{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TRE'SHAUN A SPENCER","gend":0,"add":"CRAIG SPENCER 115 STANLEY COURT","city":"DANVILLE","state":"VA","zip":"24541-9998","dob":"2005-01-29","age":"","mstatus":"","insh":"20035449*01","cliId":"","pno":4344093345,"cno":4344093345,"email":"","ename":"","eno":"","pphy":"WILLIAMS, KATIE B NP","ppno":4347992111,"pcpadd":"STE 2100 201 S MAIN STREET,","pcpcity":"DANVILLE","pcpstate":"VA","pcpzip":"24541-9998","pcpcounty":"","pcpid":"","pcpname":"Sovah Pediatrics - Danville","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4347992297,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F90.2","Z00.129","Z23.","F31.9","F51.04","G40.219","G43.019","E78.00","Z13.6","F91.1","Z00.00","E66.3"],"date":["2022-04-12","2022-04-29","2021-05-28","2022-03-08","2022-07-07","2022-07-07","2022-07-07","2021-03-03","2021-03-03","2022-07-07","2023-05-15","2023-05-15"],"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":[["","54092046801","MYDAYIS CAP","12.5MG","30","Select","Select",""],["","63402020830","APTIOM TAB","800MG","60","Select","Select",""],["","29300046810","CLONIDINE TAB","0.1MG","30","Select","Select",""],["","51293069205","PHENOBARB TAB","30MG","60","Select","Select",""],["","66993040832","CARBAMAZEPIN CAP","200MG ER","60","Select","Select",""],["","31722053960","LEVETIRACETA TAB","1000MG","90","Select","Select",""],["","00078051105","TEGRETOL-XR TAB","200MG","60","Select","Select",""],["","55111012105","ATORVASTATIN TAB","10MG","90","Select","Select",""],["","63402020830","APTIOM","TAB 800MG","60","Select","Select",""],["","29300046810","CLONIDINE","TAB 0.1MG","30","Select","Select",""],["","54092046801","MYDAYIS","CAP 12.5MG","30","Select","Select",""],["","51293069205","PHENOBARB","TAB 30MG","60","Select","Select",""],["","00078051105","TEGRETOL-XR","TAB 200MG","60","Select","Select",""],["","66993040832","CARBAMAZEPIN","CAP 200MG ER","60","Select","Select",""],["","31722053960","LEVETIRACETA","TAB 1000MG","90","Select","Select",""],["","55111012105","ATORVASTATIN","TAB 10MG","90","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":""}]}]}