{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" REFINNEJNOSNHOJ R","gend":1,"add":"OSRETTAP 585DAOR LLIM N","city":"GROTTOES","state":"VA","zip":"24441-4316","dob":"1974-12-02","age":"","mstatus":"","insh":"9027650","cliId":"","pno":"4704536252","cno":"","email":"","ename":"","eno":"","pphy":"TRAN, GEORGE M","ppno":5402139260,"pcpadd":"3881 CHURCHVILLE AVE,","pcpcity":"Churchville","pcpstate":"VA","pcpzip":"24421-2525","pcpcounty":"","pcpid":"","pcpname":"AUGUSTA HEALTH FAMILY PRACTICE","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"585 PATTERSON MILL ROAD","add3":"","madd1":"585 PATTERSON MILL ROAD","madd2":"","madd3":"","mcity":"GROTTOES","mstate":"VA","mzip":"24441-4316","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R55","Z01.419","Z12.12","Z30.41","Z12.39","R10.2","N92.6","N39.0","B96.20","F41.9","F32.9","Z87.410","E03.9","Z86.19","F33.41","F90.9","F29","F51.01","Z79.899","F41.1","F23","Z03.818","F22","F40.8","F51.05","F41.0","F17.210","Z20.822","Z72.89","Z91.410","Z91.411","Z62.810","Z56.0","Z82.3","Z82.49","Z12.31","H92.01","G43.909","M67.431","Z01.812","L73.9","E78.5","E55.9","H93.8X1","H93.91","R10.30","L29.9","Z87.42","Z87.891","Z88.0","M54.5","N72","Z11.59","Z23","L70.0","L73.8","L85.3","R53.83","J01.90","E66.3","Z12.4","Z71.3","Z68.26","Z68.25","D23.5","D48.5","L57.8","D22.5","L82.1","L81.4","L82.0","L53.8","Z68.24","J45.909","G47.00","J30.2","B37.31","L70.9","J04.0","H65.91","R03.0","N80.9","R35.0","F33.0"],"date":["2021-01-06","2023-03-30","2023-03-30","2021-07-06","2021-01-06","2023-03-10","2021-01-06","2021-06-11","2021-01-06","2021-03-10","2022-10-18","2021-01-06","2021-01-06","2021-01-06","2023-05-23","2023-05-23","2022-12-14","2023-05-23","2023-05-23","2021-01-12","2021-01-07","2021-01-07","2023-05-23","2021-01-08","2021-01-08","2021-01-08","2021-01-08","2021-08-13","2021-01-08","2021-01-08","2021-01-08","2021-01-08","2021-01-08","2021-01-08","2021-01-08","2022-10-18","2021-07-12","2022-10-18","2021-05-18","2021-04-29","2021-05-05","2023-01-10","2022-08-24","2021-07-12","2021-06-04","2021-06-11","2021-06-11","2022-10-18","2021-06-11","2021-06-11","2021-06-22","2021-07-06","2021-07-06","2022-10-18","2021-10-13","2021-10-13","2022-07-15","2022-10-26","2022-05-05","2023-04-11","2022-03-04","2023-04-11","2023-04-11","2023-01-10","2022-07-15","2022-07-15","2022-07-15","2022-07-15","2022-07-15","2022-07-15","2022-07-15","2022-07-15","2022-08-24","2022-10-18","2022-10-18","2022-10-18","2022-10-18","2022-10-18","2022-11-30","2022-11-30","2022-11-30","2023-03-10","2023-03-10","2023-04-25"],"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":[]},{"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":""}]}]}