{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TREZURE   M MOBLEY","gend":1,"add":"APT A 59 FULTON","city":"HAMPTON","state":"VA","zip":"23663-9998","dob":"2004-04-01","age":"","mstatus":"","insh":"9344020*01","cliId":"","pno":"757\/722-4665","cno":"","email":"","ename":"","eno":"","pphy":"WOOD, MERRILL L NP","ppno":"757\/838-8166","pcpadd":"2101 EXECUTIVE DR STE 160","pcpcity":"HAMPTON","pcpstate":"VA","pcpzip":23666,"pcpcounty":"","pcpid":"","pcpname":"ASSOCIATES IN PEDIATRIC CARE-HAMPTON LLC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/838-8233","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M25.519","M41.119","R45.2","Z78.9","F32.9","F41.1","Z91.5","Z13.31","Z13.39","Z00.121","Z71.82","E66.9","M54.5","Z72.820","L83.","R22.2","Z13.89","Z91.842","R55.","R09.81","R50.9","R51.9","Z20.822","NO DATA","M25.50","M54.9","R11.10","R22.0","N64.89","L02.91","E66.01","Z68.54","M41.85","Z01.00","Z01.10","Z23."],"date":["2020-02-18","2020-02-18","2021-08-12","2021-08-17","2021-08-17","2021-08-17","2021-08-13","2021-08-13","2021-08-13","2021-08-04","2020-07-16","2020-07-16","2020-07-16","2020-07-16","2021-08-04","2021-08-04","2020-07-16","2020-07-16","2020-07-16","2022-01-27","2022-01-27","2022-01-27","2022-01-27","2022-01-27","2022-01-27","2022-01-27","2022-01-27","2021-06-07","2021-08-04","2021-08-04","2021-08-04","2021-08-04","2021-08-04","2021-08-04","2021-08-04","2021-08-04"],"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":[]},{"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":[["","42571016242","AMOX\/K","TAB 875-125","14","Select","Select",""],["","10006073039","MELATONIN","TAB 5MG","30","Select","Select",""],["","65862018601","CLINDAMYCIN","CAP 300MG","21","Select","Select",""],["","67877032105","IBUPROFEN","TAB 800MG","30","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":""}]}]}