{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ANGELA B DISHMAN","gend":1,"add":"10565 CALLANDS ROAD","city":"CHATHAM","state":"VA","zip":"24531-9998","dob":"1963-07-01","age":"","mstatus":"","insh":"2313198*01","cliId":"","pno":4346889076,"cno":4346889076,"email":"","ename":"","eno":"","pphy":"GRABOWSKI, KRISTEN NP","ppno":4348350105,"pcpadd":"2767 FRANKLIN TURNPIKE,","pcpcity":"DANVILLE","pcpstate":"VA","pcpzip":"24540-9998","pcpcounty":"","pcpid":"","pcpname":"Sovah Family Medicine - Brosville","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4348350295,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I83.892","M79.605","I87.2","Z98.890","S83.282A","S83.242A","M94.8X6","M17.12","I10.","E78.5","M79.7","Z86.73","Z79.899","Z79.01","Z79.82","Z88.1","Z88.8","M67.362","M23.92","E55.9","K21.9","G89.4","G62.9","G47.00","I73.9","I83.90","I83.893","I83.813","G25.81","I48.0","G25.0","I25.2","I83.819","Z23.","M25.562","F32.9","F41.9","Z68.39","I11.0","I50.9","V58.89","J01.90","R07.9","I20.9","H25.13","H35.033","H10.45","H52.4","R73.03","E78.01","I48.91","Z68.32","E88.81","M23.322","M23.342","E11.9","E66.9","I83.891","M79.604","I25.10","R94.31","NO DATA","G43.109","B37.2","M25.50","Z68.34","R11.0","G89.29","I51.7","I51.89"],"date":["2021-10-27","2021-10-27","2022-04-26","2022-11-01","2022-01-05","2022-01-05","2022-01-05","2023-03-28","2023-08-10","2023-08-10","2022-01-05","2022-11-01","2022-01-05","2023-01-25","2022-01-05","2022-01-05","2022-01-05","2022-08-19","2022-08-19","2022-06-27","2021-04-14","2023-01-25","2022-06-27","2023-03-27","2021-12-15","2021-06-15","2023-08-10","2021-10-27","2022-06-27","2023-08-10","2021-10-06","2021-10-27","2021-12-15","2022-10-24","2022-03-15","2021-10-15","2023-01-25","2021-07-19","2021-10-27","2021-10-27","2022-05-19","2021-01-22","2021-07-12","2021-07-12","2023-08-01","2023-08-01","2023-08-01","2023-08-01","2023-01-25","2023-01-25","2023-01-25","2023-01-25","2022-06-27","2022-01-05","2022-01-05","2022-01-05","2023-03-27","2021-10-06","2021-10-06","2022-09-26","2022-09-26","2023-01-25","2021-06-10","2023-03-27","2023-03-27","2023-03-27","2023-03-27","2022-12-07","2023-08-17","2023-08-17"],"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":[["","57237016199","OMEPRAZOLE","20 MG","90","Select","Select",""],["","57664050652","METOPROL TAR","TAB 25MG","60","Select","Select",""],["","00093914801","VENLAFAXINE","TAB 37.5MG","30","Select","Select",""],["","69452015120","VITAMIN D","CAP 50000UNT","12","Select","Select",""],["","29300034901","ALLOPURINOL","100 MG","90","Select","Select",""],["","69315011610","FUROSEMIDE","TAB 20MG","30","Select","Select",""],["","00003089421","ELIQUIS","5 MG","60","Select","Select",""],["","49884017101","COLCHICINE","0.6 MG","3","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","28","Select","Select",""],["","31722099701","HYDROCO\/APAP","TAB 10-325MG","28","Select","Select",""],["","50111056101","TRAZODONE","TAB 100MG","90","Select","Select",""],["","43598029890","PREGABALIN","300 MG","60","Select","Select",""],["","67877019805","AMLODIPINE","TAB 5MG","90","Select","Select",""],["","00527193206","CLARITHROMYC","TAB 500MG","20","Select","Select",""],["","00093310905","AMOXICILLIN","500 MG","21","Select","Select",""],["","49483060450","IBUPROFEN","800 MG","90","Select","Select",""],["","68382037003","NYSTATIN","100000\/G","120","Select","Select",""],["","69238115409","EZETIMIBE","TAB 