{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MELLISA   A STONE","gend":1,"add":"235   RED POLE HOLLOW DRIVE                                 ","city":"BASSETT                       ","state":"VA","zip":"24055-4019","dob":"1979-01-08","age":"","mstatus":"","insh":6818528,"cliId":"","pno":2768061108,"cno":"","email":"","ename":"","eno":"","pphy":"KUMAR, PARDEEP                                              ","ppno":2766667723,"pcpadd":"5784 Virginia Ave                                           ,                                                            ","pcpcity":"Bassett                       ","pcpstate":"VA","pcpzip":240553879,"pcpcounty":"","pcpid":"","pcpname":"MARTINSVILLE PHYSICIAN PRACTICES","plan":"VPHP","program":"MEDICAID","lob":"MLTSS","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"235   RED POLE HOLLOW DRIVE                                 ","add3":"","madd1":"235   RED POLE HOLLOW DRIVE                                 ","madd2":"                                                            ","madd3":"","mcity":"BASSETT                       ","mstate":"VA","mzip":"24055-4019","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R07.89","F17.210","Z72.0","H69.93","H61.22","Z01.419","Z12.31","Z68.41","N92.1","R07.9","G44.89","E11.42","M79.2","R94.31","E78.00","E78.1","E55.9","E11.49","I10","R51","E08.00","Z79.4","N93.9","R23.2","R06.2","R05","R09.89","Z20.828","R53.81","Z88.1","Z88.2","Z79.899","E11.9","H65.02","L03.011","L03.113","J45.909","M79.7","Z88.8","M79.641","G43.709","G43.109","G47.19","F40.240","H66.003","R20.0","R20.2","R06.83","R35.1","E66.9","F45.8","R40.0","R51.9","Z82.0","R06.81","G44.52","H53.8","G47.33","G47.30","G47.10","G47.61","Z79.82","E11.59","M79.605","M25.562","M79.18","M17.12","M62.81","M70.52","E66.01","R53.1","R26.89","E11.65","Z87.891","F17.200","M25.532","I15.2","Z20.822","J34.89","J45.901","J01.00","E11.29","R80.9","B37.3","B86","R21","G56.00","G56.01","G56.03"],"date":["2020-01-08","2022-03-21","2020-01-08","2020-01-30","2020-01-30","2021-02-03","2022-06-30","2022-06-05","2021-02-03","2020-02-07","2020-10-29","2022-04-20","2022-04-20","2020-02-07","2022-03-21","2022-03-21","2020-02-28","2022-04-20","2022-06-13","2020-02-28","2020-12-22","2022-06-13","2020-03-02","2020-05-14","2020-05-20","2020-05-20","2020-05-20","2020-05-20","2020-05-20","2022-07-25","2022-07-25","2021-05-07","2022-06-05","2020-09-04","2020-09-12","2020-09-12","2020-09-12","2022-06-05","2020-09-12","2020-09-12","2021-03-02","2022-04-20","2020-11-13","2020-11-13","2020-11-22","2022-11-29","2022-11-29","2021-02-09","2021-01-05","2021-04-26","2021-01-05","2021-01-05","2021-02-09","2021-04-26","2021-01-05","2021-01-25","2021-01-25","2022-10-13","2021-02-09","2021-02-09","2021-02-09","2021-02-09","2022-04-20","2021-04-26","2022-02-08","2021-04-26","2022-02-10","2021-06-29","2022-02-10","2022-06-05","2022-02-08","2022-02-08","2022-02-10","2022-03-02","2022-03-21","2022-04-12","2022-04-20","2022-06-05","2022-06-05","2022-06-13","2022-06-13","2022-06-13","2022-06-13","2022-06-30","2022-07-25","2022-07-25","2022-09-28","2022-09-28","2022-10-26"],"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":[["","57599000101","FREESTYLE    KIT SENSOR","KIT SENSOR","2","Select","Select",""],["","00002143480","TRULICITY","INJ 1.5\/0.5","2","Select","Select",""],["","31604001870","VITAMIN","TAB 1000UNIT","60","Select","Select",""],["","","HYDROCHLOROT","CAP 12.5MG","30","Select","Select",""],["","68382009810","PAROXETINE","TAB 20MG","30","Select","Select",""],["","","DULOXETINE","CAP 30MG","30","Select","Select",""],["","68382013805","TOPIRAMATE","TAB 25MG","90","Select","Select",""],["","","PREGABALIN","CAP 75MG","60","Select","Select",""],["","08290320119","BD  PEN NEEDL","MIS 31GX5MM","100","Select","Select",""],["","00169255013","TRESIBA","INJ 200UNIT","45","Select","Select",""],["","43547033510","BENAZEPRIL","TAB 5MG","90","Select","Select",""],["","55111012305","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","60258016101","RENA-VITE","TAB ","30","Select","Select",""],["","16571020210","DICLOFENAC","TAB 50MG DR","16","Select","Select",""],["","57237000511","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","00378729189","NORETHIN","TAB 5MG","60","Select","Select",""],["","","ASPIRIN","CHW 81MG","30","Select","Select",""],["","64380076111","OMEGA-3-ACID","CAP 1GM","90","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","30","Select","Select",""],["","65862078330","ESOMEPRA","CAP 20MG DR","30","Select","Select",""],["","73070010315","INSULIN","INJ FLEXPEN","3","Select","Select",""],["","45802000125","NICOTINE","GUM 4MG MINT","40","Select","Select",""],["","00378363405","CARVEDILOL","TAB 25MG","180","Select","Select",""],["","67877056305","METFORMIN","TAB 1000MG","60","Select","Select",""],["","42806071501","BENZONATATE","CAP 200MG","50","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","45802026937","PERMETHRIN","CRE 0.05","60","Select","Select",""],["","70954006020","PREDNISONE","TAB 20MG","8","Select","Select",""],["","00781808926","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","69097014260","ALBUTEROL","AER HFA","6.7","Select","Select",""],["","31604002683","D3","TAB 1000UNIT","60","Select","Select",""],["","00904530660","BANOPHEN","CAP 25MG","30","Select","Select",""],["","11917004954","HYDROCORT","CRE 0.005","56","Select","Select",""],["","29300012510","MELOXICAM","TAB 15MG","30","Select","Select",""],["","43598043611","NITROGLYCERN","SUB 0.4MG","25","Select","Select",""],["","65862018601","CLINDAMYCIN","CAP 300MG","30","Select","Select",""],["","00088221905","LANTUS","INJ 100\/ML","36","Select","Select",""],["","68180051801","LISINOP\/HCTZ","TAB 10-12.5","30","Select","Select",""],["","00193731150","CONTOUR","TES NEXT","50","Select","Select",""],["","60505083001","MOMETASONE","SPR 50MCG","17","Select","Select",""],["","00555088602","ESTRADIOL","TAB 1MG","30","Select","Select",""],["","00169406012","VICTOZA","INJ 18MG\/3ML","6","Select","Select",""],["","53489012002","DOXYCYCL","TAB 100MG","20","Select","Select",""],["","63824005718","MUCINEX","TAB 60-600MG","40","Select","Select",""],["","51672129401","CLOBETASOL","GEL 0.0005","15","Select","Select",""],["","51862094205","DIAZEPAM","TAB 5MG","1","Select","Select",""],["","00591367001","NABUMETONE","TAB 500MG","14","Select","Select",""],["","23155005419","NARATRIPTAN","TAB 1MG","9","Select","Select",""],["","00527105001","ACETAZOLAMID","TAB 250MG","30","Select","Select",""],["","33342008745","RIZATRIPTAN","TAB 5MG","9","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":""}]}]}