{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"RAKEEM   A JOHNSON","gend":0,"add":"4142 EVERETT ST","city":"CHESAPEAKE","state":"VA","zip":"23324-9998","dob":"2003-12-27","age":"","mstatus":"","insh":"9142517*01","cliId":"","pno":"757-729-3099","cno":"757\/351-6297","email":"","ename":"","eno":"","pphy":"BURROWS, ADAYNA 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":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/962-8915","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F90.0","S50.362A","R21.","K29.00","J02.9","I10.","J45.909","F90.9","F90.8","F43.25","J36.","Z20.828","Z20.822","R43.0","R11.0","K92.0","U07.1","R43.8","R51.","R07.9","Z13.30","F90.2","Z23.","Z03.818","Z79.899","J03.90"],"date":["2021-12-19","2020-02-11","2020-02-11","2020-07-26","2020-10-20","2021-06-30","2021-06-30","2021-06-30","2019-12-08","2019-12-05","2020-11-05","2020-08-01","2021-02-11","2021-02-11","2020-07-26","2020-07-26","2021-02-11","2021-02-11","2019-12-05","2019-12-05","2019-12-05","2020-01-21","2020-01-21","2020-08-01","2020-08-01","2021-06-30"],"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":[["","","ADDERALL"," ADDERALL ","30","Select","Select",""],["","","AMPHET\/DEXTR"," AMPHET\/DEXTR ","30","Select","Select",""],["","","CLONIDINE","TAB 0.1MG","","Select","Select",""],["","","FAMOTIDINE","TAB 20MG","","Select","Select",""],["","","MONTELUKAST","TAB 10MG","","Select","Select",""],["","","PROAIR","AER ","","Select","Select",""],["","","APAP\/CODEINE","TAB 300-15MG","","Select","Select",""],["","","AMLODIPINE","TAB 2.5MG","","Select","Select",""],["","","ALBUTEROL","AER HFA","","Select","Select",""],["","","CEPHALEXIN","CAP 500MG","","Select","Select",""],["","","CLINDAMYCIN","CAP 300MG","","Select","Select",""],["","","AMOXICILLIN","CAP 500MG","","Select","Select",""],["","","PREDNISONE","TAB 10MG","","Select","Select",""],["","","ONDANSETRON","TAB 4MG","","Select","Select",""],["","","GG\/DM","SYP 100-10\/5","","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":""}]}]}