{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MARKIECE   D JEFFERSON","gend":0,"add":"812 WINNETKA AVE","city":"RICHMOND","state":"VA","zip":"23227-9998","dob":"2004-06-10","age":"","mstatus":"","insh":"9581405*01","cliId":"","pno":"804\/264-4013","cno":"","email":"","ename":"","eno":"","pphy":"SCHEY, NICHOLAS J MD","ppno":"804\/730-4690","pcpadd":"7347 BELL CREEK RD STE 100","pcpcity":"MECHANICSVILLE","pcpstate":"VA","pcpzip":23111,"pcpcounty":"","pcpid":"","pcpname":"BON SECOURS PEDIATRICS OF MECHANICSVILLE","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/559-0333","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F90.2","F43.9","F91.3","F43.10","Z00.121","Z23.","G47.36","E66.2","R73.09","Z13.220","R46.89","Z68.54","R05.","Z00.129","J02.9","Z60.9","G47.30","G47.10","R06.83","J30.2","E66.3","R06.89","K59.00","F41.9","S39.012A","Y04.0XXA","Y92.219","H66.002","R40.0","F39.","M92.51","M92.52","G47.33","J35.3"],"date":["2020-03-22","2020-07-01","2020-06-28","2020-06-18","2020-08-24","2020-08-24","2020-08-24","2020-08-24","2020-08-24","2020-08-24","2020-08-24","2020-08-24","2019-09-10","2019-05-06","2019-05-06","2019-05-06","2019-08-23","2019-08-23","2019-09-10","2019-09-10","2019-09-10","2019-09-10","2019-09-10","2019-07-18","2019-05-02","2019-05-02","2019-05-02","2019-03-07","2019-03-07","2019-03-07","2019-03-07","2019-03-07","2019-10-01","2019-10-01"],"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":[["","42806004801","GUANFACINE","TAB 1MG","60","Select","Select",""],["","14539067401","HYDROXYZ","CAP 25MG","60","Select","Select",""],["","29300013510","CLONIDINE","TAB 0.1MG","30","Select","Select",""],["","00591544305","PREDNISONE","TAB 20MG","5","Select","Select",""],["","64380080807","IBUPROFEN","TAB 600MG","20","Select","Select",""],["","65862001501","AMOXICILLIN","TAB 875MG","20","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":""}]}]}