{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" YELTANDROF I","gend":1,"add":"ETRAC 3821CR ELLIVSR","city":"CARTERSVILLE","state":"VA","zip":230279999,"dob":"1938-10-23","age":"","mstatus":"","insh":"10110763","cliId":"5MM2PY0CA28","pno":"1540807892","cno":8046154421,"email":"","ename":"","eno":"","pphy":"BLACKWELL, BRIAN K","ppno":4345813271,"pcpadd":"25892 N James Madison Hwy","pcpcity":"New Canton","pcpstate":"VA","pcpzip":231232234,"pcpcounty":"","pcpid":"P9058488","pcpname":"CENTRAL VIRGINIA COMMUNITY HEALTH CENTER","plan":"VPHP - VIRGINIA PREMIER","program":"Medicare","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["Z01.810","R94.31","I07.1","N39.0","Z11.59","N13.39","R31.29","N99.3","D50.0","I10","H40.9","Z90.49","C54.1","D62","Z20.828","N18.4","I12.9","N93.9","Z85.038","H40.1112","H40.1123","E78.2","E87.2","E87.5","N05.1","N17.9","N18.3","D63.1","C18.3","D64.9","N13.6","N18.5","K92.1","E44.0","I12.0","Z68.23","D12.0","D12.2","D12.4","D63.8","E78.00","E78.5","D50.9","N18.9","R10.30","R31.9","D12.3","C18.9","D49.0","C18.2","K63.89","J90","J98.11","N13.30","D25.9","R93.89","D64.89","K57.30","K66.0","R31.21","H18.51","H10.13","Z68.24","I35.1","I36.1","I77.810","I51.7","I49.1","I44.0","Z01.812","N95.0","E86.9","N17.0","E88.09","Z20.822","R62.7","Z91.15","Z90.710","Z99.2","R11.10","R14.0","N18.32","R60.9","Z48.3","L89.322","N18.6","Z79.01","Z99.3","Z91.81","E11.9","Z01.419","R87.619"],"date":["2020-11-06","2020-12-17","2020-11-06","2020-12-08","2020-12-08","2020-12-17","2020-12-21","2020-12-17","2020-12-17","2021-02-01","2021-02-04","2020-12-17","2021-02-04","2020-12-19","2020-12-19","2021-02-02","2021-01-22","2020-12-19","2020-12-19","2020-09-25","2020-09-25","2020-07-30","2021-02-04","2021-01-26","2020-07-30","2021-01-24","2020-07-30","2021-02-04","2020-08-07","2020-12-21","2020-08-01","2020-08-01","2020-08-01","2020-08-01","2021-02-04","2020-08-01","2020-08-07","2020-08-07","2020-08-07","2020-08-01","2020-08-03","2020-08-01","2020-08-07","2021-01-19","2020-08-03","2020-08-10","2020-08-07","2021-02-04","2020-08-06","2020-08-07","2021-01-19","2020-08-05","2020-08-05","2020-08-10","2020-08-06","2020-08-06","2020-08-06","2020-08-07","2020-08-07","2020-10-01","2020-09-25","2020-09-25","2020-10-15","2020-11-06","2020-11-06","2020-11-06","2020-11-06","2020-12-17","2020-12-17","2021-01-08","2021-01-08","2021-01-19","2021-02-02","2021-01-19","2021-01-19","2021-01-19","2021-01-19","2021-01-19","2021-02-04","2021-01-19","2021-01-19","2021-01-26","2021-02-02","2021-02-04","2021-02-04","2021-02-04","2021-02-04","2021-02-04","2021-02-04","2020-12-30","2020-12-30","2020-12-30"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}},{"a":[]}]},{"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":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}}]},{"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":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[]}},{"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":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[[["Select","Select","","","","","Select","",""],["Select","Select","","","","","Select","",""],["Select","Select","","","","","Select","",""],["Select","Select","","","","","Select","",""],["Select","Select","","","","","Select","",""],["Select","Select","","","","","Select","",""],["No","Select","","","","","Select","",""]]]},{"t":"Mini-Cog","q":[{"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":""}]}]}