{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BILLY KELLOGG","gend":0,"add":"4437 BUCKINGHAM RD LOT 6","city":"COEBURN","state":"VA","zip":242309999,"dob":"1964-11-14","age":"","mstatus":"","insh":11007217,"cliId":"8PH2U40VC16","pno":2762987884,"cno":"","email":"","ename":"","eno":"","pphy":"ABROKWAH, JAMES","ppno":2768351122,"pcpadd":"163 Number Ten St","pcpcity":"Clinchco","pcpstate":"VA","pcpzip":242268694,"pcpcounty":"","pcpid":"P0060295","pcpname":"FULL CARE MEDICAL CENTER","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":["M47.896","I10","J44.9","E78.2","Z13.29","N40.0","J30.1","M47.812","Z79.899","K59.00","R10.9","G89.29","R10.31","F17.210","J98.11","K42.9","K44.9","K57.30","R07.9","L20.9","R21","L03.116","L53.9","L98.9","F34.1","I16.1","I73.9","I47.2","I24.9","E87.1","I20.9","Z72.0","R06.02","R11.0","I20.0","Z79.82","I21.4","I13.0","N17.9","I50.30","E11.22","I25.5","I25.10","N18.9","E11.51","I34.0","M54.9","I46.9","E78.5","E11.9","K21.9","R94.31","I08.1","I77.89","I50.9","F10.20","Z95.810","I51.7","Z01.811","Z01.818","I50.23","F10.10","N26.1","Z45.2","I25.2","Z95.0","E78.00","I11.0","M12.9","K76.1","M51.37","I82.409","R22.42","R60.0","I77.9","I65.29","I16.0","I50.22","Z45.02","I50.43","R74.01","Z91.19","I49.8","I45.10","R57.1","R74.8","E80.6","R57.0","R91.8","R22.43","I87.8","Z46.82","Z51.5","R78.81","R79.89","R53.1","S09.90XA","W19.XXXA","T81.89XA","R93.2","T82.7XXA","T82.7XXD","I50.40"],"date":["2020-11-04","2020-11-29","2020-11-29","2020-12-02","2020-02-11","2020-02-11","2020-05-12","2020-06-09","2020-10-04","2020-06-18","2020-06-18","2020-10-04","2020-06-18","2020-12-07","2020-06-18","2020-06-18","2020-11-30","2020-06-18","2020-10-04","2019-07-08","2019-07-08","2019-07-08","2019-07-08","2019-07-08","2020-09-03","2020-10-21","2020-12-02","2020-12-07","2020-12-02","2020-12-01","2020-10-04","2020-10-04","2020-10-21","2020-10-04","2020-10-04","2020-10-04","2020-12-21","2020-10-04","2020-12-07","2020-10-04","2020-10-04","2020-12-07","2020-12-07","2020-12-07","2020-10-21","2020-10-05","2020-10-04","2020-11-29","2020-10-27","2020-10-27","2020-10-04","2020-10-05","2020-12-17","2020-10-05","2020-12-01","2020-12-02","2020-12-07","2020-12-17","2020-10-05","2020-10-05","2020-12-07","2020-12-07","2020-10-22","2020-10-08","2020-10-09","2020-10-10","2020-10-11","2020-10-27","2020-10-21","2020-10-21","2020-10-21","2020-10-21","2020-10-21","2020-10-21","2020-12-02","2020-10-27","2020-12-02","2020-11-03","2020-11-03","2020-11-29","2020-11-29","2020-11-30","2020-11-29","2020-11-29","2020-11-29","2020-11-29","2020-11-29","2020-11-30","2020-11-30","2020-11-30","2020-12-01","2020-12-01","2020-12-07","2020-12-07","2020-12-07","2020-12-07","2020-12-09","2020-12-09","2020-12-08","2020-12-09","2020-12-21","2020-12-16","2020-12-17"],"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":""}]}]}