{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"   AUHSOJOTALOC D","gend":0,"add":"TS 4517TC NEVE","city":"NOKESVILLE","state":"VA","zip":"20181-9998","dob":"2004-07-14","age":"","mstatus":"","insh":"0121210*16","cliId":"","pno":"34\/0455474-9","cno":"","email":"","ename":"","eno":"","pphy":"KATZ, DAVID MD","ppno":"703\/330-3939","pcpadd":"SUITE 306 8640 SUDLEY ROAD","pcpcity":"MANASSAS","pcpstate":"VA","pcpzip":20110,"pcpcounty":"","pcpid":"","pcpname":"PEDIATRICARE OF NORTHERN VIRGINIA PC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"NORTHERN & WINCHESTER","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":["E78.9","E55.9","R07.89","Z23.","Q24.4","I35.1","R00.2","Z87.74","J40.","R03.0","Z91.018","Z91.048","R06.09","H53.9","J30.2","L70.0","H10.10","E78.00","E78.1","E66.9","E78.5","Z68.54","Q23.8","J02.9","Z11.52","L60.0","L08.89","J01.90","B96.89","H10.13","J06.9","H65.01","R51.","D72.829"],"date":["2020-10-09","2020-10-09","2021-03-09","2021-07-30","2021-09-17","2021-09-17","2021-09-17","2021-09-17","2021-12-09","2021-12-08","2021-12-08","2021-12-08","2021-12-08","2019-05-02","2019-05-02","2021-03-05","2019-05-02","2021-06-15","2021-05-24","2019-11-22","2021-06-22","2021-06-22","2019-05-06","2021-08-18","2021-08-18","2021-03-05","2021-03-05","2021-08-26","2021-08-26","2019-05-03","2020-02-14","2020-02-14","2020-02-14","2021-04-05"],"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":[["","13668048201","MINOCYCLINE","CAP 50MG","30","Select","Select",""],["","00143928501","AMOXICILLIN","TAB 875MG","20","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","00143924920","AMOX\/K","TAB 875-125","20","Select","Select",""],["","","VITAMIN","TAB 5000UNIT","","Select","Select",""],["","","D3","CAP 5000UNIT","","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":""}]}]}