2021-10-23","2021-12-11","2023-03-13","2021-10-27","2022-04-03","2021-12-07","2021-12-07","2021-12-20","2022-02-18","2022-04-06","2022-06-02","2021-03-26","2021-05-14","2021-03-26","2021-05-01","2021-05-01","2021-12-07","2022-01-29","2022-01-12","2022-04-06","2022-01-10","2022-04-19","2022-04-19","2023-03-13","2021-11-13","2021-11-13","2021-11-13","2022-04-06","2022-04-06","2022-04-06","2022-04-06","2022-04-06","2022-04-06","2022-04-06","2022-04-06","2022-04-06","2022-05-22","2021-03-13","2021-03-13","2021-03-13","2021-09-15","2021-09-20","2021-09-20","2021-09-20","2021-09-15","2021-12-01","2021-12-01","2021-12-01","2022-01-09","2021-03-13","2021-03-13","2021-03-13","2021-03-25","2021-03-25","2021-04-19","2021-04-21","2021-05-14","2021-12-01","2021-12-04","2021-12-04","2021-12-04","2021-12-04","2021-03-23","2021-03-23","2021-12-11","2022-01-29","2022-04-03","2021-09-14","2022-07-14","2022-07-14","2022-07-14","2022-07-14"],"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":[["","30768048678","MELATONIN","TAB 3MG","60","Select","Select",""],["","57664050083","MIRTAZAPINE","TAB 30MG","30","Select","Select",""],["","65862056090","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","50111043302","TRAZODONE","TAB 50MG","30","Select","Select",""],["","80681006400","THEREMS","TAB MULTIVIT","30","Select","Select",""],["","67877022301","GABAPENTIN","CAP 300MG","180","Select","Select",""],["","00093226401","AMOXICILLIN","TAB 875MG","20","Select","Select",""],["","80681016900","VITAMIN D3","TAB 25MCG","60","Select","Select",""],["","66825000201","FLORASTOR","CAP 250MG","60","Select","Select",""],["","00781196260","CLARITHROMYC","TAB 500MG","20","Select","Select",""],["","00185067401","HYDROXYZ PAM","CAP 25MG","45","Select","Select",""],["","24385010878","GNP VIT B1","TAB 100MG","30","Select","Select",""],["","69097083512","SERTRALINE","TAB 100MG","30","Select","Select",""],["","68180098003","LISINOPRIL","TAB 10MG","30","Select","Select",""],["","23155050110","HYDROXYZ HCL","TAB 25MG","90","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","65162036111","FOLIC ACID","TAB 1MG","30","Select","Select",""],["","55111069990","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","48433010801","VITAMIN B-1","TAB 100MG","30","Select","Select",""],["","51224020650","NALTREXONE","TAB 50MG","30","Select","Select",""],["","42806071501","BENZONATATE","200 MG","9","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","50111078855","AZITHROMYCIN","TAB 500MG","3","Select","Select",""],["","64380073706","VITAMIN D","CAP 50000UNT","4","Select","Select",""],["","68382013506","LOSARTAN POT","TAB 25MG","30","Select","Select",""],["","10135013210","THIAMINE HCL","TAB 100MG","30","Select","Select",""],["","10006070011","VITAMIN B1","TAB 100MG","30","Select","Select",""],["","65862050320","AMOX\/K CLAV","TAB 875-125","14","Select","Select",""],["","63824060064","MUCINEX MS","LIQ COLD NGH","236","Select","Select",""],["","96295013577","MULTIVITAMIN","TAB ADULTS","30","Select","Select",""],["","30768048678","MELATONIN TAB","3MG","30","Select","Select",""],["","13107003134","MIRTAZAPINE TAB","15MG","30","Select","Select",""],["","00536466038","THEREMS TAB","","30","Select","Select",""],["","67877022305","GABAPENTIN CAP","300MG","180","Select","Select",""],["","65862056090","PANTOPRAZOLE TAB","40MG","30","Select","Select",""],["","50111043302","TRAZODONE TAB","50MG","30","Select","Select",""],["","96295013577","MULTIVITAMIN TAB ADULTS","","30","Select","Select",""],["","55111069990","CETIRIZINE TAB","10MG","30","Select","Select",""],["","47335034483","CETIRIZINE CHW","10MG","30","Select","Select",""],["","00781196260","CLARITHROMYC TAB","500MG","20","Select","Select",""],["","65162036111","FOLIC ACID TAB","1MG","30","Select","Select",""],["","10006070011","VITAMIN B","1 TAB 100MG","30","Select","Select",""],["","00093226401","AMOXICILLIN TAB","875MG","20","Select","Select",""],["","64380073706","VITAMIN D CAP","50000UNT","4","Select","Select",""],["","69097083512","SERTRALINE TAB","100MG","30","Select","Select",""],["","42806071401","BENZONATATE CAP","100MG","15","Select","Select",""],["","00781261305","AMOXICILLIN CAP","500MG","40","Select","Select",""],["","66993001968","ALBUTEROL AER HFA","","18","Select","Select",""],["","65862020190","LOSARTAN POT TAB","25MG","30","Select","Select",""],["","00185067405","HYDROXYZ PAM CAP","25MG","90","Select","Select",""],["","60505082901","FLUTICASONE SPR","50MCG","16","Select","Select",""],["","50111078855","AZITHROMYCIN TAB","500MG","3","Select","Select",""],["","48433010801","VITAMIN B-","1 TAB 100MG","30","Select","Select",""],["","00406117001","NALTREXONE TAB","50MG","30","Select","Select",""],["","10135013210","THIAMINE HCL TAB","100MG","30","Select","Select",""],["","63824060064","MUCINEX MS LIQ COLD NGH","","236","Select","Select",""],["","66825000201","FLORASTOR CAP","250MG","60","Select","Select",""],["","23155050110","HYDROXYZ HCL TAB","25MG","90","Select","Select",""],["","68180098003","LISINOPRIL TAB","10MG","30","Select","Select",""],["","80681006400","THEREMS TAB MULTIVIT","","30","Select","Select",""],["","24385010878","GNP VIT B","1 TAB 100MG","30","Select","Select",""],["","67877042805","GABAPENTIN TAB","600MG","90","Select","Select",""],["","65862050320","AMOX\/K CLAV TAB","875-125","14","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":""}]}]}