{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TRAVIS   R CHISHOLM","gend":0,"add":"2801 LAFLIN PL APT 5","city":"HENRICO","state":"VA","zip":"23228-9998","dob":"1946-11-02","age":"","mstatus":"","insh":"20025331*01","cliId":"","pno":"804\/484-5729","cno":"804\/484-5729","email":"","ename":"","eno":"","pphy":"WADNERKAR, RAHUL MD","ppno":"804\/968-5700","pcpadd":"5000 COX RD STE 100","pcpcity":"GLEN ALLEN","pcpstate":"VA","pcpzip":23060,"pcpcounty":"","pcpid":"","pcpname":"PATIENT FIRST RICHMOND MEDICAL GROUP PLLC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/968-5739","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F41.9","NO DATA","F41.1","M47.817","Z46.6","N40.1","R35.1","R35.0","R10.13","R53.83","Z87.828","M17.9","M43.16","M47.816","M47.814","M47.812","G47.00","J44.9","D50.9","N50.812","R53.82","B35.4","E86.0","R33.9","T83.9XXA","T83.511A","N39.0","K21.9","R10.84","N45.1","Z01.812","Z20.822","S61.211A","S61.412A","E78.5","Z23.","F17.200","Z79.82","M79.642","Z79.891","M76.61","R06.02","Z71.9","R91.1","F13.10","L98.9","R33.8","N30.90","R19.7","G25.81","G47.61","V58.89","R06.83","F11.20","Z87.891","G89.21","N62.","N18.9","K59.00","S63.8X1A","D64.9","N18.3","R80.9","D63.1","I10.","N25.81","S60.311A","S83.422A","I83.93","Z00.00","M25.552","M25.562","L30.9","Z92.29","D12.2","S00.03XA","Z12.11","Z86.010","K63.5","K64.8","R09.89","I12.9","N52.9","Z13.6","R64.","Z11.59","I50.32","Z13.31","I70.219","Z86.19","I70.0","Z68.27","E66.3","R22.2"],"date":["2021-11-09","2022-05-17","2021-09-24","2020-07-28","2021-06-24","2022-10-24","2021-09-15","2021-07-23","2021-09-15","2020-06-07","2020-06-24","2020-06-24","2020-06-24","2020-06-24","2020-06-24","2020-06-24","2022-08-09","2022-08-09","2021-11-09","2022-04-23","2020-06-24","2020-06-24","2021-02-20","2022-01-26","2021-03-24","2021-03-24","2021-03-24","2022-10-25","2021-09-15","2022-10-24","2022-03-01","2022-03-01","2020-07-13","2021-10-15","2022-03-10","2021-10-15","2021-10-15","2021-10-15","2021-10-15","2020-06-24","2020-12-11","2021-04-22","2022-02-08","2021-04-22","2021-06-17","2020-01-31","2021-03-24","2021-06-24","2021-10-02","2022-02-08","2021-11-09","2020-07-23","2021-06-14","2019-02-18","2019-08-30","2019-05-18","2019-07-27","2019-01-05","2019-05-15","2019-01-07","2019-04-09","2019-02-26","2022-05-17","2022-05-17","2019-02-26","2019-02-26","2019-07-12","2019-07-31","2019-07-31","2022-10-19","2019-04-23","2019-04-23","2019-06-22","2019-07-03","2022-03-10","2022-07-27","2022-03-10","2022-03-10","2022-03-10","2022-03-10","2022-09-07","2022-05-17","2022-10-24","2022-10-19","2022-10-19","2022-10-19","2022-10-19","2022-10-19","2022-10-19","2022-10-19","2022-10-19","2022-10-19","2022-08-09","2022-11-08"],"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":[["","23155002405","BUSPIRONE","TAB 10MG","60","Select","Select",""],["","52268020101","SUTAB","TAB ","24","Select","Select",""],["","68382080505","TRAZODONE","TAB 50MG","30","Select","Select",""],["","00597007541","SPIRIVA","CAP HANDIHLR","30","Select","Select",""],["","62756016013","TAMSULOSIN","CAP 0.4MG","30","Select","Select",""],["","00093077110","PRAVASTATIN","TAB 10MG","30","Select","Select",""],["","00781286810","OMEPRAZOLE","CAP 20MG","30","Select","Select",""],["","13668056630","TADALAFIL","TAB 5MG","27","Select","Select",""],["","69618004610","ASPIRIN","TAB 81MG EC","30","Select","Select",""],["","","MIRTAZAPINE","TAB 15MG","","Select","Select",""],["","43547028111","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","10572010001","PEG-3350","SOL ELECTROL","4000","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","42806031250","DOXYCYCL","TAB 100MG","20","Select","Select",""],["","70461012203","FLUAD","INJ 2022-23","0","Select","Select",""],["","67877025115","TRIAMCINOLON","CRE 0.001","15","Select","Select",""],["","00173088710","TRELEGY","AER ELLIPTA","60","Select","Select",""],["","00310460012","BEVESPI","AER 9-4.8MCG","11","Select","Select",""],["","00172392670","DIAZEPAM","TAB 5MG","63","Select","Select",""],["","57237009960","CEFDINIR","CAP 300MG","14","Select","Select",""],["","","SM","TAB 81MG EC","","Select","Select",""],["","80777027310","MODERNA","INJ COVID-19","0","Select","Select",""],["","68462018905","NAPROXEN","TAB 375MG","20","Select","Select",""],["","58160082311","SHINGRIX","INJ 50\/0.5ML","1","Select","Select",""],["","00172572860","FAMOTIDINE","TAB 20MG","30","Select","Select",""],["","00904699880","DOCUSATE","CAP 100MG","30","Select","Select",""],["","52268001201","SUPREP","SOL PREP KIT","354","Select","Select",""],["","52268010001","GOLYTELY","SOL ","4000","Select","Select",""],["","","CLOTRIMAZOLE","CRE 0.01","","Select","Select",""],["","","IBUPROFEN","TAB 600MG","","Select","Select",""],["","76385012301","METHOCARBAM","TAB 500MG","40","Select","Select",""],["","67253090150","ALPRAZOLAM","TAB 0.5MG","30","Select","Select",""],["","51672129801","KETOCONAZOLE","CRE 0.02","15","Select","Select",""],["","00597015561","STIOLTO","AER 2.5-2.5","4","Select","Select",""],["","12496120203","SUBOXONE","MIS 2-0.5MG","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":""}]}]}