{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MELISSA   M WHITE","gend":1,"add":"927 GUINEA ROAD","city":"FARMVILLE","state":"VA","zip":"23901-9998","dob":"1967-05-06","age":"","mstatus":"","insh":"1640324*01","cliId":"","pno":"434\/390-0731","cno":"434\/394-4043","email":"","ename":"","eno":"","pphy":"ADANIEL, VICTOR R MD","ppno":"434\/392-9438","pcpadd":"502 BEECH STREET","pcpcity":"FARMVILLE","pcpstate":"VA","pcpzip":23901,"pcpcounty":"","pcpid":"","pcpname":"SOUTHSIDE MEDICAL PRACTICE PLLC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/392-4630","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K81.9","G43.019","M54.2","M79.7","F41.1","G43.719","G43.711","K80.10","G43.709","R63.5","K59.00","M19.90","R10.0","M54.9","K80.70","K76.0","K58.9","F32.9","Z79.1","Z79.891","Z88.8","Z88.5","Z68.30","M25.562","M25.561","D48.5","L82.1","R20.8","R22.9","R10.9","R13.10","R25.2","R51.","R11.0","L98.9","R10.11","M25.569","M79.672","R05.","J06.9","H66.90","Z87.39","G43.909","R19.7","G43.911","F06.31","M35.8","M25.531","M25.532","Z23.","A69.23","Z79.899","G62.9","S70.269A","M25.9","R20.2","D24.9","R41.2","G44.40","F32.2","R59.1","R63.4","I73.00","M62.838"],"date":["2020-08-04","2021-08-26","2021-05-06","2021-09-13","2021-05-06","2021-09-13","2020-03-03","2020-08-20","2021-12-03","2020-03-10","2020-03-10","2021-01-19","2020-08-02","2020-08-02","2020-08-08","2020-08-08","2020-08-10","2020-08-08","2020-08-08","2020-08-10","2020-08-08","2020-08-08","2020-08-10","2021-09-28","2021-09-28","2021-11-30","2021-11-30","2021-11-30","2020-05-22","2020-05-22","2020-05-22","2020-07-06","2020-07-06","2020-07-06","2021-11-02","2020-08-02","2021-09-13","2020-02-03","2020-02-03","2020-02-03","2020-02-28","2020-05-07","2021-01-19","2021-01-19","2019-06-07","2019-12-06","2019-06-18","2019-06-18","2019-06-18","2019-10-09","2019-10-11","2019-10-11","2019-10-23","2019-08-29","2019-08-29","2019-05-20","2019-07-02","2019-07-02","2019-03-19","2019-03-19","2019-05-07","2019-05-07","2019-08-06","2019-08-06"],"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":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"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":[["","","ONDANSETRON","TAB 4MG","","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","","LINZESS","CAP 72MCG","","Select","Select",""],["","65862014836","SUMATRIPTAN","TAB 100MG","9","Select","Select",""],["","68462050033","ZOLMITRIPTAN","TAB 5MG ODT","6","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","70710111108","TIZANIDINE","CAP 2MG","180","Select","Select",""],["","","AMPICILLIN","CAP 500MG","","Select","Select",""],["","","PROMETHAZINE","TAB 25MG","","Select","Select",""],["","49035023814","EQ","CAP SOFTENER","90","Select","Select",""],["","","TRAMADOL","TAB 50MG","","Select","Select",""],["","51525590101","CARISOPRODOL","TAB 250MG","40","Select","Select",""],["","","AMOX\/K","TAB 500-125","","Select","Select",""],["","","PHENTERMINE","CAP 37.5MG","","Select","Select",""],["","","AMOXICILLIN","CAP 500MG","","Select","Select",""],["","","AZITHROMYCIN","TAB 250MG","","Select","Select",""],["","","PANTOPRAZOLE","TAB 20MG","","Select","Select",""],["","","HYDROCO\/APAP","TAB 7.5-325","","Select","Select",""],["","","FAMOTIDINE","TAB 20MG","","Select","Select",""],["","55513084101","AIMOVIG","INJ 70MG\/ML","1","Select","Select",""],["","53746061701","TRAMADL\/APAP","TAB 37.5-325","28","Select","Select",""],["","16729017001","ESCITALOPRAM","TAB 20MG","30","Select","Select",""],["","68180015301","DESLORATADIN","TAB 5MG","3","Select","Select",""],["","00172392570","DIAZEPAM","TAB 2MG","30","Select","Select",""],["","51759020410","AJOVY","INJ 225\/1.5","2","Select","Select",""],["","00832105415","BACLOFEN","TAB 10MG","90","Select","Select",""],["","65862052730","VENLAFAXINE","CAP 37.5 ER","30","Select","Select",""],["","68462056435","MUPIROCIN","CRE 0.02","30","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","00115143713","CYCLOBENZAPR","CAP 30MG ER","30","Select","Select",""],["","00143314250","DOXYCYCL","CAP 100MG","14","Select","Select",""],["","00536106210","STOOL","CAP 100MG","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":""}]}]}