{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KYRA CARRINGTON","gend":1,"add":"4503 MC GILL ST APT C","city":"HENRICO","state":"VA","zip":"23231-9998","dob":"2000-07-13","age":"","mstatus":"","insh":"20050582*01","cliId":"","pno":"804\/926-5121","cno":"","email":"","ename":"","eno":"","pphy":"TAYLOR, DONALD A MD","ppno":"804\/288-9898","pcpadd":"STE 310 5875 BREMO ROAD","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":23226,"pcpcounty":"","pcpid":"","pcpname":"PEDIATRIC NEUROLOGY ASSOC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/673-6616","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F43.20","K29.70","R10.9","G40.401","Z20.828","F31.74","F90.2","Z30.013","Z11.3","S93.401A","M79.671","F33.1","Z00.00","Z23.","F31.9","N76.0","Z30.09","N89.8","T78.40XA","G40.919","R56.9","G40.409","I10.","Z68.54","H66.002"],"date":["2020-07-20","2020-08-26","2020-08-26","2021-11-19","2021-07-19","2021-09-28","2021-12-26","2020-03-25","2020-03-25","2021-03-27","2021-03-27","2021-12-20","2020-02-12","2020-02-12","2021-11-22","2020-06-18","2020-01-29","2020-01-29","2019-03-01","2019-07-29","2019-07-29","2019-12-12","2019-01-24","2019-01-24","2019-02-28"],"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":[["","51991029301","OXCARBAZEPIN","TAB 300MG","60","Select","Select",""],["","80777027399","MODERNA","INJ COVID-19","0","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0","Select","Select",""],["","","METRONIDAZOL","TAB 500MG","","Select","Select",""],["","","ESOMEPRA","CAP 40MG DR","","Select","Select",""],["","","SUCRALFATE","TAB 1GM","","Select","Select",""],["","","NEXIUM","TAB 20MG","","Select","Select",""],["","","EQ","TAB 20MG","","Select","Select",""],["","","FAMOTIDINE","TAB 20MG","","Select","Select",""],["","53489011905","DOXYCYCL","CAP 100MG","14","Select","Select",""],["","16571020210","DICLOFENAC","TAB 50MG DR","14","Select","Select",""],["","68382091634","METHYLPRED","TAB 4MG","21","Select","Select",""],["","69315030805","CIPROFLOXACN","SOL 0.3% OP","5","Select","Select",""],["","00555902542","JUNEL","TAB ","378","Select","Select",""],["","68180085211","MY","TAB 1.5MG","2","Select","Select",""],["","61783000012","FC2","MIS CONDOM","24","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":""}]}]}