{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" LEAHCIMRHEID E","gend":0,"add":"IELAR 53TRUOC HG","city":"WINCHESTER","state":"VA","zip":"22601-5520","dob":"1971-05-14","age":"","mstatus":"","insh":"10111355","cliId":"","pno":"8404533716","cno":"","email":"","ename":"","eno":"","pphy":"DELANOY, ANNE E","ppno":"3042634999          ","pcpadd":"99 Tavern Rd, PO Box 1146","pcpcity":"Martinsburg","pcpstate":"WV","pcpzip":"254012890","pcpcounty":"","pcpid":"","pcpname":"SHENANDOAH COMMUNITY HEALTH CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"NORTHERN & WINCHESTER","aligned":"Y","ano":"","add2":"","add3":"","madd1":"35 RALEIGH COURT","madd2":"","madd3":"","mcity":"WINCHESTER","mstate":"VA","mzip":"22601-5520","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.3","R00.0","E13.9","G21.11","I10","F25.0","I50.9","E66.01","E03.9","Z59.9","Z13.220","E11.9","N17.0","R07.9","Z68.42","E87.2","Z20.822","F32.9","F25.9","E11.65","E86.0","R19.7","E83.42","E87.5","I87.2","G89.29","N17.9","R07.89","E87.70","D50.9","K52.9","M43.16","R10.9","B37.2","R21","Z68.43","L03.311","I11.0","L40.9","F32.A","Z87.891","Z86.14","Z79.890","Z79.899","Z79.84","L03.314","E07.9","L03.90","R59.0","K76.0"],"date":["2022-01-26","2022-01-28","2022-01-28","2022-01-28","2022-01-28","2022-01-28","2022-01-28","2022-01-28","2022-01-28","2022-01-28","2022-01-28","2021-12-16","2021-06-17","2021-06-17","2021-06-17","2021-06-20","2021-06-17","2021-06-17","2021-12-16","2021-12-18","2021-06-17","2021-06-17","2021-06-17","2021-06-20","2021-06-17","2021-06-17","2021-06-20","2021-12-16","2021-06-20","2021-06-20","2021-06-19","2021-06-19","2021-12-15","2021-12-16","2021-12-16","2021-12-16","2021-12-18","2021-12-16","2021-12-16","2021-12-16","2021-12-16","2021-12-16","2021-12-16","2021-12-16","2021-12-16","2021-12-16","2021-12-16","2021-12-16","2021-12-16","2021-12-16"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"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":[]}},{"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":["",""]}},{"a":{"indx":["1",""],"comment":["",""]}},{"a":{"indx":["1",""],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","",""],[""],[""],[""],[""]],"comment":[["","",""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"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":""}]}]}