10MG","30","Select","Select",""],["","00116200116","CHLORHEX GLU","SOL 0.0012","473","Select","Select",""],["","43547042309","LOSARTAN\/HCT","TAB 50-12.5","90","Select","Select",""],["","72511076002","REPATHA SURE","INJ 140MG\/ML","2","Select","Select",""],["","43547030303","ARIPIPRAZOLE","5 MG","30","Select","Select",""],["","68462010530","ONDANSETRON","TAB 4MG","40","Select","Select",""],["","00378668910","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","00169450514","WEGOVY","0.5MG\/.5ML","2","Select","Select",""],["","71930002012","HYDROCODONE-ACETAMINOPHEN","7.5-325 MG","8","Select","Select",""],["","43547042309","LOSARTAN-HYDROCHLOROTHIAZIDE","50-12.5 MG","90","Select","Select",""],["","72511076002","REPATHA SURECLICK","140 MG\/ML","2","Select","Select",""],["","61874011530","VRAYLAR","1.5 MG","30","Select","Select",""],["","00378668910","PANTOPRAZOLE SODIUM","40 MG","30","Select","Select",""],["","50111056101","TRAZODONE HCL","100 MG","90","Select","Select",""],["","00116200116","CHLORHEXIDINE GLUCONATE","0.12 %","473","Select","Select",""],["","68462010530","ONDANSETRON HCL","4 MG","40","Select","Select",""],["","68382003416","VENLAFAXINE HCL ER","37.5 MG","90","Select","Select",""],["","00527193206","CLARITHROMYCIN","500 MG","20","Select","Select",""],["","16571066101","MECLIZINE HCL","25 MG","120","Select","Select",""],["","73796080034","BLOOD PRESSURE CUFF","","1","Select","Select",""],["","71930005552","ACETAMINOPHEN-CODEINE","300MG-30MG","12","Select","Select",""],["","65862052730","VENLAFAXINE CAP","37.5 ER","90","Select","Select",""],["","42858010201","OXYCOD\/APAP TAB","5-325MG","30","Select","Select",""],["","69452015120","VITAMIN D CAP","50000UNT","36","Select","Select",""],["","57237016199","OMEPRAZOLE CAP","20MG","90","Select","Select",""],["","55111072901","ALLOPURINOL TAB","100MG","90","Select","Select",""],["","00591256201","COLCHICINE TAB","0.6MG","3","Select","Select",""],["","57664050658","METOPROL TAR TAB","25MG","60","Select","Select",""],["","69315011610","FUROSEMIDE TAB","20MG","30","Select","Select",""],["","00003089421","ELIQUIS TAB","5MG","60","Select","Select",""],["","50111056101","TRAZODONE TAB","100MG","90","Select","Select",""],["","31722099701","HYDROCO\/APAP TAB","10-325MG","28","Select","Select",""],["","43598029890","PREGABALIN CAP","300MG","60","Select","Select",""],["","67877019805","AMLODIPINE TAB","5MG","90","Select","Select",""],["","00527193206","CLARITHROMYC TAB","500MG","20","Select","Select",""],["","00093914801","VENLAFAXINE TAB","37.5MG","90","Select","Select",""],["","00093310905","AMOXICILLIN CAP","500MG","30","Select","Select",""],["","49483060450","IBUPROFEN TAB","800MG","90","Select","Select",""],["","00116200116","CHLORHEX GLU SOL","0.12%","473","Select","Select",""],["","69238115409","EZETIMIBE TAB","10MG","90","Select","Select",""],["","68382037003","NYSTATIN POW","100000","120","Select","Select",""],["","72511076002","REPATHA SURE INJ","140MG\/ML","2","Select","Select",""],["","43547042309","LOSARTAN\/HCT TAB","50-12.5","30","Select","Select",""],["","68462010530","ONDANSETRON TAB","4MG","40","Select","Select",""],["","43547030303","ARIPIPRAZOLE TAB","5MG","30","Select","Select",""],["","00378668910","PANTOPRAZOLE TAB","40MG","30","Select","Select",""],["","72888000400","METOPROLOL TARTRATE","25 MG","180","Select","Select",""],["","23155000301","HYDRALAZINE HCL","50 MG","60","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":""}]}]}