{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ARIEL   L STARKEY","gend":1,"add":"420 W BUTE ST 7 CANAL DRIVE","city":"NORFOLK","state":"VA","zip":"23510-9998","dob":"2004-07-19","age":"","mstatus":"","insh":"1565330*01","cliId":"","pno":"757\/871-7220","cno":"","email":"","ename":"","eno":"","pphy":"SCHANK, EMILY L MD","ppno":"757\/640-0022","pcpadd":"1909 A GRANBY STREET","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23517,"pcpcounty":"","pcpid":"","pcpname":"CMG - Children's Hospital of The King's Daughters - Pediatric Associates","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/627-8064","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F34.1","F90.2","F32.1","F33.2","J30.81","L50.8","J30.1","F33.8","F41.1","F90.9","L70.0","Z71.9","F41.8","V62.84","F41.9","F90.0","Z63.79","F33.1","F32.9","Z28.21"],"date":["2021-01-07","2020-10-29","2021-03-16","2021-06-17","2020-12-10","2020-12-10","2020-12-10","2021-03-02","2021-04-23","2021-03-16","2020-05-04","2020-05-04","2021-01-05","2021-01-05","2021-03-02","2021-01-27","2021-01-27","2019-04-02","2019-06-07","2019-11-25"],"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":[["","","VYVANSE"," VYVANSE ","30","Select","Select",""],["","50111064801","FLUOXETINE","CAP 20MG","30","Select","Select",""],["","50228043605","NAPROXEN","TAB 500MG","14","Select","Select",""],["","","BUPROPN"," BUPROPN ","30","Select","Select",""],["","","TRETINOIN"," TRETINOIN ","40","Select","Select",""],["","","RETIN-A"," RETIN-A ","40","Select","Select",""],["","","CLINDAMY\/BEN"," CLINDAMY\/BEN ","45","Select","Select",""],["","","CLINDAMYCIN","CAP 300MG","","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":""}]}]}