{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ROSEMARY SUTTON","gend":1,"add":"225 AIRPORT ROAD","city":"VICTORIA","state":"VA","zip":239742516,"dob":"1956-02-01","age":"","mstatus":"","insh":11000765,"cliId":"1A29KY5YC52","pno":4348652516,"cno":"","email":"","ename":"","eno":"","pphy":"YORK, LISA M","ppno":4346962165,"pcpadd":"200 E 5th St","pcpcity":"CHASE CITY","pcpstate":"VA","pcpzip":239241456,"pcpcounty":"","pcpid":"P9058797","pcpname":"LUNENBURG MEDICAL CENTER","plan":"VPHP - VIRGINIA PREMIER","program":"Medicare","lob":"DSNP","region":"CENTRAL","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":["F25.0","R19.5","M25.562","M17.12","I10","R73.03","Z96.641","M23.52","M23.51","R26.89","K29.50","R00.2","K04.01","K74.60","D50.9","E66.9","Z68.41","Z86.19","Z23","B18.2","L40.50","M81.0","Z79.899","Z01.810","E11.42","J44.9","L40.9","B19.20","R73.02","Z01.818","Z96.652","E66.3","Z12.39","Z68.39","G62.9","D64.9","E11.9","I47.1","R05","Z68.38","L40.0","Z11.59","G89.29","Z12.31","J44.1","R06.00","R00.0","Z78.9","M16.12","M25.451","Z88.5","M25.662","Z98.890","Z79.51","Z79.1","M54.2","M54.5","Z87.891","I49.9","R94.31","K62.5","Z86.010","K92.1","K57.30","K44.9","E78.00","Z88.6","E78.2","S40.811A","W22.8XXA","N63.20","R07.9","R10.11","K76.89","K76.6","K80.20","N28.1","M19.90","K57.90","K64.9","L03.115","R20.2","Z74.3","L30.9","M17.9","K82.0","D50.0","R94.4","E78.5","M25.561","L81.1","R82.90","J98.11","R06.02","Z99.89","R53.83","Z12.11","D17.9","R04.0","K64.4","M17.10","R26.2","R29.3","M62.81","I77.1","N18.2","N14.1","I12.9","D50.8","E66.8","M48.061","M51.27","M47.817","Z87.19","K57.10","R79.89","J45.901","Z20.828","J06.9","B37.0"],"date":["2021-01-06","2019-01-03","2021-01-27","2021-01-27","2020-11-02","2018-01-09","2019-04-12","2018-01-09","2018-01-09","2019-10-09","2020-01-13","2018-12-07","2020-01-18","2020-11-25","2020-11-25","2020-11-25","2020-08-11","2020-11-25","2019-02-04","2019-08-01","2019-10-03","2020-02-05","2020-02-05","2020-02-05","2020-02-06","2020-02-06","2020-05-05","2019-07-03","2019-10-03","2020-02-10","2020-02-10","2019-08-26","2018-02-12","2019-09-18","2019-02-14","2019-08-06","2020-11-02","2019-08-09","2021-01-26","2020-02-24","2019-02-26","2021-01-26","2021-01-27","2019-08-19","2021-01-26","2020-03-09","2018-03-16","2018-03-20","2020-08-11","2019-03-20","2019-10-03","2019-04-12","2019-04-12","2019-10-03","2019-04-12","2020-04-23","2020-11-16","2020-11-25","2018-05-02","2018-05-02","2020-11-25","2019-05-09","2019-07-03","2019-05-09","2019-05-09","2019-05-09","2019-07-03","2020-11-02","2018-06-05","2018-06-05","2018-06-28","2019-06-18","2018-06-20","2018-06-20","2018-06-20","2019-08-06","2019-11-18","2019-07-03","2019-10-03","2019-10-03","2018-07-09","2019-10-03","2018-07-09","2018-07-11","2019-07-30","2019-08-01","2019-08-06","2019-08-06","2019-10-03","2018-08-07","2019-08-13","2019-08-26","2019-09-02","2019-09-02","2019-09-02","2018-09-06","2018-09-06","2019-09-18","2019-10-03","2019-10-03","2019-10-03","2019-10-09","2019-10-09","2019-10-09","2018-11-27","2019-11-18","2019-10-29","2019-10-29","2020-11-02","2020-11-02","2020-11-16","2020-11-16","2020-11-16","2020-11-25","2020-11-25","2019-12-09","2020-12-18","2020-12-18","2021-01-26","2021-01-26"],"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":[[["Select","Select","","","","","Select","",""],["Select","Select","","","","","Select","",""],["Select","Select","","","","","Select","",""],["Select","Select","","","","","Select","",""],["Select","Select","","","","","Select","",""],["Select","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":""}]}]}