{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LA KEA BAKER","gend":1,"add":"3007 3RD AVENUE","city":"RICHMOND","state":"VA","zip":232229999,"dob":"1989-07-06","age":"","mstatus":"","insh":11007240,"cliId":"8CD8WA9TK68","pno":8042472906,"cno":"","email":"","ename":"","eno":"","pphy":"BROOKS-WILLIAMS, MALINDA","ppno":8047800840,"pcpadd":"4730 N Southside Plaza St","pcpcity":"Richmond","pcpstate":"VA","pcpzip":232241742,"pcpcounty":"","pcpid":"P0124846","pcpname":"NORTHSIDE MEDICAL CENTER","plan":"VPHP - VIRGINIA PREMIER","program":"Medicare","lob":"DSNP","region":"CENTRAL","aligned":"N","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":["J45.40","R06.02","R51","Z86.59","E11.9","Z86.39","Z79.899","Z79.84","I10","M79.602","S63.502A","W01.0XXA","Z68.43","E66.01","J45.909","Y93.01","S69.92XA","J06.9","J45.20","Z30.42","Z30.9","E11.42","L60.2","L84","L30.1","M20.41","M25.774","N39.0","F31.32","F31.81","G47.33","Z11.59","R30.0","B37.3","Z12.4","R87.610","R87.5","R05","E66.3","L02.422","Z01.411","E66.9","Z68.54","Z01.419","S69.92XD","M19.032","Z98.890","Z00.01","Z13.29","F31.9","R00.0","R87.619","K52.9","R11.10","Z68.42","G47.30","Z99.81","M54.5","Z72.0","Z71.3","Z71.82","R10.33","M25.512","M13.862","M13.861","R79.89","M25.531","X50.1XXA","R22.31","M75.82","B35.1","L60.3","M79.674","M79.675","G89.29","M25.532","F17.210","Z79.3","Z11.51","Z11.3","K29.50","K20.8","R11.0","K29.70","R10.13","Z68.41","M25.562","R20.0","F17.200","M17.0","Z79.1","Z79.51","M27.2","E11.65","R68.84","K08.89","R22.0","F90.9","S63.8X1A","M25.431"],"date":["2020-01-31","2020-01-31","2020-01-31","2020-01-31","2020-12-14","2020-01-31","2020-12-14","2020-12-14","2021-01-03","2020-02-16","2020-02-16","2020-02-16","2020-02-16","2021-01-03","2021-01-03","2020-02-16","2020-02-28","2020-03-03","2020-05-20","2020-09-01","2020-03-31","2020-07-28","2020-07-17","2020-07-17","2020-09-21","2020-04-09","2020-04-03","2020-04-21","2019-12-30","2020-09-01","2020-05-08","2020-05-20","2020-05-11","2021-01-14","2020-05-11","2020-05-11","2020-05-11","2019-05-16","2019-05-16","2020-05-19","2019-05-21","2019-05-21","2019-05-21","2020-12-01","2020-06-05","2020-06-05","2020-09-01","2019-06-24","2019-06-24","2021-01-03","2019-07-09","2020-07-08","2019-07-26","2019-12-06","2020-12-14","2021-01-03","2019-07-16","2020-08-24","2020-07-22","2020-08-17","2020-08-17","2019-07-26","2019-11-14","2019-08-17","2019-08-17","2020-08-18","2021-01-19","2020-09-10","2020-09-14","2019-10-11","2020-09-21","2020-09-21","2020-09-21","2020-09-21","2020-10-27","2020-10-27","2020-10-27","2020-10-27","2020-12-01","2020-12-01","2019-12-06","2019-12-06","2019-12-06","2019-12-06","2019-12-06","2021-01-03","2020-12-14","2020-12-14","2021-01-03","2021-01-03","2020-12-14","2020-12-14","2021-01-03","2021-01-03","2021-01-03","2021-01-03","2021-01-03","2021-01-03","2021-01-08","2021-01-17"],"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":[[["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":""}]}]}