{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SHAKIYAH   N BLACK-SPELL","gend":1,"add":"1722 SELDEN AVE APT A","city":"NORFOLK","state":"VA","zip":"23523-9998","dob":"2004-07-27","age":"","mstatus":"","insh":"9635971*01","cliId":"","pno":"757\/738-9071","cno":"","email":"","ename":"","eno":"","pphy":"MONEYMAKER, CAROLYN S MD","ppno":"757\/668-7400","pcpadd":"601 CHILDRENS LANE","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23507,"pcpcounty":"","pcpid":"","pcpname":"CMG - Children's Hospital of The King's Daughters - General Academic Pediatrics","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/668-9810","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R60.0","K59.00","M79.661","M79.662","K50.80","R10.84","R11.0","Z13.31","R10.31","K59.01","D50.8","K50.812","R70.0","R79.82","M79.89","R51.","J45.909","R93.5","R03.0","N39.0","R10.13","D17.9","M25.411","R22.2","R10.33","R19.7","R53.83","R63.0","M79.604","M79.605","R10.9","Z79.899","NO DATA","K50.90","I10.","E66.9","J02.9","R21.","R05.","D17.1","R11.11","Z51.81","J45.30","R89.8","Z23.","D17.0","Z01.812","Z20.822","R50.9","R04.0","R11.2","R79.89","R11.10","Z00.121","H50.34","K62.89","Z68.53","Z71.3","K50.912","D50.9"],"date":["2019-02-28","2020-03-11","2019-02-28","2019-02-28","2019-09-10","2019-03-15","2019-03-15","2021-08-10","2021-12-02","2019-09-10","2021-08-06","2021-12-02","2021-08-06","2019-02-21","2019-02-28","2019-02-28","2020-10-19","2019-10-18","2020-06-17","2020-10-19","2020-10-19","2021-04-01","2021-04-01","2021-09-17","2020-03-11","2019-02-12","2019-02-12","2019-02-12","2019-02-28","2019-02-28","2020-03-11","2021-05-12","2019-09-10","2020-03-11","2021-08-06","2021-03-03","2020-08-26","2020-08-26","2020-08-26","2021-10-15","2019-01-04","2019-01-04","2021-08-10","2019-02-26","2021-08-10","2021-10-15","2021-10-15","2021-10-15","2020-03-11","2020-03-26","2021-12-02","2020-03-17","2020-10-19","2021-08-10","2021-08-26","2019-01-22","2019-06-18","2019-06-18","2019-09-10","2019-09-10"],"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":[["","29300022701","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","00173071820","FLOVENT","AER 44MCG","11","Select","Select",""],["","45802005436","TRIAMCINOLON","OIN 0.00025","80","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","17","Select","Select",""],["","45802086803","POLYETH","POW 3350 NF","1020","Select","Select",""],["","06000053766","CERAVE","CRE MOISTURI","453","Select","Select",""],["","59746017506","PREDNISONE","TAB 20MG","15","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","30","Select","Select",""],["","00591079501","DICYCLOMINE","TAB 20MG","90","Select","Select",""],["","59310057922","PROAIR","AER ","17","Select","Select",""],["","00245010811","FERROUS","TAB 325MG EC","50","Select","Select",""],["","","LISINOPRIL","TAB 5MG","","Select","Select",""],["","68462050201","AZATHIOPRINE","TAB 50MG","60","Select","Select",""],["","64380073706","VITAMIN","CAP 50000UNT","1","Select","Select",""],["","11822033209","ALLERGY","CAP 25MG","30","Select","Select",""],["","11822303990","RA","TAB 25MG","30","Select","Select",""],["","45802093726","HYDROCORT","LOT 0.025","118","Select","Select",""],["","00904555124","BANOPHEN","TAB 25MG","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":""}]}]}