{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JESSE   W DRAPER","gend":0,"add":"229 RIVER OAK DR","city":"RIDGEWAY","state":"VA","zip":"24148-9998","dob":"1977-09-18","age":"","mstatus":"","insh":"2326223*01","cliId":"","pno":"276\/340-7015","cno":"","email":"","ename":"","eno":"","pphy":"GILRAINE, WENDY NP","ppno":"276\/670-7141","pcpadd":"319 HOSPITAL DRIVE SUITE 107","pcpcity":"MARTINSVILLE","pcpstate":"VA","pcpzip":24112,"pcpcounty":"","pcpid":"","pcpname":"MARTINSVILLE PHYSICIAN PRACTICES LLC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"276\/666-0363","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["L73.2","Z79.899","M05.9","M25.50","R73.09","E11.69","F51.04","F51.02","F32.9","G47.33","K14.3","E66.9","J45.40","R06.00","M06.9","R59.0","K14.6","R91.8","Z87.891","Z79.891","M17.10","E66.01","G89.4","M25.552","M17.12","F17.200","I10.","Z68.43","M76.62","M92.62","E08.40","Z79.4","H52.4","E11.65","H04.123","B37.0","Z51.81","G56.01","M54.5","Z23.","G56.03","Z71.89","Z71.85","N20.0","R31.29","Z80.42","M25.641","M25.642","NO DATA","R06.02","D72.829","R93.89","M67.972","L98.9","Z99.89","M25.561","M25.562","M25.572","E11.9","Z79.84","Z71.3","D22.5","L30.4","L28.1","N21.8","N40.0"],"date":["2022-09-06","2022-09-02","2022-09-06","2022-08-18","2022-03-01","2022-08-18","2021-08-05","2021-08-05","2021-08-05","2022-09-08","2021-08-05","2022-08-18","2022-09-08","2021-10-29","2022-10-06","2021-10-29","2022-09-08","2021-10-29","2021-10-29","2022-11-02","2022-04-27","2022-09-08","2022-11-02","2022-04-27","2022-04-27","2022-04-27","2022-08-18","2022-09-08","2021-07-22","2021-07-22","2021-12-20","2021-12-20","2021-04-01","2022-05-09","2022-05-02","2021-07-23","2022-09-06","2022-03-18","2021-08-04","2021-09-30","2022-01-20","2021-09-30","2022-09-06","2022-05-06","2022-05-06","2022-05-06","2022-09-06","2022-09-06","2022-11-02","2020-10-21","2020-10-21","2020-10-21","2020-10-21","2021-03-15","2021-05-26","2022-11-02","2022-11-02","2022-11-02","2021-01-25","2021-01-25","2022-02-25","2022-03-03","2022-03-03","2022-03-03","2022-02-11","2022-03-04"],"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":[["","49502060561","PERFOROMIST","NEB 20MCG","120","Select","Select",""],["","68180065208","DOXYCYC","CAP 100MG","30","Select","Select",""],["","00169413602","OZEMPIC","INJ 2\/1.5ML","9","Select","Select",""],["","00093005805","TRAMADOL","TAB 50MG","120","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","70377002711","ATORVASTATIN","TAB 10MG","90","Select","Select",""],["","00378001401","METHOTREXATE","TAB 2.5MG","40","Select","Select",""],["","53489011905","DOXYCYCL","CAP 100MG","10","Select","Select",""],["","53885000810","ONETOUCH","MIS PLUS 33G","100","Select","Select",""],["","00074012402","HUMIRA","INJ 80\/0.8ML","2","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","60432046400","LIDOCAINE","SOL 2% VISC","900","Select","Select",""],["","00093406106","FORMOTEROL","NEB 20\/2ML","120","Select","Select",""],["","69097012203","TOPIRAMATE","TAB 25MG","180","Select","Select",""],["","00169406013","VICTOZA","INJ 18MG\/3ML","9","Select","Select",""],["","43598075201","BUPROPION","TAB 150MG SR","180","Select","Select",""],["","00002223680","TRULICITY","INJ 3\/0.5","6","Select","Select",""],["","63304069301","CLINDAMYCIN","CAP 300MG","14","Select","Select",""],["","68180051801","LISINOP\/HCTZ","TAB 10-12.5","90","Select","Select",""],["","67877025145","TRIAMCINOLON","CRE 0.001","454","Select","Select",""],["","66689000816","NYSTATIN","SUS 100000","480","Select","Select",""],["","69315012710","FOLIC","TAB 1000MCG","30","Select","Select",""],["","10702002501","PHENTERMINE","TAB 37.5MG","90","Select","Select",""],["","00093216568","NALOXONE","SPR 4MG","2","Select","Select",""],["","68462010530","ONDANSETRON","TAB 4MG","20","Select","Select",""],["","00121077516","GG\/CODEINE","SOL 100-10\/5","120","Select","Select",""],["","47781023001","OXYCOD\/APAP","TAB 10-325MG","16","Select","Select",""],["","00186037020","SYMBICORT","AER 160-4.5","31","Select","Select",""],["","57664050083","MIRTAZAPINE","TAB 30MG","30","Select","Select",""],["","69336081228","FORAXA","EMU ","56","Select","Select",""],["","08290320119","BD  PEN NEEDL","MIS 31GX5MM","100","Select","Select",""],["","68382075810","METFORMIN","TAB 500MG","180","Select","Select",""],["","50428016183","CVS","CAP 2000UNIT","180","Select","Select",""],["","00310737020","BUDES\/FORMOT","AER 160-4.5","20","Select","Select",""],["","14539067501","HYDROXYZ","CAP 50MG","60","Select","Select",""],["","50111056001","TRAZODONE","TAB 50MG","60","Select","Select",""],["","70710113803","FLUCONAZOLE","TAB 100MG","4","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":""}]}]}