{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"THOMAS COCHRAN","gend":0,"add":"2901 STOCKTON ST","city":"RICHMOND","state":"VA","zip":"23224-9998","dob":"1960-04-04","age":"","mstatus":"","insh":"20064659*01","cliId":"","pno":8045230814,"cno":8045230814,"email":"","ename":"","eno":"","pphy":"MIRSHAHI, IRAJ DO","ppno":8046732814,"pcpadd":"5855 BREMO RD #102,","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":"23226-9998","pcpcounty":"","pcpid":"","pcpname":"Monument Internal Medicine","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8046732873,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G47.33","G47.36","F51.04","Z86.59","Z68.42","R07.9","E78.00","E53.8","M25.561","M25.562","G89.29","D50.9","R79.89","R73.03","R06.00","F33.9","E66.01","D64.9","K63.5","R53.82","E61.1","Z20.828","G47.9","I20.0","R06.02","M51.36","M17.0","Z87.891","M54.9","R69.","K29.70","K59.00","Z86.010","I51.7","R10.33","M17.11","M17.12","M79.661","M79.662","V54.13","K04.7","E66.9","K08.89","D50.0","N40.1","R35.0","Z68.41","R07.89","D12.2","K64.8","K22.8","K31.7","K44.9","Z86.39","K92.1","B88.8","R60.0","R42.","I21.3","R11.2","L03.115","L03.116","R21.","R10.84","M62.81"],"date":["2021-04-20","2021-03-23","2021-03-23","2021-03-23","2022-09-29","2021-08-27","2022-09-29","2022-05-03","2022-05-03","2022-05-03","2022-05-03","2022-05-03","2022-05-03","2022-05-03","2022-11-12","2022-05-03","2022-05-03","2021-08-05","2021-08-10","2022-02-17","2022-02-17","2022-01-12","2022-02-17","2021-08-27","2021-08-27","2022-03-20","2022-09-29","2022-09-29","2022-03-20","2021-08-07","2021-10-25","2021-10-25","2021-10-25","2021-07-28","2021-08-25","2022-03-20","2022-03-20","2022-03-21","2022-05-24","2022-05-24","2022-09-29","2022-09-29","2022-09-29","2021-07-31","2021-11-02","2021-11-02","2021-11-02","2021-07-27","2021-07-30","2021-07-29","2021-07-29","2021-07-29","2021-07-29","2022-02-17","2021-07-30","2021-08-05","2023-06-25","2023-07-09","2023-07-09","2023-07-09","2023-06-25","2023-06-25","2023-06-25","2023-07-09","2023-07-09"],"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":[["","00173068220","VENTOLIN HFA AER","","18","Select","Select",""],["","68645056259","IBUPROFEN TAB","600MG","20","Select","Select",""],["","16571020150","DICLOFENAC TAB","75MG DR","60","Select","Select",""],["","00186037020","SYMBICORT AER","160-4.5","10","Select","Select",""],["","66993001968","ALBUTEROL AER HFA","","18","Select","Select",""],["","00143928501","AMOXICILLIN TAB","875MG","20","Select","Select",""],["","00054001925","PREDNISONE TAB","50MG","3","Select","Select",""],["","31722099601","HYDROCO\/APAP TAB","5-325MG","12","Select","Select",""],["","50111078751","AZITHROMYCIN TAB","250MG","6","Select","Select",""],["","68645056354","IBUPROFEN","800 MG","21","Select","Select",""],["","00186037020","SYMBICORT","160-4.5MCG","10.2","Select","Select",""],["","67877021905","CEPHALEXIN","500 MG","28","Select","Select",""],["","29300035501","TRAMADOL HCL","50 MG","8","Select","Select",""],["","00904672040","ACETAMINOPHEN","500 MG","24","Select","Select",""],["","66993001968","ALBUTEROL SULFATE HFA","90 MCG","18","Select","Select",""],["","16571020150","DICLOFENAC SODIUM","75 MG","28","Select","Select",""],["","00116200116","CHLORHEXIDINE GLUCONATE","0.12 %","473","Select","Select",""],["","00093505898","ATORVASTATIN CALCIUM","40 MG","30","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":""}]}]}