{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TAMITHA   L HAYES","gend":1,"add":"107 SEA COVE CT APT 201","city":"VIRGINIA BEACH","state":"VA","zip":"23451-9998","dob":"1992-09-03","age":"","mstatus":"","insh":"2735156*01","cliId":"","pno":"757\/667-0499","cno":"757\/631-3079","email":"","ename":"","eno":"","pphy":"ESCALERA II, ROBERT MD","ppno":"757\/668-7213","pcpadd":"601 CHILDRENS LANE","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23507,"pcpcounty":"","pcpid":"","pcpname":"CSG - Children's Hospital of The King's Daughters - Pediatric Cardiology","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/668-8225","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["O47.03","Z3A.29","O10.913","R07.89","R03.0","R31.21","Z20.828","O10.912","O35.8XX0","O40.2XX0","O36.62X0","V23.5","O10.013","O40.3XX0","Z3A.28","V23.9","Z3A.32","O36.63X0","F43.23","O10.92","Z37.0","Z3A.39","O99.824","O99.214","O69.81X0","O66.0","O70.1","E66.9","Z79.82","Z79.899","M25.861","M22.41","O28.3","Q21.0","Q22.1","Q23.8","O35.9XX0","Z3A.25","Q21.2","I51.7","I34.1","Z3A.34","Z23.","O14.05","Z20.822","N91.2","I10.","Z68.41","R11.2","O20.0","V23.87","M17.11","M22.8X1","Z39.1","Z34.82","Z34.83","Q25.0","O26.891","R10.9","R51.","Z3A.11","Z13.32","Z3A.30","Z3A.33","Z3A.36","Z01.30","O14.95","O14.14","Z3A.35","K21.9","E66.01","Z82.49","Z81.8","Z80.9","Z91.048","O13.4","D56.0","O99.62","O99.42","R10.2","O10.911","O99.331","F17.210","Z3A.12","Z86.19","Z87.09","R30.0","O80.","O20.9","Z3A.00","Z87.59","O26.93","Z30.430","Z32.02","U07.1","O03.9","O35.2XX0","Z3A.22","I37.0","I05.0","O99.210","Z3A.24","V23.2","J06.9","O03.4","Z33.1","Z34.90","O36.5920","O99.212","O14.15","O99.43","O99.215","O99.03","O99.63","Z80.41"],"date":["2019-06-19","2019-06-19","2021-06-07","2020-07-14","2020-07-14","2020-07-14","2020-07-14","2021-04-09","2021-06-07","2021-04-09","2021-05-10","2021-05-10","2021-06-08","2021-06-08","2021-04-19","2021-05-28","2021-05-14","2021-06-07","2021-12-28","2019-08-26","2021-06-08","2019-08-26","2019-08-26","2021-06-07","2021-06-07","2019-08-26","2019-08-26","2019-08-26","2019-08-26","2021-06-11","2020-08-31","2020-09-23","2021-05-11","2021-06-10","2021-03-22","2021-03-22","2021-03-24","2021-03-24","2021-05-11","2021-05-11","2021-06-23","2021-05-28","2021-05-28","2021-06-11","2021-11-09","2019-01-10","2021-03-16","2019-01-10","2019-01-10","2020-02-26","2020-02-26","2020-09-23","2020-09-23","2021-04-16","2021-04-16","2021-04-16","2021-06-10","2019-02-12","2019-02-12","2019-02-12","2019-02-11","2019-10-09","2021-04-29","2021-05-24","2021-06-08","2021-06-23","2021-06-23","2021-06-07","2021-06-07","2021-06-11","2021-06-11","2021-06-11","2021-06-11","2021-06-07","2021-06-07","2021-06-07","2021-06-07","2021-06-07","2021-06-07","2019-02-12","2019-02-12","2019-02-12","2019-02-12","2019-02-12","2019-02-12","2019-02-12","2019-02-12","2019-08-26","2020-03-04","2020-03-04","2021-05-11","2021-05-21","2021-07-21","2021-07-21","2021-08-12","2020-03-04","2021-03-05","2021-03-05","2021-04-19","2021-04-19","2019-05-14","2021-03-22","2019-08-02","2020-01-15","2020-03-02","2021-03-16","2021-03-16","2021-03-22","2021-03-22","2021-06-11","2021-06-11","2021-06-11","2021-06-11","2021-06-11","2021-06-11"],"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":[["","","PRENATE"," PRENATE ","30","Select","Select",""],["","","LABETALOL"," LABETALOL ","60","Select","Select",""],["","","ONDANSETRON"," ONDANSETRON ","30","Select","Select",""],["","","METHYLDOPA"," METHYLDOPA ","60","Select","Select",""],["","","NIFEDIPINE"," NIFEDIPINE ","30","Select","Select",""],["","","FERROUS"," FERROUS ","60","Select","Select",""],["","","RANITIDINE"," RANITIDINE ","45","Select","Select",""],["","","HYDROCO\/APAP"," HYDROCO\/APAP ","20","Select","Select",""],["","","IBUPROFEN"," IBUPROFEN ","30","Select","Select",""],["","","PRENATAL","","","Select","Select",""],["","","AZITHROMYCIN","TAB 250MG","","Select","Select",""],["","","OSELTAMIVIR","CAP 75MG","","Select","Select",""],["","","ASPIRIN","TAB 81MG EC","","Select","Select",""],["","","FAMOTIDINE","TAB 20MG","","Select","Select",""],["","","NAPROXEN","TAB 500MG","","Select","Select",""],["","","NABUMETONE","TAB 750MG","","Select","Select",""],["","","METRONIDAZOL","TAB 500MG","","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":""}]}]}