{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DAEQUANDA COLES","gend":1,"add":"5605 CRENSHAW RD APT H","city":"RICHMOND","state":"VA","zip":"23227-9998","dob":"1997-10-23","age":"","mstatus":"","insh":"8055386*01","cliId":"","pno":8043960931,"cno":8043960931,"email":"","ename":"","eno":"","pphy":"ELLIOTT, CHARMAINE N MD","ppno":8046441665,"pcpadd":"SUITE 308 1510 N 28TH STREET,","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":"23223-9998","pcpcounty":"","pcpid":"","pcpname":"Primary Healthcare Associates","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8046445285,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F31.32","F41.1","Z04.9","R07.2","R09.89","H04.123","R79.89","B37.3","N76.0","R68.2","E55.9","B96.89","M62.81","R53.83","B37.49","R30.0","R23.2","F51.01","NO DATA","J30.89","Z68.24","R07.9","G44.209","I49.8","R00.1","R07.89","R94.6","F17.200","S70.02XA","V89.2XXA","Z20.2","Z11.4","R42.","G44.40","G43.009","Z68.27","M79.671","M20.11","M79.672","M20.12","R76.8","H57.13","H57.11","S90.812A","Z51.81","Z11.3","N89.8","A08.4","J45.909","H57.10","R19.7","Z20.828","Z32.02","D06.9","Z91.040","J30.9","J45.30","F90.2","E78.2","D64.9","F90.0","I73.00","J30.2","Z68.23","H04.129","Z01.419","N93.0","R87.611","R87.619","N76.4","H66.001","R51.9"],"date":["2023-06-18","2022-07-06","2021-08-28","2022-03-24","2022-03-24","2022-12-19","2022-08-01","2022-09-29","2022-12-29","2022-08-01","2022-08-01","2022-08-01","2022-09-20","2022-09-20","2023-04-27","2023-04-27","2021-01-18","2021-01-18","2022-12-19","2022-06-08","2022-11-02","2021-09-11","2021-10-15","2022-06-22","2022-06-22","2022-06-22","2022-08-11","2022-08-11","2022-09-20","2022-09-20","2021-08-11","2022-09-29","2021-09-10","2022-02-01","2022-11-02","2022-02-01","2022-08-18","2022-12-02","2022-08-18","2022-08-18","2022-12-13","2022-12-13","2023-01-13","2021-05-18","2022-05-26","2022-12-29","2023-04-25","2022-11-22","2022-12-02","2022-12-19","2023-04-25","2021-09-04","2023-02-23","2023-03-08","2023-05-03","2023-05-03","2023-05-03","2021-02-09","2022-01-31","2022-01-31","2022-01-31","2022-01-31","2022-05-17","2022-06-08","2022-08-29","2023-01-20","2023-01-20","2023-02-23","2023-02-23","2022-12-23","2023-03-04","2023-03-04"],"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":[["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","00603020922","MAG OXIDE","TAB 400MG","90","Select","Select",""],["","49483060450","IBUPROFEN","800 MG","60","Select","Select",""],["","69452015120","VITAMIN D","CAP 50000UNT","4","Select","Select",""],["","00093310905","AMOXICILLIN","500 MG","30","Select","Select",""],["","71930005412","APAP\/CODEINE","TAB 300-15MG","5","Select","Select",""],["","68462011940","FLUCONAZOLE","150 MG","1","Select","Select",""],["","68180016011","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","54092038301","ADDERALL XR","CAP 10MG","30","Select","Select",""],["","00781233501","AMPHET\/DEXTR","CAP 10MG ER","30","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","16571066450","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","16571040250","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","31722070530","VALACYCLOVIR","1000 MG","30","Select","Select",""],["","00093081101","NORTRIPTYLIN","CAP 25MG","30","Select","Select",""],["","10702005601","OXYCODONE","TAB 10MG","24","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","20","Select","Select",""],["","65162052110","PROMETHAZINE","TAB 25MG","40","Select","Select",""],["","42858010401","OXYCOD\/APAP","TAB 10-325MG","28","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","10","Select","Select",""],["","65862042005","SULFAMETHOXAZOLE-TRIMETHOPRIM","800-160 MG","6","Select","Select",""],["","00168034720","TERCONAZOLE","0.8 %","20","Select","Select",""],["","50111033401","METRONIDAZOLE","500 MG","14","Select","Select",""],["","69097081312","GABAPENTIN","100 MG","90","Select","Select",""],["","10702005601","OXYCODONE HCL","10 MG","25","Select","Select",""],["","24658031205","DOXYCYCLINE HYCLATE","100 MG","14","Select","Select",""],["","49483060450","IBUPROFEN TAB","800MG","60","Select","Select",""],["","00603020922","MAG OXIDE TAB","400MG","90","Select","Select",""],["","59746000103","METHYLPRED TAB","4MG","21","Select","Select",""],["","69452015120","VITAMIN D CAP","50000UNT","4","Select","Select",""],["","00093310905","AMOXICILLIN CAP","500MG","21","Select","Select",""],["","71930005412","APAP\/CODEINE TAB","300-15MG","5","Select","Select",""],["","68462011940","FLUCONAZOLE TAB","150MG","1","Select","Select",""],["","16571040250","CETIRIZINE TAB","10MG","30","Select","Select",""],["","68180016011","AZITHROMYCIN TAB","250MG","6","Select","Select",""],["","54092038301","ADDERALL XR CAP","10MG","30","Select","Select",""],["","00781233501","AMPHET\/DEXTR CAP","10MG ER","90","Select","Select",""],["","68682045570","METRONIDAZOL GEL","0.75%VAG","70","Select","Select",""],["","00093226301","AMOXICILLIN TAB","500MG","21","Select","Select",""],["","66993001968","ALBUTEROL AER HFA","","18","Select","Select",""],["","31722070530","VALACYCLOVIR TAB","1GM","30","Select","Select",""],["","65862039010","ONDANSETRON TAB","4MG ODT","10","Select","Select",""],["","00093081101","NORTRIPTYLIN CAP","25MG","30","Select","Select",""],["","10702005601","OXYCODONE TAB","10MG","24","Select","Select",""],["","53746052101","PROMETHAZINE TAB","25MG","40","Select","Select",""],["","16571066450","METRONIDAZOL TAB","500MG","14","Select","Select",""],["","42858010401","OXYCOD\/APAP TAB","10-325MG","28","Select","Select",""],["","68180012202","CEPHALEXIN CAP","500MG","20","Select","Select",""],["","42858010201","OXYCODONE-ACETAMINOPHEN","5 MG-325MG","25","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":""}]}]}