{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JAMIE L HUBBARD","gend":1,"add":"506 HUNTERS DR","city":"NEW CASTLE","state":"VA","zip":"24127-9998","dob":"1979-10-23","age":"","mstatus":"","insh":"2335390*01","cliId":"","pno":5405885097,"cno":5405885097,"email":"","ename":"","eno":"","pphy":"HANSBARGER, JOHN MD","ppno":5408646390,"pcpadd":"226 MARKET STREET,","pcpcity":"NEW CASTLE","pcpstate":"VA","pcpzip":"24127-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":5408646356,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.1","F43.12","J45.50","F12.99","Z63.0","Z65.8","Z91.410","Z91.49","J45.40","R20.2","Z23.","J32.9","K13.70","E83.51","C73.","J33.9","J34.89","J34.2","J34.3","Z72.0","H93.13","K08.9","M54.42","Z76.0","R03.0","M54.41","G89.29","J45.909","R13.10","R14.0","K21.9","G47.30","E89.0","F33.0","F41.1","M25.532","M25.522","E03.9","Z79.890","Z79.899","R53.1","D50.9","M54.9","R20.0","N39.46","R06.02","NO DATA","S01.01XS","Z01.818","F15.10","E55.9","M62.838","F41.0","G45.9","Z68.41","F17.200","I10.","J44.9","E66.9","D72.829","D53.9","R29.810","R73.03","Z79.82","R10.11","Z11.52","M99.00","M99.01","M99.02","M99.03","M99.05","M99.08","M99.06","M99.07","M99.04","E07.9","H00.025","R30.0","R10.31","F41.9","Z86.59","S01.81XA","R53.81","E20.9","F43.10","N88.8","M47.814","M47.817","M51.44","Z79.51","R10.9","F33.3"],"date":["2023-09-27","2022-10-19","2022-01-07","2022-02-16","2021-05-10","2021-05-10","2021-05-10","2021-05-10","2022-11-11","2022-10-14","2022-10-14","2023-03-20","2023-03-20","2023-03-20","2023-03-20","2023-03-20","2023-03-20","2023-03-20","2023-03-20","2023-03-20","2023-03-20","2023-03-20","2022-04-19","2022-01-07","2021-04-20","2022-04-19","2022-09-15","2022-11-01","2021-01-18","2021-01-18","2022-01-12","2021-01-18","2022-09-15","2022-01-07","2022-10-14","2022-01-19","2022-01-12","2022-01-12","2023-01-04","2023-01-04","2022-09-09","2022-09-09","2022-09-09","2022-10-14","2022-09-15","2022-09-15","2023-01-19","2023-01-27","2021-01-13","2022-10-12","2021-01-07","2022-01-27","2022-09-08","2022-09-08","2022-09-08","2022-09-08","2023-01-15","2023-01-15","2022-09-08","2022-09-08","2022-09-08","2022-09-08","2022-09-08","2023-01-15","2023-01-15","2022-02-08","2022-04-19","2022-04-19","2022-04-19","2022-04-19","2022-04-19","2022-04-19","2022-04-19","2022-04-19","2022-04-19","2022-09-08","2022-09-13","2022-09-13","2023-01-15","2023-01-19","2023-01-19","2023-01-19","2022-09-08","2022-10-14","2022-10-14","2023-01-04","2023-01-04","2023-01-04","2023-01-04","2023-01-04","2023-01-04","2023-07-05"],"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":[["","57896048930","POLYETH GLYC","POW 3350 NF","510","Select","Select",""],["","69097084615","CYCLOBENZAPR","TAB 10MG","60","Select","Select",""],["","69097082412","CITALOPRAM","TAB 40MG","30","Select","Select",""],["","23155002405","BUSPIRONE","TAB 10MG","180","Select","Select",""],["","31722072610","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","66993058697","FLUTIC\/SALME","AER 500\/50","60","Select","Select",""],["","64764017530","DEXILANT","CAP 60MG DR","30","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8","Select","Select",""],["","00173069700","ADVAIR DISKU","AER 500\/50","60","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","16729045317","LEVOTHYROXIN","TAB 125MCG","40","Select","Select",""],["","00781286810","OMEPRAZOLE","20 MG","60","Select","Select",""],["","23155066301","CALCITRIOL","0.5 MCG","30","Select","Select",""],["","00597016061","SPIRIVA","AER 1.25MCG","4","Select","Select",""],["","57896074201","CALCIUM\/D","TAB 500MG","90","Select","Select",""],["","57237001999","DULOXETINE","CAP 60MG","30","Select","Select",""],["","69097042207","CELECOXIB","100 MG","60","Select","Select",""],["","00904671746","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","200","Select","Select",""],["","96295013597","CALCIUM+D","3 TAB 600-20","100","Select","Select",""],["","45802006003","BACITRACIN","OIN 500\/GM","28","Select","Select",""],["","65162027250","SMZ\/TMP DS","TAB 