{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BRENDA   L MUSICK","gend":1,"add":"11 SECOND ST SE","city":"PULASKI","state":"VA","zip":"24301-9998","dob":"1970-05-12","age":"","mstatus":"","insh":"20049258*01","cliId":"","pno":"540\/385-9445","cno":"","email":"","ename":"","eno":"","pphy":"CARD, RICHARD D DO","ppno":"540\/509-5443","pcpadd":"141 E MAIN ST STE 420","pcpcity":"PULASKI","pcpstate":"VA","pcpzip":24301,"pcpcounty":"","pcpid":"","pcpname":"NEW RIVER VALLEY MEDICINE PC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"540\/440-8924","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.69","F31.9","F17.210","E78.2","E66.9","G62.9","G89.29","M54.41","E55.9","M19.90","E11.9","R63.5","R40.0","R06.83","Z12.39","Z80.0","M54.16","Z23.","Z12.11","R09.81","F32.1","Z71.89","R68.89","M70.61","NO DATA","I10.","S29.012A","M54.31","E78.5","F17.200","M54.6","K64.8","Z83.71","K64.9","M54.42","M70.71","Z12.31"],"date":["2022-05-25","2022-05-25","2022-05-25","2022-05-25","2020-12-09","2020-12-09","2022-05-25","2022-05-25","2020-04-08","2022-05-25","2021-07-01","2020-01-08","2020-01-08","2020-01-08","2020-12-09","2022-08-11","2022-06-22","2020-12-09","2022-08-11","2021-11-03","2021-09-23","2020-01-22","2020-08-03","2022-06-22","2022-09-30","2022-10-02","2022-10-02","2022-10-02","2022-10-02","2022-10-02","2022-10-02","2022-08-11","2022-08-11","2022-08-11","2022-05-25","2022-05-25","2022-05-25"],"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":[["","00002143380","TRULICITY","INJ 0.75\/0.5","2","Select","Select",""],["","","VENLAFAXINE"," VENLAFAXINE ","30","Select","Select",""],["","00093342210","CYCLOBENZAPR","TAB 10MG","30","Select","Select",""],["","70436001002","BUPROPN","TAB 150MG XL","30","Select","Select",""],["","00378064205","PREDNISONE","TAB 20MG","14","Select","Select",""],["","","HYDROXYZ"," HYDROXYZ ","90","Select","Select",""],["","","METOPROL"," METOPROL ","60","Select","Select",""],["","69584061150","METHOCARBAM","TAB 500MG","90","Select","Select",""],["","50428085942","PREP","PAD ","300","Select","Select",""],["","","MELOXICAM"," MELOXICAM ","60","Select","Select",""],["","62175061743","PANTOPRAZOLE","TAB 40MG","90","Select","Select",""],["","","DIVALPROEX"," DIVALPROEX ","60","Select","Select",""],["","","ONETOUCH","TES ULTRA BL","","Select","Select",""],["","","AMITRIPTYLIN","TAB 25MG","","Select","Select",""],["","62332014231","CELECOXIB","CAP 200MG","60","Select","Select",""],["","","PRAVASTATIN"," PRAVASTATIN ","30","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","43386009019","GAVILYTE-G","SOL ","4000","Select","Select",""],["","43386035701","HYDROCO\/APAP","TAB 7.5-325","15","Select","Select",""],["","00228207610","TEMAZEPAM","CAP 15MG","30","Select","Select",""],["","00310654004","BYDUREON","INJ 2\/0.85ML","3","Select","Select",""],["","00169406012","VICTOZA","INJ 18MG\/3ML","6","Select","Select",""],["","00169633910","NOVOLOG","INJ FLEXPEN","15","Select","Select",""],["","80777027398","MODERNA","INJ COVID-19","0","Select","Select",""],["","08290328203","BD  PEN NEEDL","MIS 29GX12.7","100","Select","Select",""],["","","VITAMIN","CAP 50000UNT","","Select","Select",""],["","00069047103","CHANTIX","PAK 0.5& 1MG","53","Select","Select",""],["","","FLUCLVX","INJ 2020-21","","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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}