{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DONAISA   S MITCHELL","gend":1,"add":"979 RUGBY STREET","city":"NORFOLK","state":"VA","zip":"23504-2156","dob":"2002-07-24","age":"","mstatus":"","insh":6884486,"cliId":"","pno":7573592927,"cno":"","email":"","ename":"","eno":"","pphy":"EMEJURU, OGUBUIKE","ppno":7574362300,"pcpadd":"513 BAYLOR COURT, ","pcpcity":"CHESAPEAKE","pcpstate":"VA","pcpzip":233203824,"pcpcounty":"","pcpid":"","pcpname":"CHILDRENS HEALTH ASSOCIATION OF TIDEWATER","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"979 RUGBY STREET","madd2":"","madd3":"","mcity":"NORFOLK","mstate":"VA","mzip":"23504-2156","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N30.01","Z23","Q36.9","Z87.730","Z01.419","Z20.2","Z11.3","A54.9","A74.9","Z86.19","Z77.120","E66.9","Z68.54","Z00.01","L83","Z13.31","Z71.3","Z28.82","Z71.82","M26.79","Z98.890","F12.90","Z13.5","Z11.4","Z72.89","Z72.0","Z97.3","Z72.51","Q35.9","Q30.2","Z94.6","K08.109","M54.50","R51.9","R82.71","K13.0","J34.89","M26.211","L90.5","Q37.9","R22.0","F91.3"],"date":["2020-08-25","2020-02-23","2020-07-14","2021-09-14","2020-11-27","2020-11-27","2021-08-10","2021-08-13","2021-08-13","2020-12-30","2021-06-18","2021-08-10","2021-08-10","2021-08-10","2021-08-10","2021-08-10","2021-08-10","2021-08-10","2021-08-10","2021-08-10","2021-09-14","2021-08-10","2021-08-10","2021-08-10","2021-08-10","2021-08-13","2021-08-10","2021-08-13","2021-09-14","2021-09-14","2021-09-14","2021-09-14","2021-10-13","2021-10-13","2021-10-13","2019-04-24","2019-04-24","2019-04-24","2019-04-24","2019-04-24","2019-04-25","2019-10-27"],"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":[["","51224012230","AZITHROMYCIN","TAB 500MG","2","Select","Select",""],["","67877032005","IBUPROFEN","TAB 600MG","30","Select","Select",""],["","76385012350","METHOCARBAM","TAB 500MG","40","Select","Select",""],["","59267100002","PFIZER","INJ COVID-19","0.3","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","20","Select","Select",""],["","00185012201","NITROFURANTN","CAP 100MG","10","Select","Select",""],["","43386035701","HYDROCO\/APAP","TAB 7.5-325","20","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","00116200116","CHLORHEX","SOL 0.0012","473","Select","Select",""],["","11822060597","RA","LIE F 10 MG T","30","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","28","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":""}]}]}