{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ANGELICA   R PATRICK","gend":1,"add":"362 RIDGEWELL AVE APT C","city":"NORFOLK","state":"VA","zip":"23503-9998","dob":"2001-01-31","age":"","mstatus":"","insh":"20052856*01","cliId":"","pno":"757\/227-2919","cno":"","email":"","ename":"","eno":"","pphy":"RODRIGUEZ, HIRAM J MD","ppno":"757\/547-0688","pcpadd":"705 BATTLEFIELD BOULEVARD","pcpcity":"CHESAPEAKE","pcpstate":"VA","pcpzip":23320,"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":"757\/547-2902","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J01.00","J98.01","J02.9","R50.9","J45.21","Z76.0","R06.89","F31.32","J45.909","F99.","R06.02","J80.","R68.83","J45.41","R06.2","Z20.822","K08.89","B34.9","S50.12XA","S50.02XA","Z91.010","M79.89","R07.9","R09.81","R07.2","Z00.01","E05.90","J45.40","Z01.00","J12.9","R78.9","R07.0","R51.","F91.3","F90.2","R68.89","R69.","J02.8","R50.81","NO DATA","J06.9","J32.9","R10.84","R11.2","R19.7","J03.90","R05.","R53.83","E86.0","E87.1","E87.8","R74.0","J45.30","F90.9","F41.9","F32.9","R16.1","Z79.51","Z79.899","R59.0","R10.10","Z13.31","J45.20"],"date":["2020-02-24","2020-04-19","2021-10-24","2021-10-17","2021-05-04","2020-09-13","2020-10-28","2021-04-25","2021-05-20","2020-01-05","2020-04-19","2020-04-19","2020-04-21","2021-01-07","2021-01-07","2021-10-17","2021-08-06","2021-11-18","2020-01-08","2020-01-08","2020-10-05","2020-01-08","2021-10-17","2021-11-18","2021-11-18","2020-10-05","2020-10-05","2020-10-05","2020-10-05","2021-11-18","2021-11-18","2021-10-24","2019-05-20","2019-06-02","2019-06-02","2019-11-21","2019-02-06","2019-02-04","2019-02-04","2019-02-04","2019-05-20","2019-05-20","2019-07-31","2019-07-31","2019-07-31","2019-02-07","2019-05-20","2019-02-07","2019-02-07","2019-02-07","2019-02-07","2019-02-07","2019-02-07","2019-02-07","2019-02-07","2019-02-07","2019-02-07","2019-02-07","2019-02-07","2019-05-20","2019-07-30","2019-07-08","2019-10-21"],"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":[["","59310057922","PROAIR","AER ","17","Select","Select",""],["","00173068220","VENTOLIN","AER ","18","Select","Select",""],["","11822316450","LORATADINE","TAB 10MG","30","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","65862057490","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","00591544310","PREDNISONE","TAB 20MG","12","Select","Select",""],["","60432026415","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","00173071620","ADVAIR","AER 115\/21","12","Select","Select",""],["","","AMOXICILLIN","TAB 875MG","","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","20","Select","Select",""],["","00116200116","CHLORHEX","SOL 0.0012","473","Select","Select",""],["","59267100002","PFIZER","INJ COVID-19","0","Select","Select",""],["","62332025118","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","69452014320","BENZONATATE","CAP 100MG","30","Select","Select",""],["","65162046650","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","31722099601","HYDROCO\/APAP","TAB 5-325MG","12","Select","Select",""],["","57896010201","ACETAMINOPHE","TAB 325MG","30","Select","Select",""],["","00406051201","OXYCOD\/APAP","TAB 5-325MG","12","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","51293082101","METHIMAZOLE","TAB 10MG","60","Select","Select",""],["","","IPRATROPIUM\/","SOL ALBUTER","","Select","Select",""],["","","CLINDAMYCIN","CAP 300MG","","Select","Select",""],["","69238110005","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","11822317640","RA","TAB 325MG","20","Select","Select",""],["","58160089652","FLUARIX","INJ 2019-20","0","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":""}]}]}