{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DONALD   A WOODRUFF","gend":0,"add":"PO BOX 395","city":"SAINT PAUL","state":"VA","zip":"24283-9998","dob":"1975-06-20","age":"","mstatus":"","insh":"2200151*01","cliId":"","pno":"276\/385-8250","cno":"","email":"","ename":"","eno":"","pphy":"CRABTREE, EMILY S NP","ppno":"","pcpadd":"344 OVERLOOK DR STE 100","pcpcity":"LEBANON","pcpstate":"VA","pcpzip":"24266","pcpcounty":"","pcpid":"","pcpname":"MOUNTAIN STATES HEALTH ALLIANCE","plan":"OHP","program":"MEDICAID","lob":"M4","region":"SOUTHWEST","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"276\/883-8042","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G47.19","R06.83","M18.12","G47.33","E66.09","G47.09","F41.9","Z68.31","M19.041","M19.042","M54.42","G89.29","F32.9","Z79.899","Z13.9","F32.2","F43.10","R45.89","R06.00","R00.2","M18.11","G47.10","M62.838","G47.00","M54.2","I05.8","M79.645","E78.2","R05.","I49.1","I49.3","E78.5","R07.9","M50.20","G56.02","G56.22","S44.11XS","M54.5","Z13.220","G56.90","M54.16"],"date":["2020-11-03","2020-05-22","2021-10-19","2021-11-18","2021-09-30","2021-09-30","2021-10-11","2021-09-30","2021-02-10","2021-02-10","2021-10-19","2021-10-19","2021-07-19","2021-10-19","2021-08-12","2021-10-11","2021-10-11","2021-08-12","2021-09-30","2021-09-30","2020-06-18","2020-06-23","2020-07-17","2020-07-17","2021-02-11","2021-06-02","2021-10-06","2021-10-19","2021-05-28","2021-09-08","2021-09-08","2021-09-15","2021-08-03","2020-12-07","2020-04-09","2020-04-09","2021-06-24","2021-02-11","2020-04-14","2020-05-12","2021-02-11"],"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":[["","50228017705","GABAPENTIN","TAB 600MG","90","Select","Select",""],["","57664037713","TRAMADOL","TAB 50MG","120","Select","Select",""],["","68645052054","ESCITALOPRAM","TAB 20MG","90","Select","Select",""],["","65162019011","NAPROXEN","TAB 500MG","60","Select","Select",""],["","00093720210","PRAVASTATIN","TAB 40MG","90","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","16729017401","AMITRIPTYLIN","TAB 75MG","90","Select","Select",""],["","55111018015","TIZANIDINE","TAB 4MG","90","Select","Select",""],["","63481068447","VOLTAREN","GEL 0.01","100","Select","Select",""],["","69547035302","NARCAN","SPR ","2","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":""}]}]}