{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" NOWQEAJSINNICM","gend":0,"add":"HAM 503EVA ENO","city":"NORFOLK","state":"VA","zip":"23523-9998","dob":"2002-08-23","age":"","mstatus":"","insh":"29400210*90","cliId":"","pno":"04\/7578626-5","cno":"","email":"","ename":"","eno":"","pphy":"FAYTON, CHARLES E MD","ppno":"757\/962-8605","pcpadd":"1682 CHURCH STREET","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23504,"pcpcounty":"","pcpid":"","pcpname":"TIDEWATER PEDIATRIC CONSULTANTS PC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F90.2","F91.1","Z73.3","F90.0","G47.00","S50.311A","R68.84","M25.521","S71.132A","W34.00XA","F90.9","R03.0","L30.9","J45.909","J30.9","F91.9","M25.512","M54.5","M79.605","M79.604","J30.2","J45.901","J06.9","R50.9","R11.10","I44.0","R94.31","R46.89","T14.90XA","Z00.121","Z71.3","Z68.22","Z71.82","Z76.89","M79.602","M54.9","R51.9","M25.519","M79.609","I10.","F91.3","V87.7XXA","Z13.89","Z01.00"],"date":["2020-04-30","2021-12-22","2021-12-22","2019-06-21","2020-06-17","2019-08-10","2019-08-10","2021-03-04","2019-10-13","2019-10-13","2021-12-22","2020-05-21","2020-04-02","2021-09-13","2019-10-10","2019-10-10","2021-04-05","2021-04-05","2021-04-05","2021-04-05","2021-09-13","2020-01-30","2020-01-30","2020-01-30","2020-01-30","2020-02-27","2020-02-27","2020-03-03","2019-10-12","2020-08-06","2020-02-04","2020-02-04","2020-02-04","2020-06-17","2021-03-04","2021-03-30","2021-03-30","2021-03-30","2021-03-30","2020-02-27","2020-09-29","2021-03-04","2020-08-06","2020-08-06"],"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":[]},{"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":""}]}]}