{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MICHAEL N LEE SR","gend":0,"add":"1419 LYNHAVEN AVE","city":"RICHMOND","state":"VA","zip":232249999,"dob":"1956-11-17","age":"","mstatus":"","insh":11002640,"cliId":"1UR2MK8CU07","pno":8044378638,"cno":8048881481,"email":"","ename":"","eno":"","pphy":"MULLET, EMILY K","ppno":8048285883,"pcpadd":"4730 N Southside Plaza St","pcpcity":"Richmond","pcpstate":"VA","pcpzip":232241742,"pcpcounty":"","pcpid":"P0060162","pcpname":"VCUHS HAYES E WILLIS HEALTH 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":["R39.81","R15.9","J44.1","M79.2","G90.09","I10","R80.9","E78.5","J44.9","R73.01","G62.9","D64.9","F10.10","F17.210","T24.001D","E78.2","F10.229","G47.00","K08.109","K21.9","K44.9","N39.43","N40.1","R39.15","Z79.51","Z79.899","Z87.828","Z91.81","Z98.890","D12.0","D12.2","D12.3","D12.5","Z12.11","K64.8","M25.561","R30.9","N52.9","Z71.6","Z71.41","E11.9","Z00.00","N40.0","Z13.0","R82.99","N39.0","R35.0","R32","R39.198","R35.1","R82.998","R31.9","A41.9","R53.1","R68.83","R05","N17.9","F17.200","Z20.828","J98.11","A41.89","Z03.818","M17.11","E66.9","Z01.89","F10.129","N20.0","N13.5","N32.3","Z87.440","R30.0","Z68.29","F10.24","F32.9","M15.9","N39.498","R73.03","R25.1","Z97.3","R33.9","Z12.5","Z23","L29.9","Z72.0"],"date":["2020-12-06","2020-12-06","2020-12-06","2020-12-06","2020-12-06","2020-10-28","2020-10-28","2020-06-04","2020-10-28","2020-10-28","2019-12-12","2020-11-16","2020-10-28","2020-11-17","2018-03-29","2018-04-24","2018-04-24","2018-04-24","2018-04-24","2018-04-24","2018-04-24","2018-04-24","2020-12-03","2018-04-24","2018-04-24","2019-08-19","2018-04-24","2018-04-24","2018-04-24","2018-05-21","2018-05-21","2018-05-21","2018-05-21","2018-05-21","2018-05-21","2020-06-04","2019-08-19","2019-06-26","2019-06-26","2019-06-26","2020-10-28","2020-10-28","2020-10-28","2019-07-10","2018-08-15","2020-11-16","2019-08-19","2019-08-19","2019-08-19","2019-08-19","2020-12-03","2020-12-03","2020-10-08","2020-10-08","2020-10-08","2020-10-08","2020-11-16","2020-10-08","2020-10-08","2020-10-08","2020-10-08","2020-10-08","2020-10-28","2020-10-28","2019-11-05","2019-11-05","2020-11-12","2020-11-12","2020-11-12","2020-11-12","2020-12-03","2019-12-03","2019-12-03","2019-12-03","2019-12-03","2019-12-03","2019-12-03","2019-12-03","2019-12-03","2020-12-03","2020-12-03","2018-12-12","2019-12-12","2019-12-12"],"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":[[["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["Yes","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":""}]}]}