{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" S   YRAMTRAHKCOL","gend":1,"add":"12 817TS TS","city":"NEWPORT NEWS","state":"VA","zip":"23607-9998","dob":"1977-03-31","age":"","mstatus":"","insh":"0605110*75","cliId":"","pno":"24\/4089667-9","cno":"","email":"","ename":"","eno":"","pphy":"WUNDER, NICHOLAS PA","ppno":"804\/968-5700","pcpadd":"5000 COX ROAD SUITE 100","pcpcity":"GLEN ALLEN","pcpstate":"VA","pcpzip":23060,"pcpcounty":"","pcpid":"","pcpname":"PATIENT FIRST RICHMOND MEDICAL GROUP PLLC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K08.89","R19.7","F17.210","R13.10","M62.830","D64.9","K21.9","B34.9","R42.","M79.632","R51.9","V87.7XXA","R07.89","R19.5","R10.30","R10.13","E66.9","R53.1","F32.0","J40.","L02.211","K02.9","R07.9","F17.200","I49.9","F41.9","F41.0","R10.33","N39.0","Z20.822","Z88.0","Z90.49","R06.89","R09.89","R20.2","R55.","E86.0","R13.14","K22.2","R06.02","R11.0","M02.29","T50.B95A","N30.00","Z20.828","T50.Z95A"],"date":["2022-05-17","2022-07-31","2022-07-31","2021-12-21","2020-12-07","2022-06-04","2021-12-21","2020-10-06","2022-08-01","2020-11-15","2022-08-01","2020-11-15","2021-08-15","2019-03-27","2019-03-27","2021-11-30","2019-03-27","2019-06-18","2021-02-11","2021-11-30","2021-11-30","2021-05-24","2021-08-15","2019-06-18","2021-08-15","2021-10-08","2021-10-25","2020-05-15","2020-05-15","2022-01-25","2022-07-31","2022-01-25","2022-07-31","2022-07-31","2022-07-31","2022-07-31","2022-07-31","2022-01-11","2022-01-11","2022-01-25","2022-07-31","2022-06-04","2022-06-04","2022-06-04","2022-06-04","2022-06-04"],"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":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"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":[["","","CLINDAMYCIN","CAP 300MG","","Select","Select",""],["","59676058015","JANSSEN","INJ COVID-19","0","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","20","Select","Select",""],["","62175061743","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","23155050105","HYDROXYZ","TAB 25MG","28","Select","Select",""],["","69097084805","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","53489011905","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","00143312601","DICYCLOMINE","CAP 10MG","28","Select","Select",""],["","45802011222","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","68180035202","SERTRALINE","TAB 50MG","30","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","00378041510","DIPHEN\/ATROP","TAB 2.5MG","60","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","","IBUPROFEN","TAB 800MG","","Select","Select",""],["","","APAP\/CODEINE","TAB 300-30MG","","Select","Select",""],["","","MECLIZINE","CHW 25MG","","Select","Select",""],["","","CEPHALEXIN","CAP 500MG","","Select","Select",""],["","","NAPROXEN","TAB 500MG","","Select","Select",""],["","","LIDOCAINE","SOL 2% VISC","","Select","Select",""],["","","ONDANSETRON","TAB 4MG ODT","","Select","Select",""],["","","CYCLOBENZAPR","TAB 10MG","","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":""}]}]}