{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JEREMY   L MARABLE","gend":0,"add":"2297 ROBIN HOOD DRIVE","city":"DANVILLE                      ","state":"VA","zip":"24540-5805","dob":"1996-12-11","age":"","mstatus":"","insh":4365937,"cliId":"","pno":8609788279,"cno":"","email":"","ename":"","eno":"","pphy":"KURIAN, WILBY","ppno":4347912612,"pcpadd":"404 Airport Dr Ste A,","pcpcity":"Danville                      ","pcpstate":"VA","pcpzip":245405196,"pcpcounty":"","pcpid":"","pcpname":"CENTRA MEDICAL GROUP","plan":"VPHP","program":"MEDICAID","lob":"MLTSS","region":"WESTERN\/ CHARLOTTESVILLE","aligned":"","ano":"","add2":"2297 ROBIN HOOD DRIVE","add3":"","madd1":"2297 ROBIN HOOD DRIVE","madd2":"","madd3":"","mcity":"DANVILLE                      ","mstate":"VA","mzip":"24540-5805","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F10.20","F25.1","F20.9","F43.10","I10","F33.2","R52","M54.2","H53.8","S13.9XXA","I27.20","E04.1","V49.50XA","F17.210","Z79.899","R07.9","R51","R10.9","H31.011","H31.092","L05.01","L02.32","Z87.891","L05.02","Z04.1","R07.89","V43.62XA","Y92.9","Y99.9","F90.9","F32.9","A41.9","J18.9","J96.00","R65.20","J96.01","I16.1","E87.2","E46","I24.8","R04.2","R06.02","D64.9","E83.39","R74.8","F31.9","R06.09","R79.89","R58","R09.02","R06.89","R00.0","U07.1","J18.0","S61.441A","S61.011A","S61.212A","S61.214A","S61.216A","M79.641","W25.XXXA","Z72.0","Z48.02","H61.23","G44.89","F33.1","S62.314A","M25.511","Y09","S62.324A","R20.0","R20.2","Y04.0XXA","Y93.89","Y92.149","M62.82","Z20.822","R45.851","L03.113","R74.01","F25.0","I16.0","F19.10","Z87.09","S27.401S","Z91.5","Z82.3","Z83.3","Z80.9"],"date":["2020-09-16","2020-09-16","2021-07-02","2020-09-16","2021-07-02","2020-08-09","2021-02-20","2020-04-19","2020-04-19","2020-04-19","2020-04-19","2020-04-19","2020-04-19","2021-06-28","2020-04-19","2020-04-19","2020-06-10","2020-04-19","2020-05-18","2020-05-18","2020-06-04","2020-06-04","2020-06-10","2020-06-04","2020-06-10","2020-06-10","2020-06-10","2020-06-10","2020-06-10","2021-07-02","2021-06-28","2020-07-01","2020-07-07","2020-07-02","2020-07-02","2020-07-01","2020-07-01","2020-07-01","2020-07-01","2020-07-01","2020-07-01","2021-06-28","2020-06-30","2020-06-30","2020-06-30","2020-06-30","2020-06-30","2020-06-30","2020-06-30","2021-02-20","2020-06-30","2020-06-30","2020-06-30","2020-06-30","2021-07-06","2020-08-07","2020-08-07","2020-08-07","2020-08-07","2020-08-07","2020-08-07","2020-08-07","2020-08-13","2020-09-21","2021-02-20","2021-12-26","2021-06-28","2021-06-28","2021-06-28","2021-06-28","2021-06-28","2021-06-28","2021-06-28","2021-06-28","2021-06-28","2021-07-02","2021-07-02","2021-07-02","2021-07-02","2021-07-02","2021-07-02","2021-07-02","2021-07-02","2021-07-02","2021-07-02","2021-07-02","2021-07-02","2021-07-02","2021-07-02"],"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":""}]}]}