{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DOUGLAS   M OSBORNE","gend":0,"add":"2181 OLD TAVERN RD","city":"POWHATAN","state":"VA","zip":"23139-9998","dob":"1945-07-14","age":"","mstatus":"","insh":"900042285*01","cliId":"","pno":"804\/898-9764","cno":"","email":"","ename":"","eno":"","pphy":"CRESS, ALICIA MD","ppno":"804\/285-6050","pcpadd":"STE D 3452 ANDERSON HWY","pcpcity":"POWHATAN","pcpstate":"VA","pcpzip":23139,"pcpcounty":"","pcpid":"","pcpname":"POWHATAN MEDICAL ASSOCIATES","plan":"OHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/598-2481","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J44.9","E66.01","I10.","E11.9","M54.6","E78.00","Z68.42","G89.29","J44.0","Z79.899","Z00.00","Z23.","K21.9","M17.0"],"date":["2021-12-12","2021-12-12","2021-11-08","2021-04-30","2021-04-30","2021-04-30","2021-04-30","2021-04-30","2021-11-08","2021-04-30","2021-11-08","2021-11-08","2021-11-08","2021-11-08"],"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":[]}]},{"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":[["","70377000712","ROSUVASTATIN CALCIUM                                                  ","10MG","-90","Select","Select",""],["","62175061743","PANTOPRAZOLE SODIUM                                                   ","40MG","-90","Select","Select",""],["","00186037020","SYMBICORT                                                             ","160-4.5","31","Select","Select",""],["","00093310905","AMOXICILLIN                                                           ","500MG","30","Select","Select",""],["","68180072003","AMLODIPINE BESYLATE                                                   ","5MG","90","Select","Select",""],["","68180021509","LOSARTAN POTASSIUM\/HYDROCHLOROTHIAZIDE                                ","50-12.5","90","Select","Select",""],["","00378064205","PREDNISONE                                                            ","20MG","20","Select","Select",""],["","33342002208","LEVOFLOXACIN                                                          ","500MG","10","Select","Select",""],["","68180012202","CEPHALEXIN                                                            ","500MG","40","Select","Select",""],["","65162019050","NAPROXEN                                                              ","500MG","60","Select","Select",""],["","00378967130","IPRATROPIUM BROMIDE\/ALBUTEROL SULFATE                                 ","ALBUTER","360","Select","Select",""],["","00310737020","BUDESONIDE\/FORMOTEROL FUMARATE DIHYDRATE                              ","160-4.5","31","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":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"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":""}]}]}