{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JOEY CRAIG","gend":0,"add":"6700 SHINGLE RIDGE RD APT 4A","city":"ROANOKE","state":"VA","zip":"24018-9998","dob":"1987-08-16","age":"","mstatus":"","insh":"2356048*01","cliId":"","pno":5403538939,"cno":5403538939,"email":"","ename":"","eno":"","pphy":"JONES, DIANNA L LNP","ppno":5409811102,"pcpadd":"3517 BRANDON AVE SW,","pcpcity":"ROANOKE","pcpstate":"VA","pcpzip":"24018-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":5405272900,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["S01.81XA","F20.9","G89.4","J20.9","Z72.0","F15.20","F12.20","F11.20","F19.20","F16.20","S00.81XA","S50.312A","M25.551","NO DATA","M54.2","R51.9","F11.21","Z11.1","Z11.3","F41.1","F43.10","N39.0","F15.10","R19.7","R10.9","F25.9","F19.922","R11.10","F17.200","L02.11","Z79.899","Z79.891","Z87.891","E11.9","F19.10","V62.84","Z20.822","F11.10","L03.221","L02.91","R50.9","M54.9","V49.40XA","R44.1","D64.9","R44.0","F32.9","V62.85","L02.412","F17.290","M79.622"],"date":["2021-06-21","2021-12-17","2021-10-08","2021-11-17","2021-11-17","2022-09-23","2021-12-17","2022-10-14","2021-12-17","2021-12-17","2022-08-15","2022-08-15","2022-08-15","2022-08-15","2022-08-15","2022-08-15","2022-09-23","2022-09-23","2022-09-23","2022-09-23","2022-09-23","2022-09-23","2021-10-26","2021-10-26","2021-10-26","2022-07-27","2022-07-27","2021-11-17","2021-11-17","2022-07-21","2022-10-12","2022-10-12","2021-10-26","2021-10-26","2021-12-25","2022-07-24","2021-12-25","2022-06-24","2022-07-19","2022-07-21","2022-07-21","2022-08-15","2022-08-15","2021-08-04","2021-08-04","2021-08-04","2021-08-03","2021-08-03","2023-07-19","2023-07-19","2023-07-19"],"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":[["","65862042005","SMZ\/TMP DS","TAB 800-160","20","Select","Select",""],["","57896050401","ONE-DAILY","TAB MULT VIT","30","Select","Select",""],["","96295013577","MULTIVITAMIN","TAB ADULTS","30","Select","Select",""],["","12496120403","SUBOXONE","MIS 4-1MG","14","Select","Select",""],["","30768015745","MELATONIN","TAB 5MG","30","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","00781717612","NALOXONE","SPR 4MG","2","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","15","Select","Select",""],["","11917002103","SENNA","TAB 8.6MG","30","Select","Select",""],["","00121043130","MILK OF MAGN","SUS ","330","Select","Select",""],["","55111015330","ONDANSETRON","TAB 4MG","20","Select","Select",""],["","00093342201","CYCLOBENZAPR","TAB 10MG","30","Select","Select",""],["","57896040110","DOCUSATE SOD","CAP 100MG","30","Select","Select",""],["","00378668910","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","82607066026","FLOWFLEX","KIT TEST","8","Select","Select",""],["","14613033972","QUICKVUE HOM","KIT COVID-19","2","Select","Select",""],["","59267030402","PFIZER BIVAL","INJ BA4\/BA5","0","Select","Select",""],["","67877032005","IBUPROFEN","TAB 600MG","60","Select","Select",""],["","70000003401","ANTACID","CHW 500MG","100","Select","Select",""],["","19515080852","FLULAVAL QUA","INJ 2022-23","0","Select","Select",""],["","54629011090","FERROUS SULF","TAB 325MG","30","Select","Select",""],["","65862042005","SULFAMETHOXAZOLE-TRIMETHOPRIM","800-160 MG","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":""}]}]}