{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"HAYDEN OVERSTREET","gend":1,"add":"460 CHANEYS STORE ROAD","city":"RINGGOLD","state":"VA","zip":"24586-9998","dob":"2005-07-21","age":"","mstatus":"","insh":"20038823*01","cliId":"","pno":5403533383,"cno":5403533383,"email":"","ename":"","eno":"","pphy":"MCBRYDE, AUBREY NP","ppno":4347992111,"pcpadd":"SUITE 2100 201 S MAIN ST,","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":4347992296,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F84.0","F31.32","F33.1","F98.9","F90.2","F91.1","F84.5","Z00.00","E66.9","K59.00","Z23.","E22.1","R79.89","Z91.83","U07.1","J06.9","J03.90","Z79.899","H53.032","H50.012","H40.013","L70.9","R68.89","T50.Z95A"],"date":["2022-04-14","2023-08-21","2023-08-21","2023-05-18","2023-02-16","2023-08-21","2022-11-15","2022-07-06","2022-07-06","2022-07-06","2022-08-11","2021-06-11","2021-06-11","2023-08-21","2021-08-16","2021-08-16","2023-04-05","2023-07-24","2023-02-09","2023-02-09","2023-02-09","2021-02-17","2021-02-17","2022-08-16"],"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":[["","69097083512","SERTRALINE","TAB 100MG","60","Select","Select",""],["","00555902658","JUNEL FE","1MG-20(21)","28","Select","Select",""],["","10702010201","METHYLPHENID","TAB 20MG","30","Select","Select",""],["","50458058701","CONCERTA","54 MG","30","Select","Select",""],["","59746001032","RISPERIDONE","TAB 0.5MG OD","60","Select","Select",""],["","13668001005","CITALOPRAM","TAB 20MG","180","Select","Select",""],["","00228212750","CLONIDINE","TAB 0.1MG","180","Select","Select",""],["","00115180301","HYDROXYZ PAM","CAP 25MG","30","Select","Select",""],["","59779030602","CVS PURELAX","POW ","476","Select","Select",""],["","69452015120","VITAMIN D","CAP 50000UNT","4","Select","Select",""],["","43547030303","ARIPIPRAZOLE","5 MG","30","Select","Select",""],["","00115180301","HYDROXYZINE PAMOATE","25 MG","30","Select","Select",""],["","69097083512","SERTRALINE HCL","100 MG","60","Select","Select",""],["","67877019905","AMLODIPINE BESYLATE","10 MG","30","Select","Select",""],["","13811070910","METHYLPHENIDATE ER","54 MG","30","Select","Select",""],["","65862001501","AMOXICILLIN","875 MG","20","Select","Select",""],["","00378064205","PREDNISONE","20 MG","18","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":""}]}]}