{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" C SEMAJNAMELOC","gend":0,"add":"             841 XOB .O.P                         ","city":"MOUNT JACKSON            ","state":"VA","zip":"22842-0148","dob":"1979-05-10","age":"","mstatus":"","insh":"10112948","cliId":"","pno":"1604534097","cno":"","email":"","ename":"","eno":"","pphy":"MELAKU, SIMEON A","ppno":5404773185,"pcpadd":"120 MEDICAL DR,","pcpcity":"Mount Jackson","pcpstate":"VA","pcpzip":228429417,"pcpcounty":"","pcpid":"","pcpname":"RMH MEDICAL GROUP LLC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"NORTHERN & WINCHESTER","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"P.O. BOX 148                                      ","madd2":"                                                  ","madd3":"","mcity":"MOUNT JACKSON            ","mstate":"VA","mzip":"22842-0148","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M47.816","Z01.818","M48.061","M51.16","M51.26","F31.9","F60.3","F41.1","F41.0","Z65.9","F42.2","M54.50","M48.062","D47.02","I10","E78.5","E11.9","Z98.84","R11.0","E11.8","E78.2","Z79.4","Z20.822","G89.29","G89.18","Z79.891","Z51.81","M54.9","Z87.19","Z79.899","M51.36","F40.231","E11.65","G47.00","M53.3","M54.16","Z00.00","Z91.81","R12","R19.7","M25.50"," ","M47.817","E53.8","E61.1","K59.1","K21.9","R23.2","L29.9","D47.09","R10.31","R11.10","Z98.890","D50.9","Z72.0","M25.559","R63.4","Z23","K57.92","E78.1","K86.1","K58.9","Z79.84","F17.210","M54.6","W10.9XXA","J45.20","F31.70","R16.1","K57.30","R11.2","R50.9"],"date":["2022-09-26","2021-11-02","2022-07-20","2022-03-07","2022-10-12","2022-12-01","2022-12-01","2022-12-01","2022-12-01","2022-12-01","2022-12-01","2022-11-14","2022-07-21","2022-11-04","2022-11-11","2022-11-14","2022-11-14","2022-10-28","2022-10-12","2022-03-03","2021-11-02","2022-10-28","2022-03-04","2022-11-14","2021-11-11","2022-01-24","2022-03-24","2022-10-28","2022-09-28","2022-09-28","2022-01-24","2022-01-24","2022-07-21","2022-12-01","2022-08-09","2022-07-20","2022-07-21","2022-07-21","2022-07-01","2022-09-28","2022-07-01","2022-12-01","2022-09-26","2022-07-01","2022-07-01","2022-07-01","2022-11-11","2022-07-01","2022-07-01","2022-10-28","2022-09-28","2022-09-28","2022-09-28","2022-11-11","2022-11-11","2022-10-12","2022-10-12","2022-10-12","2022-10-28","2022-10-28","2022-10-28","2022-10-28","2022-10-28","2022-10-28","2022-08-22","2022-08-22","2022-08-22","2022-08-22","2022-11-01","2022-11-01","2022-09-28","2022-09-28"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":{"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":["",""]}},{"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":""}]}]}