{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LA NAMYAIMIMAT-","gend":0,"add":"INNEP 8092DAOR NOTGN","city":"HENRICO","state":"VA","zip":"23294-9998","dob":"2003-02-28","age":"","mstatus":"","insh":"92200210*16","cliId":"","pno":"39\/4085503-5","cno":"","email":"","ename":"","eno":"","pphy":"YUCHA, KIM MD","ppno":"804\/747-1750","pcpadd":"STE 100 9900 INDEPENDENCE PK","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":23233,"pcpcounty":"","pcpid":"","pcpname":"Richmond Pediatric Associates, Inc.","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","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":["R32.","R39.81","R63.3","J20.8","R50.9","R10.13","J45.909","Q79.2","Q42.3","R21.","Z78.9","K62.89","K31.89","R10.84","K29.50","R89.6","NO DATA","R10.9","Q45.8","R30.0","Z23.","Q67.5","Q64.12","M62.08","Z20.828","R74.8","Z93.1","R62.51","R68.89","E44.0","R62.7","R63.4","R19.7","Q56.4","Z68.1","J40.","R10.11","J02.9","L98.8","Z68.52","R68.83","R09.81","K59.00","K82.8","R63.39","R10.31","Z87.898","B34.9","Z87.738","Z01.812","Z20.822","Z00.00","K21.9","R15.9","Q87.19","K43.9","M25.551","B37.89","J20.9","L03.311"],"date":["2021-04-18","2022-10-25","2021-09-15","2021-08-16","2020-10-06","2021-04-04","2021-10-25","2022-08-29","2022-03-03","2022-10-25","2022-05-13","2021-10-25","2021-10-25","2021-10-25","2021-10-25","2021-10-25","2021-10-25","2022-02-18","2022-08-04","2020-09-15","2022-03-03","2019-10-25","2022-08-04","2019-10-30","2020-11-18","2021-04-04","2022-08-29","2022-03-30","2021-09-28","2021-10-01","2021-10-01","2021-10-01","2021-10-01","2022-03-03","2021-10-01","2019-10-22","2021-03-30","2019-03-15","2019-05-26","2020-04-30","2020-11-18","2020-11-18","2020-12-12","2021-03-30","2022-03-30","2020-02-09","2020-02-09","2020-10-06","2021-12-23","2021-10-21","2021-10-21","2022-03-03","2022-03-03","2022-02-18","2022-10-25","2022-01-03","2022-01-24","2022-01-24","2022-11-17","2022-11-17"],"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":[["","00254101196","SUCRALFATE","SUS 1GM\/10ML","450","Select","Select",""],["","","URSODIOL","TAB 250MG","","Select","Select",""],["","","OMEPRAZOLE","CAP 20MG","","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","14","Select","Select",""],["","00781185220","AMOX\/K","TAB 875-125","20","Select","Select",""],["","59762313001","AZITHROMYCIN","SUS 200\/5ML","45","Select","Select",""],["","76204020060","ALBUTEROL","NEB 0.00083","180","Select","Select",""],["","00574200830","NYSTOP","POW 100000","30","Select","Select",""],["","","MUPIROCIN","OIN 0.02","","Select","Select",""],["","00378668999","PANTOPRAZOLE","TAB 40MG","20","Select","Select",""],["","42192033901","HYOSCYAMINE","SUB 0.125MG","90","Select","Select",""],["","65862001705","AMOXICILLIN","CAP 500MG","21","Select","Select",""],["","","ESOMEPRA","CAP 20MG DR","","Select","Select",""],["","","MILK","SUS 400\/5ML","","Select","Select",""],["","00172572860","FAMOTIDINE","TAB 20MG","60","Select","Select",""],["","","SULFATRIM","SUS 200-40\/5","","Select","Select",""],["","","DICYCLOMINE","CAP 10MG","","Select","Select",""],["","","ACID","TAB 20MG","","Select","Select",""],["","","CEFDINIR","SUS 250\/5ML","","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","64380080807","IBUPROFEN","TAB 600MG","30","Select","Select",""],["","00406012305","HYDROCO\/APAP","TAB 5-325MG","10","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":""}]}]}