{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BRYAN   O ELIAS","gend":0,"add":"PO BOX 14444","city":"NORFOLK","state":"VA","zip":"23518-9998","dob":"2004-06-13","age":"","mstatus":"","insh":"9833609*01","cliId":"","pno":"757\/318-8122","cno":"757\/907-2083","email":"","ename":"","eno":"","pphy":"JOYCE, MICHAEL H MD","ppno":"757\/451-5000","pcpadd":"7423 GRANBY STREET","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23505,"pcpcounty":"","pcpid":"","pcpname":"WARDS CORNER PEDIATRICS","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/451-5005","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z03.89","Z11.59","I10.","E66.9","Z00.121","E66.01","F90.9","N62.","Z13.0","Z23.","Z13.89","I12.0","G47.33","R00.0","F41.9","E78.5","Z68.54","R06.83","Z99.89","G47.21","A08.4","Z13.31","R10.9","R05.","B34.8","Z86.19","E78.2","E66.8","F90.0","Z79.899","R63.5","R07.89","G47.9","L21.0","Z02.89","Z04.1","M25.511","M79.601"],"date":["2020-07-30","2020-07-30","2021-12-13","2021-12-13","2021-10-08","2019-08-14","2021-09-13","2020-09-08","2021-10-08","2021-10-08","2019-12-16","2020-06-03","2021-09-03","2020-12-05","2020-12-09","2020-12-05","2021-01-26","2021-03-14","2021-03-30","2021-03-30","2021-09-13","2021-10-08","2020-11-05","2020-11-05","2020-11-01","2020-11-01","2021-09-03","2021-09-03","2020-12-09","2019-12-16","2019-04-15","2020-10-30","2020-10-30","2021-10-08","2020-10-30","2021-06-28","2021-06-28","2021-06-28"],"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":[["","","LOSARTAN\/HCT"," LOSARTAN\/HCT ","30","Select","Select",""],["","","AMLODIPINE"," AMLODIPINE ","30","Select","Select",""],["","","IRON"," IRON ","30","Select","Select",""],["","","FLUTICASONE"," FLUTICASONE ","16","Select","Select",""],["","","ALLERGY"," ALLERGY ","30","Select","Select",""],["","","ALLOPURINOL"," ALLOPURINOL ","60","Select","Select",""],["","","FLONASE"," FLONASE ","10","Select","Select",""],["","","VYVANSE"," VYVANSE ","30","Select","Select",""],["","","VITAMIN"," VITAMIN ","4","Select","Select",""],["","","RA"," RA ","30","Select","Select",""],["","","FEROSUL","TAB 325MG","","Select","Select",""],["","","CETIRIZINE","TAB 10MG","","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":""}]}]}