{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"  AEANAJSIWEL D ","gend":1,"add":"C S 522TS YRRU","city":"HAMPTON","state":"VA","zip":"23663-9998","dob":"1998-06-12","age":"","mstatus":"","insh":"76600210*48","cliId":"","pno":"22\/7570907-4","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":"OHCC","region":"TIDEWATER","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":["N89.8","J30.1","J30.2","J30.89","J30.81","J35.3","R09.81","H92.03","H91.93","R42.","J45.909","R09.82","J02.9","O20.9","Z3A.00","S05.12XA","M32.9","M32.19","Z87.448","Z86.2","Z79.899","E67.3","J34.2","L50.0","L93.0","J45.20","Z01.82","R10.9","L25.9","T14.90XA","Z71.9","L50.9","Z28.21","H00.024","L70.0","Z20.828","R05.","R68.83","R53.83","NO DATA","R51.9","R11.2","R63.0","R43.0","H10.013","S82.009A","M17.11","O20.0","S00.12XA","J45.41","Z23.","J35.03","Z09.","J35.01","J35.2","H93.8X9","L50.1","O00.90","O26.899","N93.8","S19.9XXA","J06.9","N93.9","M23.91","O00.80","O26.90","I10.","Z88.5","Z88.0","Z88.2","Z88.8","Z91.048","D48.5","Z01.818","J30.9","J34.3","Z91.018","U07.1","K04.7","R07.9","J30.5","O00.101","K02.9","Z87.891","K08.89","R10.2","L30.9"],"date":["2020-06-24","2021-01-29","2021-01-27","2021-01-29","2021-01-27","2020-08-11","2021-01-27","2020-08-11","2021-01-27","2020-08-11","2021-01-06","2021-01-27","2021-02-23","2020-08-15","2020-08-21","2020-10-15","2021-02-12","2021-02-12","2021-02-12","2021-02-12","2021-02-12","2021-02-12","2021-01-06","2020-07-16","2020-07-28","2021-01-27","2020-07-23","2020-08-21","2020-10-26","2020-10-19","2020-12-17","2020-07-09","2020-07-09","2020-10-12","2020-12-17","2021-03-04","2021-03-02","2021-03-02","2021-03-02","2021-03-02","2021-03-02","2021-03-02","2021-03-02","2021-03-02","2021-04-20","2020-07-07","2020-07-07","2020-08-15","2020-10-15","2020-12-10","2020-12-10","2021-01-11","2021-01-27","2021-01-27","2021-01-27","2021-01-27","2020-07-20","2020-08-21","2020-08-21","2020-11-18","2021-02-24","2021-02-24","2021-10-19","2020-07-21","2020-08-21","2020-08-21","2020-11-11","2020-10-15","2020-10-15","2020-10-15","2020-10-15","2020-10-15","2020-10-26","2021-01-06","2021-01-06","2021-01-06","2021-01-06","2021-03-04","2021-10-06","2020-06-01","2020-07-28","2020-08-21","2020-11-11","2020-11-11","2020-11-11","2021-04-20","2021-11-30"],"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":[["","","METHOCARBAM","TAB 750MG","","Select","Select",""],["","","HYDROXYCHLOR","TAB 200MG","","Select","Select",""],["","","LEVOCETIRIZI","TAB 5MG","","Select","Select",""],["","","PREDNISONE","TAB 10MG","","Select","Select",""],["","","OXYCOD\/APAP","TAB 5-325MG","","Select","Select",""],["","","CLINDAMYCIN","CAP 300MG","","Select","Select",""],["","","MOMETASONE","SPR 50MCG","","Select","Select",""],["","","FLUCONAZOLE","TAB 150MG","","Select","Select",""],["","","EPIPEN","INJ 0.3MG","","Select","Select",""],["","","FOLIC","TAB 400MCG","","Select","Select",""],["","","CETIRIZINE","TAB 10MG","","Select","Select",""],["","","FAMOTIDINE","TAB 40MG","","Select","Select",""],["","","STOOL","CAP 100MG","","Select","Select",""],["","","VALACYCLOVIR","TAB 1GM","","Select","Select",""],["","","MUPIROCIN","OIN 0.02","","Select","Select",""],["","","ARTHRTS","TAB 650MG","","Select","Select",""],["","","DOXYCYC","CAP 50MG","","Select","Select",""],["","","ERYTHROMYCIN","OIN OP","","Select","Select",""],["","","ACYCLOVIR","OIN 0.05","","Select","Select",""],["","","VIOS","MIS SYSTEM","","Select","Select",""],["","","PRENATAL","TAB 28-0.8MG","","Select","Select",""],["","","CVS","CAP 25MG","","Select","Select",""],["","","ONDANSETRON","TAB 4MG ODT","","Select","Select",""],["","","LIDO\/PRILOCN","CRE 2.5-2.5%","","Select","Select",""],["","","DICLOFENAC","TAB 75MG DR","","Select","Select",""],["","","OXYCODONE","TAB 5MG","","Select","Select",""],["","","TRIAMCINOLON","OIN 0.001","","Select","Select",""],["","","METHYLPRED","TAB 4MG","","Select","Select",""],["","","VITAMIN","CAP 50000UNT","","Select","Select",""],["","","LIDOCAINE","SOL 2% VISC","","Select","Select",""],["","","KETOROLAC","TAB 10MG","","Select","Select",""],["","","SPIRONOLACT","TAB 100MG","","Select","Select",""],["","","DOXYCYCL","CAP 100MG","","Select","Select",""],["","","IVERMECTIN","TAB 3MG","","Select","Select",""],["","","ALBUTEROL","NEB 0.00083","","Select","Select",""],["","","APAP\/CODEINE","TAB 300-30MG","","Select","Select",""],["","","AMITRIPTYLIN","TAB 25MG","","Select","Select",""],["","","AZITHROMYCIN","TAB 250MG","","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":""}]}]}