{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MARIE BOYNTON","gend":1,"add":"425 AUDUBON DR APT 1","city":"DANVILLE","state":"VA","zip":"24540-9998","dob":"1963-09-22","age":"","mstatus":"","insh":"20008986*01","cliId":"","pno":4344415996,"cno":4344415996,"email":"","ename":"","eno":"","pphy":"WHITE, VALERIE A NP","ppno":"","pcpadd":"142 S MAIN ST","pcpcity":"DANVILLE","pcpstate":"VA","pcpzip":"24540-9998","pcpcounty":"","pcpid":"","pcpname":"Sovah Family Medicine - Danville","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.9","F31.81","R07.9","I16.1","N17.9","N39.0","G93.41","I13.0","N18.4","I50.32","E44.0","E11.22","F14.10","E87.5","I16.0","A08.4","E83.42","A53.9","B18.2","R91.1","E78.5","Z68.24","R10.84","I49.9","R07.89","I10.","I13.2","J18.9","I50.33","J96.01","E87.2","J90.","F31.9","Z91.19","Z53.29","D63.1","NO DATA","B19.20","M10.9","T40.5X1A","I50.9","E11.21","F31.4","F33.1","F41.1","M06.9","N18.6","Z99.2","J44.1","J96.10","I33.0","D64.9","R41.82","R78.81","R18.8","A41.9","J96.21","J96.22","J12.3","Z20.822","K74.60","B95.7","R13.10","G93.49","F19.10","Z91.199","I34.0","E87.70","H40.1131","R15.9","R53.81","R26.2","M62.50","Z53.20","L29.2","K92.2","K26.9","D62.","T82.7XXA","A41.02","J96.11","I38.","L03.818","E83.51","R74.01","I25.10","E87.79","E11.65","Z88.9","L30.9","E61.1","R19.5","R50.9","R53.1","A41.01","I50.30","Z09.","R26.89","R68.89","Z99.3","R39.81","F41.8","M51.9","F17.210","Z91.81","Z79.2","Z99.81","Z79.82","B95.61","G47.9","I12.9","N18.9","F41.9","F39.","F60.9","R73.9","R06.9","R00.0","R61.","E11.29","F14.129","R53.83","G47.10","R06.02","N18.5","E55.9","R80.9","R20.2","R89.9","E11.8","L22.","R41.89","I50.43","N39.46","M54.12","R31.29","R22.0","N39.3","E87.1","E11.40","D50.9","Z91.14","R10.9","K29.70","K44.9","F19.99","K92.1","K26.3","R10.13","R60.1","Z01.810","R40.4","R11.2","I12.0","Z79.4","Z87.891","K12.0","R26.0","R60.0","M79.604","M79.605","Z39.2","I51.9","N25.81","A04.8","N17.0","N04.9","I13.11","M32.9","R21.","E78.2","Z72.0","Z88.8","K74.69","R19.7","D69.6","R79.89","R74.8","Z79.899","I21.4","F14.929","F20.9","R73.03","E10.65","M05.9","J81.0","M62.81","R00.1","E08.65","K86.1","S22.42XA","W18.30XA","R09.02","E87.6","R77.8","Z91.15","R22.43","R58.","R41.0","R60.9","Z74.01","F33.2","N28.1","G89.4","J06.9","R04.0","Z91.89","R05.9","R06.00","I24.8","R14.0","R11.0","Z86.19","J44.9","J91.8","F03.90","Z11.59","L50.6","T50.905A","L29.9","R39.2","J96.90","G44.89","G31.89","F02.80","K57.90","R07.81","R06.2","K72.00","Z86.14","I36.1","W19.XXXA","B95.8","I45.10","I35.1","I37.1","I51.7","I08.1","I47.1","I36.8"],"date":["2023-04-13","2023-04-20","2022-10-04","2022-08-29","2022-08-11","2023-01-03","2022-04-05","2022-08-12","2022-12-12","2022-10-06","2022-09-19","2023-03-23","2022-11-22","2022-07-18","2023-03-17","2022-04-03","2022-04-03","2022-04-03","2022-12-12","2022-05-04","2023-04-13","2022-04-03","2023-03-08","2022-04-03","2022-10-04","2023-03-22","2023-03-23","2023-02-24","2022-12-09","2022-07-31","2022-07-18","2023-03-23","2023-04-13","2022-05-10","2022-12-13","2022-08-29","2023-04-05","2023-03-23","2022-12-12