{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JOHN C PITCHER","gend":0,"add":"AUTUMN CARE CENTER","city":"MADISON","state":"VA","zip":227279999,"dob":"1959-04-16","age":"","mstatus":"","insh":11000381,"cliId":"6UW0HT6KW23","pno":5408140185,"cno":4344295260,"email":"","ename":"","eno":"","pphy":"MIRANDA, ALTORY M","ppno":8045546132,"pcpadd":"2237 Rose Family Dr","pcpcity":"Midlothian","pcpstate":"VA","pcpzip":231124187,"pcpcounty":"","pcpid":"P0114062","pcpname":"VIRGINIA HEALTHCARE PC","plan":"VPHP - VIRGINIA PREMIER","program":"Medicare","lob":"DSNP","region":"WESTERN\/CHARLOTTESVILLE","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":["F02.80","M62.81","R26.2","R13.12","R48.8","H54.8","E44.1","G47.00","K21.9","B18.2","F41.9","G60.9","K59.00","E56.9","I82.91","R52","Z96.21","F03.90","F10.19","Z91.81","M19.90","G89.21","G89.29","R26.89","N18.3","R54","H90.3","Z48.89","Z46.2","M19.91","S71.101A","S71.101S","H91.93","F03.91","H53.429","E87.0","I10","E46","S71.101D","S81.801A","Z23","Z20.828","Z11.59","Z20.822"],"date":["2018-01-02","2021-02-09","2020-06-01","2018-11-03","2021-01-01","2021-01-01","2021-01-26","2021-02-25","2021-01-01","2021-01-01","2018-08-07","2021-01-01","2021-01-01","2021-01-01","2021-01-01","2021-01-01","2021-01-01","2021-02-25","2021-01-01","2021-01-01","2019-12-03","2020-01-07","2021-02-25","2019-01-15","2020-01-21","2019-02-12","2019-07-16","2018-04-11","2018-04-11","2019-10-22","2018-06-08","2018-07-12","2019-07-19","2018-08-17","2020-08-18","2019-10-22","2019-09-03","2018-09-11","2018-10-12","2018-10-23","2018-11-03","2020-12-02","2020-12-29","2021-01-01"],"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":[[["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["No","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":""}]}]}