800-160","20","Select","Select",""],["","70000040701","ANTISEPTIC","SOL 0.04","237","Select","Select",""],["","69230030401","ALLERGY RELI","TAB 10MG","30","Select","Select",""],["","49502010202","EPINEPHRINE","INJ 0.3MG","2","Select","Select",""],["","49502050002","EPIPEN 2-PAK","INJ 0.3MG","2","Select","Select",""],["","60505083001","MOMETASONE","SPR 50MCG","17","Select","Select",""],["","96295013597","CALCIUM+D3","TAB 600-20","100","Select","Select",""],["","62756014202","METFORMIN","TAB 500MG ER","30","Select","Select",""],["","00093227434","AMOX\/K CLAV","TAB 500-125","20","Select","Select",""],["","00378932232","WIXELA INHUB","AER 500\/50","60","Select","Select",""],["","00904759180","FEROSUL","TAB 325MG","15","Select","Select",""],["","00904675180","ASPIRIN LOW","TAB 81MG EC","30","Select","Select",""],["","24208091055","ERYTHROMYCIN","OIN 5MG\/GM","4","Select","Select",""],["","69097017353","IPRATROPIUM\/","SOL ALBUTER","90","Select","Select",""],["","50242021401","XOLAIR","INJ 75\/0.5","4","Select","Select",""],["","16729045617","LEVOTHYROXINE SODIUM","175 MCG","30","Select","Select",""],["","49483069250","ALLERGY RELIEF","10 MG","30","Select","Select",""],["","57237001999","DULOXETINE HCL","60 MG","30","Select","Select",""],["","10702000710","CYCLOBENZAPRINE HCL","10 MG","90","Select","Select",""],["","00173069700","ADVAIR DISKUS","500-50 MCG","60","Select","Select",""],["","68180096301","ALBUTEROL SULFATE HFA","90 MCG","8.5","Select","Select",""],["","00378623301","CITALOPRAM HBR","40 MG","30","Select","Select",""],["","23155002405","BUSPIRONE HCL","10 MG","180","Select","Select",""],["","67877041305","METFORMIN HCL ER","500 MG","30","Select","Select",""],["","60505083001","MOMETASONE FUROATE","50 MCG","17","Select","Select",""],["","31722072610","MONTELUKAST SODIUM","10 MG","30","Select","Select",""],["","68462019005","NAPROXEN","500 MG","10","Select","Select",""],["","66993058697","FLUTICASONE-SALMETEROL","500-50 MCG","60","Select","Select",""],["","65862018601","CLINDAMYCIN HCL","300 MG","15","Select","Select",""],["","60505082901","FLUTICASONE PROPIONATE","50 MCG","16","Select","Select",""],["","57237001930","DULOXETINE CAP","60MG","30","Select","Select",""],["","69097042207","CELECOXIB CAP","100MG","60","Select","Select",""],["","31722072610","MONTELUKAST TAB","10MG","30","Select","Select",""],["","59310057922","PROAIR HFA AER","","8","Select","Select",""],["","23155002405","BUSPIRONE TAB","10MG","180","Select","Select",""],["","00173069700","ADVAIR DISKU AER","500\/50","60","Select","Select",""],["","60505083001","MOMETASONE SPR","50MCG","17","Select","Select",""],["","10702000710","CYCLOBENZAPR TAB","10MG","90","Select","Select",""],["","69230030401","ALLERGY RELI TAB","10MG","30","Select","Select",""],["","69097082412","CITALOPRAM TAB","40MG","30","Select","Select",""],["","00781286810","OMEPRAZOLE CAP","20MG","60","Select","Select",""],["","49502010202","EPINEPHRINE INJ","0.3MG","2","Select","Select",""],["","57896048930","POLYETH GLYC POW","3350 NF","510","Select","Select",""],["","49502050002","EPIPEN","2-PAK INJ 0.3MG","2","Select","Select",""],["","16729045617","LEVOTHYROXIN TAB","175MCG","30","Select","Select",""],["","00093227434","AMOX\/K CLAV TAB","500-125","20","Select","Select",""],["","62756014202","METFORMIN TAB","500MG ER","30","Select","Select",""],["","68180096301","ALBUTEROL AER HFA","","8","Select","Select",""],["","69452020820","CALCITRIOL CAP","0.5MCG","30","Select","Select",""],["","00378932232","WIXELA INHUB AER","500\/50","60","Select","Select",""],["","00904675180","ASPIRIN LOW TAB","81MG EC","30","Select","Select",""],["","00904679480","ASPIRIN LOW CHW","81MG","30","Select","Select",""],["","24208091055","ERYTHROMYCIN OIN","5MG\/GM","4","Select","Select",""],["","00904759180","FEROSUL TAB","325MG","15","Select","Select",""],["","50242021501","XOLAIR INJ","150MG\/ML","4","Select","Select",""],["","00904671746","CETIRIZINE TAB","10MG","30","Select","Select",""],["","69097017353","IPRATROPIUM\/ SOL ALBUTER","","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":""}]}]}