{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"XTAVON   A BARKERS","gend":0,"add":"560 CANDLE LN APT 302","city":"NEWPORT NEWS","state":"VA","zip":"23608-9998","dob":"2004-02-28","age":"","mstatus":"","insh":"9284052*01","cliId":"","pno":"757\/310-2211","cno":"","email":"","ename":"","eno":"","pphy":"YOUNG, ELISA M MD","ppno":"757\/668-4800","pcpadd":"12705 MCMANUS BOULEVARD","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":23602,"pcpcounty":"","pcpid":"","pcpname":"CMG - Children's Hospital of The King's Daughters - Liberty Pediatrics","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/668-4828","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F91.3","V62.84","J45.909","F32.9","F41.9","Z02.89","Z04.89","R06.00","J45.21","J45.51","R06.02","R55.","R94.31","R53.83","S16.1XXA","M54.2","R11.2","R19.7","F90.0","F32.0","Z00.121","F91.8","J45.30","R00.0"],"date":["2021-03-12","2021-03-08","2021-03-08","2021-03-08","2021-03-08","2021-03-08","2021-03-08","2020-10-03","2020-10-02","2020-10-03","2020-10-03","2022-01-26","2022-01-26","2021-12-28","2019-10-17","2019-10-17","2019-03-12","2019-03-12","2019-10-25","2019-10-25","2019-10-22","2019-10-22","2019-10-22","2022-02-14"],"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":[["","00173071920","FLOVENT","AER 110MCG","12","Select","Select",""],["","76204020025","ALBUTEROL","NEB 0.00083","150","Select","Select",""],["","00085113204","PROVENTIL","AER HFA","7","Select","Select",""],["","59310030240","QVAR","AER 40MCG","11","Select","Select",""],["","","IPRATROPIUM\/","SOL ALBUTER","","Select","Select",""],["","59310057922","PROAIR","AER ","17","Select","Select",""],["","31722072690","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","","BACITRACIN","OIN 500\/GM","","Select","Select",""],["","","CEPHALEXIN","CAP 250MG","","Select","Select",""],["","","FLUOXETINE","CAP 20MG","","Select","Select",""],["","00591544305","PREDNISONE","TAB 20MG","12","Select","Select",""],["","57237007530","ONDANSETRON","TAB 4MG","15","Select","Select",""],["","83490031065","VIOS","MIS SYSTEM","1","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","16","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":""}]}]}