{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ANGELA D OSBORNE","gend":1,"add":"661 MOUNT VIEW ROAD","city":"DANVILLE","state":"VA","zip":"24540-9998","dob":"1969-10-18","age":"","mstatus":"","insh":"20032943*01","cliId":"","pno":4348363249,"cno":4348363249,"email":"","ename":"","eno":"","pphy":"STEPHENS, AMBER L DO","ppno":4347994488,"pcpadd":"SUITE 201 109 BRIDGE STREET,","pcpcity":"DANVILLE","pcpstate":"VA","pcpzip":"24541-9998","pcpcounty":"","pcpid":"","pcpname":"Sovah Family Medical Residency Clinic","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4347736977,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I10.","Z79.899","F17.210","F39.","E78.5","E03.9","M19.90","K58.9","N39.46","N81.84","F41.1","F41.0","R07.9","R06.02","K76.89","Z20.822","F41.9","F29.","R10.31","K57.90","E78.00","Z88.0","Z90.49","F32.89","K65.9","R10.9","J30.2","E55.9","Z12.11","S00.83XA","R51.9","Z23.","R11.2","Z76.89","Z20.828","R11.10","R10.84","Z01.42","Z72.0","K21.9","I45.10","K76.9","K91.5","R19.7","K44.9","Z79.1","Z01.411","S09.90XA","W01.10XA","K92.1","D72.829"],"date":["2023-07-15","2022-06-07","2021-03-25","2023-04-20","2023-07-12","2023-07-12","2023-07-12","2021-03-25","2023-09-14","2023-09-14","2023-03-09","2023-03-09","2022-11-07","2022-11-07","2022-11-07","2022-11-07","2023-05-16","2022-11-17","2023-01-27","2023-01-27","2023-07-15","2023-07-15","2023-01-27","2022-08-25","2023-01-27","2023-01-27","2023-07-12","2023-07-12","2023-07-31","2023-07-15","2023-07-15","2022-12-28","2023-07-31","2023-04-20","2021-10-08","2021-10-08","2023-07-31","2022-05-19","2022-12-28","2023-04-20","2022-06-07","2022-11-07","2023-07-31","2023-07-31","2023-07-31","2023-07-31","2022-03-23","2023-07-15","2023-07-15","2021-11-03","2021-11-03"],"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":[["","50111056101","TRAZODONE","TAB 100MG","75","Select","Select",""],["","69452015120","VITAMIN D","2 1250 MCG","4","Select","Select",""],["","69584009350","BUSPIRONE","TAB 15MG","120","Select","Select",""],["","13668013701","ESCITALOPRAM","TAB 20MG","30","Select","Select",""],["","49483060450","IBUPROFEN","800 MG","90","Select","Select",""],["","68180023209","FENOFIBRATE","160 MG","30","Select","Select",""],["","55111073390","VALSARTAN","160 MG","30","Select","Select",""],["","33342006907","OLANZAPINE","7.5 MG","30","Select","Select",""],["","00172392770","DIAZEPAM","10 MG","60","Select","Select",""],["","00378180310","LEVOTHYROXIN","TAB 50MCG","90","Select","Select",""],["","00143122701","DICYCLOMINE","TAB 20MG","30","Select","Select",""],["","45802065078","LORATADINE","10 MG","30","Select","Select",""],["","58160082311","SHINGRIX","INJ 50\/0.5ML","1","Select","Select",""],["","69584009350","BUSPIRONE HCL","15 MG","120","Select","Select",""],["","50111056101","TRAZODONE HCL","100 MG","75","Select","Select",""],["","13668013701","ESCITALOPRAM OXALATE","20 MG","30","Select","Select",""],["","00378180310","LEVOTHYROXINE SODIUM","50 MCG","90","Select","Select",""],["","00143122701","DICYCLOMINE HCL","20 MG","30","Select","Select",""],["","00093005805","TRAMADOL HCL","50 MG","20","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":""}]}]}