","2022-05-15","2022-12-12","2022-05-18","2021-04-30","2021-04-30","2021-04-30","2021-11-06","2023-04-14","2023-04-13","2022-12-15","2023-02-24","2023-04-13","2023-03-22","2023-03-22","2023-04-13","2023-03-22","2022-12-09","2022-12-12","2022-12-12","2022-12-12","2022-12-08","2023-03-23","2023-03-17","2022-12-08","2022-12-12","2023-03-22","2023-03-22","2023-04-08","2023-03-23","2022-03-04","2022-09-02","2022-10-31","2022-10-15","2022-04-07","2023-03-08","2022-07-11","2022-07-23","2022-07-20","2022-07-23","2022-08-05","2022-08-12","2023-03-23","2023-04-14","2022-08-05","2022-08-05","2022-08-05","2022-08-05","2022-09-19","2023-03-17","2022-07-03","2022-07-16","2022-07-17","2022-07-17","2022-08-10","2022-11-23","2022-08-13","2022-08-13","2022-09-02","2022-09-02","2022-09-02","2022-09-02","2022-09-02","2022-09-02","2022-09-02","2022-11-22","2022-10-06","2022-10-06","2022-12-15","2022-10-06","2022-09-07","2022-09-28","2023-01-03","2023-01-03","2022-09-28","2022-09-28","2022-09-28","2023-03-08","2022-11-22","2022-11-22","2022-11-22","2022-07-23","2022-04-04","2022-04-04","2022-04-04","2023-03-08","2022-07-18","2022-06-09","2022-06-09","2022-03-10","2021-05-06","2022-12-01","2022-04-23","2022-04-23","2022-01-29","2022-03-10","2022-03-10","2022-06-02","2022-03-10","2022-03-10","2022-08-31","2022-03-20","2023-03-17","2022-12-02","2023-03-23","2022-07-17","2022-07-17","2022-07-18","2022-07-18","2022-07-18","2022-10-23","2022-10-23","2023-04-13","2023-02-03","2023-03-08","2023-03-23","2023-03-08","2023-03-08","2022-05-04","2022-05-04","2022-06-02","2022-05-04","2022-05-04","2022-05-04","2022-06-02","2022-07-13","2022-07-13","2022-07-18","2022-07-23","2022-12-02","2022-08-29","2022-07-23","2022-08-10","2022-10-04","2022-12-15","2022-12-02","2023-01-03","2023-01-03","2022-09-17","2022-07-31","2022-01-27","2022-01-28","2022-01-28","2022-05-30","2022-06-02","2022-06-02","2022-06-02","2022-08-31","2022-12-12","2023-04-08","2022-11-15","2022-11-15","2023-03-23","2023-02-03","2023-03-17","2022-09-17","2022-09-17","2022-12-02","2022-09-17","2022-09-17","2022-11-23","2023-03-08","2022-11-23","2023-03-21","2021-06-03","2021-05-18","2021-06-03","2021-06-03","2021-06-03","2022-11-22","2022-11-22","2022-07-31","2023-03-17","2022-10-31","2023-02-03","2023-03-23","2022-12-12","2022-12-12","2022-12-12","2022-07-03","2022-07-03","2022-07-03","2022-07-13","2022-08-31","2022-10-23","2022-12-02","2022-12-02","2023-01-03","2023-02-03","2023-03-08","2023-03-22","2023-03-27","2023-04-08","2023-03-21","2023-04-13","2023-04-08","2023-03-29","2023-03-29","2023-03-29","2023-03-23","2023-03-23","2023-04-05"],"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":[["","43598016430","OLANZAPINE","TAB 5MG","30","Select","Select",""],["","27241009990","DULOXETINE","CAP 60MG","60","Select","Select",""],["","00169633910","NOVOLOG","INJ FLEXPEN","12","Select","Select",""],["","53885026701","ONETOUCH","KIT VERIO IQ","1","Select","Select",""],["","60505258009","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","59267100001","PFIZER VACC","INJ COVID-19","0","Select","Select",""],["","10702000650","CYCLOBENZAPR","TAB 5MG","60","Select","Select",""],["","96295012804","IRON","TAB 325MG","30","Select","Select",""],["","68462026390","ROSUVASTATIN","TAB 20MG","30","Select","Select",""],["","68382009405","CARVEDILOL","TAB 12.5MG","60","Select","Select",""],["","00536100836","ASPIRIN","CHW 81MG","30","Select","Select",""],["","69097012715","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","16729013416","ALLOPURINOL","TAB 100MG","30","Select","Select",""],["","13668010410","ISOSORB MONO","TAB 30MG ER","30","Select","Select",""],["","00245010810","FERROUS SULF","TAB 325MG EC","30","Select","Select",""],["","59762033302","LATANOPROST","SOL 0.00005","2","Select","Select",""],["","75834002012","VITAMIN D3","CAP 50000UNT","4","Select","Select",""],["","31722071310","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","69315011710","FUROSEMIDE","TAB 40MG","90","Select","Select",""],["","23155000310","HYDRALAZINE","TAB 50MG","60","Select","Select",""],["","23155050110","HYDROXYZ HCL","TAB 25MG","30","Select","Select",""],["","00378064210","PREDNISONE","TAB 20MG","10","Select","Select",""],["","29300022705","METRONIDAZOL","TAB 500MG","6","Select","Select",""],["","65862017760","CEFDINIR","CAP 300MG","2","Select","Select",""],["","00223172101","SODIUM BICAR","TAB 650MG","60","Select","Select",""],["","00527600274","LIDOCAINE","SOL 2% VISC","300","Select","Select",""],["","00536510895","HYDROSKIN","CRE 0.01","28","Select","Select",""],["","72140003868","EUCERIN","CRE ","57","Select","Select",""],["","66689000816","NYSTATIN","SUS 100000","200","Select","Select",""],["","00472034356","HYDROCORT","CRE 0.01","28","Select","Select",""],["","69618000701","RENAL VITAMN","TAB ","30","Select","Select",""],["","57237000511","FLUCONAZOLE","TAB 150MG","5","Select","Select",""],["","08137005010","CORTAID","CRE 0.01","28","Select","Select",""],["","42192015206","SELENIUM SUL","SHA 0.0225","180","Select","Select",""],["","70074056501","ENSURE CLEAR","LIQ BBRY\/POM","90","Select","Select",""],["","00185064801","DIPHENHYDRAM","CAP 25MG","30","Select","Select",""],["","65862018730","ONDANSETRON","TAB 4MG","10","Select","Select",""],["","60258016001","RENA-VITE","TAB ","30","Select","Select",""],["","80681015500","MINERIN","CRE ","113","Select","Select",""],["","56151146001","TRUE METRIX","TES GLUCOSE","50","Select","Select",""],["","86227012105","SURE COMFORT","MIS 31GX3\/16","100","Select","Select",""],["","00487020101","IPRATROPIUM\/","SOL ALBUTER","180","Select","Select",""],["","00002771559","BASAGLAR","INJ 100UNIT","15","Select","Select",""],["","64380073706","VITAMIN D","CAP 50000UNT","4","Select","Select",""],["","53885001110","ONETOUCH DEL","MIS PLUS 30G","100","Select","Select",""],["","47781030301","NITROFURANTOIN MONO-MACRO","100 MG","14","Select","Select",""],["","00536120215","LIDOCAINE PAIN RELIEF","4 %","30","Select","Select",""],["","68382065001","ISOSORBIDE MONONITRATE ER","30 MG","90","Select","Select",""],["","68462026390","ROSUVASTATIN CALCIUM","20 MG","30","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":""}]}]}