{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MICHAEL WAGGONER","gend":0,"add":"709 KENSINGTON AVE","city":"COLONIAL HEIGHTS","state":"VA","zip":"23834-9998","dob":"1959-07-07","age":"","mstatus":"","insh":"20065180*01","cliId":"","pno":9043650623,"cno":9043650623,"email":"","ename":"","eno":"","pphy":"EGGLESTON III, WILLIAM MD","ppno":4342927261,"pcpadd":"213 NORTH MAIN ST","pcpcity":"BLACKSTONE","pcpstate":"VA","pcpzip":"23824-9998","pcpcounty":"","pcpid":"","pcpname":"Blackstone Family Practice Center","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4342927965,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M79.605","B18.2","Z68.32","NO DATA","Z91.09","I16.0","R94.39","I87.2","E66.3","L98.9","L82.1","D22.4","Z12.83","Z21.","Z23.","M45.0","Z68.31","G95.9","M48.10","E53.8","E55.9","E78.2","B19.20","R59.0","M79.89","K59.00","R10.31","R59.9","R07.89","D22.39","L81.4","R74.8","R53.83","M17.12","R00.1","M25.561","M25.551","K06.8","Z68.30","M47.812","G89.29","M48.14","Z79.899","R00.2","R94.31","R20.2","R11.2","Z86.711","M47.12","J45.909","B20.","Z86.718","Z91.81","J39.9","R53.82","M62.838","R11.0","Z68.29","R10.9","R26.89","M54.09","W18.30XA","M79.601","H61.23","R05.9","K59.01","M79.604","M54.2","R30.0","Z68.35","V58.89","M75.01","K59.04","F41.9","M19.012","M16.11","I83.813","I82.409","S63.591A","M25.511","R35.0","Z12.11","E78.5","I10.","R20.8","K12.0","I73.9","R21.","M19.90"],"date":["2021-05-28","2023-04-14","2021-03-16","2023-04-14","2021-04-12","2021-06-02","2021-07-08","2022-07-18","2021-06-02","2022-07-07","2023-02-08","2021-10-06","2021-10-06","2023-02-20","2022-09-22","2023-04-14","2023-02-20","2023-04-14","2023-04-14","2023-04-14","2023-03-30","2021-10-11","2022-03-22","2022-07-07","2023-01-04","2022-03-09","2023-03-20","2022-12-02","2022-12-02","2023-02-08","2023-02-08","2023-02-20","2023-03-20","2021-01-06","2021-05-28","2022-03-14","2022-08-17","2022-01-12","2023-03-30","2022-02-11","2022-03-14","2022-03-26","2022-09-10","2022-10-10","2022-07-18","2022-09-10","2022-09-10","2023-04-14","2021-03-18","2023-04-14","2023-04-14","2023-04-14","2023-04-14","2022-01-19","2022-04-27","2022-07-07","2022-09-13","2022-10-10","2022-12-09","2021-02-02","2021-02-02","2021-08-10","2021-08-25","2021-08-25","2021-11-15","2022-03-14","2021-05-28","2022-06-01","2021-07-29","2021-07-29","2021-08-25","2021-08-25","2022-06-16","2023-03-20","2021-02-17","2021-02-17","2021-05-06","2021-05-06","2021-08-11","2022-06-01","2022-08-17","2022-08-17","2021-05-06","2021-05-06","2021-05-12","2022-04-06","2022-09-07","2022-12-02","2023-04-14"],"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":[["","61958200201","DESCOVY","200MG-25MG","30","Select","Select",""],["","49702022813","TIVICAY","50 MG","30","Select","Select",""],["","21922000909","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","59651039401","BACLOFEN","10 MG","90","Select","Select",""],["","45802065087","LORATADINE","TAB 10MG","90","Select","Select",""],["","65862064163","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","70954006030","PREDNISONE","TAB 20MG","10","Select","Select",""],["","50742017501","ISOSORB MONO","TAB 30MG ER","30","Select","Select",""],["","00172392560","DIAZEPAM","TAB 2MG","6","Select","Select",""],["","27241012502","RANOLAZINE","TAB 500MG ER","60","Select","Select",""],["","69315011610","FUROSEMIDE","20 MG","15","Select","Select",""],["","65862018730","ONDANSETRON","TAB 4MG","30","Select","Select",""],["","00185012201","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","33342002108","LEVOFLOXACIN","TAB 250MG","5","Select","Select",""],["","62332042771","BENZONATATE","CAP 200MG","30","Select","Select",""],["","00406048401","APAP\/CODEINE","TAB 300-30MG","21","Select","Select",""],["","23155065201","METRONIDAZOL","TAB 500MG","7","Select","Select",""],["","42571016201","AMOX\/K CLAV","TAB 875-125","20","Select","Select",""],["","64980050924","DEXAMETHASON","ELX 0.5\/5ML","225","Select","Select",""],["","11523726803","MIRALAX","POW 3350 NF","30","Select","Select",""],["","67877021660","CEFUROXIME","TAB 500MG","14","Select","Select",""],["","31722099601","HYDROCO\/APAP","TAB 5-325MG","6","Select","Select",""],["","69543038810","KETOROLAC","TAB 10MG","10","Select","Select",""],["","29300012401","MELOXICAM","TAB 7.5MG","30","Select","Select",""],["","42571025201","CLINDAMYCIN","CAP 300MG","21","Select","Select",""],["","00074262528","MAVYRET","TAB 100-40MG","84","Select","Select",""],["","70700026305","LANSOPRAZOLE","CAP 30MG DR","90","Select","Select",""],["","33342032715","TRIAMCINOLON","CRE 0.00025","75","Select","Select",""],["","70710166307","CYANOCOBALAMIN INJECTION","1000MCG\/ML","5","Select","Select",""],["","00093506001","HYDROXYZINE HCL","10 MG","15","Select","Select",""],["","67877021905","CEPHALEXIN","500 MG","21","Select","Select",""],["","13668013605","ESCITALOPRAM OXALATE","10 MG","30","Select","Select",""],["","72888008000","TRAMADOL HCL","50 MG","12","Select","Select",""],["","27808023402","DOXYCYCLINE HYCLATE","100 MG","14","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":""}]}]}