{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JO ANN ARNETTE","gend":1,"add":"ROY ARNETTE","city":"MECHANICSVILLE","state":"VA","zip":231166563,"dob":"1943-03-26","age":"","mstatus":"","insh":11008296,"cliId":"6J90Y71TN47","pno":8043808479,"cno":"","email":"","ename":"","eno":"","pphy":"STEWART, JACQUELINE","ppno":8047557581,"pcpadd":"10150 Staples Mill Rd Ste E","pcpcity":"Glen Allen","pcpstate":"VA","pcpzip":230603452,"pcpcounty":"","pcpid":"P0123404","pcpname":"CROSSRIDGE PEDIATRICS & INTERNAL MEDICINE","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":["I63.9","M79.602","I67.9","I69.391","E11.9","M24.522","M25.522","R29.3","Z23","I69.30","M62.81","R26.2","G47.09","F41.9","Z68.21","E78.2","J44.9","F32.9","G47.00","G31.84","M62.49","E11.65","I69.354","R54","E11.8","I10","F33.9","H04.123","Z96.1","M20.41","M20.42","L85.3","M79.674","M79.675","B35.1","F01.50","R41.0","F01.51","I63.239","J44.1","M19.041","Z87.39","F41.0","R52","G58.8","D51.9","D64.9","R41.89","K21.9","R13.10","F03.90","R29.6","R13.14","R41.841","R13.12","F32.1","E55.9","E78.5","R31.9","N39.0","M79.673","D50.9","R41.82","R82.90","K44.9","R91.1","B35.3","E11.42","F32.0","F51.01","G81.14","R32","F41.8","I11.0","I67.89","E13.40","F34.89","R51","R26.81","I69.393","J45.20","K21.0","R13.11","F42.3","I69.365","F33.1","F41.1"],"date":["2021-02-01","2020-08-16","2021-02-01","2021-02-01","2021-02-04","2021-01-12","2020-07-16","2021-01-12","2020-04-01","2021-02-01","2021-02-04","2020-07-16","2021-01-07","2021-02-01","2020-04-01","2020-11-19","2021-02-04","2020-10-30","2020-05-31","2020-03-27","2021-02-01","2020-02-03","2020-02-03","2020-10-26","2020-10-05","2021-01-12","2021-02-01","2020-02-25","2020-02-25","2021-01-26","2021-01-26","2021-01-26","2021-01-26","2021-01-26","2021-01-26","2020-03-27","2020-10-26","2021-02-01","2021-02-01","2021-02-01","2021-02-01","2021-02-01","2021-02-01","2020-04-18","2020-09-15","2020-05-21","2020-09-12","2020-07-17","2021-02-04","2021-01-12","2021-02-01","2019-09-16","2019-09-16","2019-09-16","2020-08-06","2019-11-01","2020-09-12","2020-09-12","2020-12-09","2020-12-09","2020-09-15","2019-09-20","2020-09-28","2020-10-05","2019-11-16","2019-11-16","2021-02-01","2021-01-26","2019-11-21","2019-11-21","2021-01-12","2019-12-19","2020-06-18","2020-02-20","2020-03-05","2020-07-02","2020-11-19","2020-04-18","2020-04-18","2020-05-31","2020-06-18","2020-07-02","2020-08-06","2020-10-01","2020-11-19","2020-12-18","2020-12-18"],"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":[[["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["No","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":""}]}]}