{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CAROLYN M TYLER","gend":1,"add":"653 WESTOVER HILLS BLVD","city":"RICHMOND","state":"VA","zip":232259999,"dob":"1949-11-04","age":"","mstatus":"","insh":11002544,"cliId":"8AY5CM5FA58","pno":8046562415,"cno":8045624157,"email":"","ename":"","eno":"","pphy":"BARR, MARK CAMERON","ppno":8047416200,"pcpadd":"9600 Patterson Ave Ste B","pcpcity":"Henrico","pcpstate":"VA","pcpzip":232296053,"pcpcounty":"","pcpid":"P0060015","pcpname":"PATTERSON AVENUE FAMILY PRACTICE","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":["M79.605","R09.89","Z68.41","M17.12","M79.604","H40.1131","Z96.1","H43.812","K50.90","M16.0","M25.552","K50.813","R06.00","R73.03","I10","Z12.39","R74.0","Z13.220","Z79.899","Z23","K62.4","E66.01","K76.0","K43.9","D25.9","H26.9","H40.009","K08.409","L90.5","R06.02","Z97.2","Z98.49","Z98.890","H26.492","E87.6","R94.31","Z12.31","K51.90","R07.9","R05","R63.5","I51.7","D12.0","D12.3","K50.80","Z11.59","D72.819","H40.1130","Z68.42","H40.9","H25.013","Z00.00","Z13.89","Z13.31"],"date":["2020-01-28","2020-01-15","2020-01-15","2020-01-28","2020-01-20","2020-01-24","2020-01-24","2020-01-24","2020-09-11","2020-01-28","2020-01-28","2020-11-04","2018-02-05","2019-08-16","2020-09-11","2018-02-05","2018-02-07","2019-04-16","2019-08-16","2020-09-11","2019-07-11","2019-10-29","2018-02-27","2019-10-29","2018-02-27","2018-03-15","2018-03-15","2018-03-15","2018-03-15","2018-03-15","2018-03-15","2018-03-15","2018-03-15","2019-04-10","2019-04-16","2019-04-16","2018-04-18","2019-10-29","2018-05-07","2018-05-17","2018-05-07","2019-10-29","2019-10-29","2019-07-11","2018-08-10","2019-08-16","2020-09-11","2020-09-16","2019-10-29","2019-10-29","2019-10-29","2019-12-18","2019-12-18","2019-12-18"],"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":""}]}]}