{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MOHAMMED B SHONAR","gend":0,"add":"7945 AUDOBOUN AVE","city":"ALEXANDRIA","state":"VA","zip":223069999,"dob":"1935-03-03","age":"","mstatus":"","insh":11009926,"cliId":"4C98AY3PM56","pno":7036601389,"cno":7033601389,"email":"","ename":"","eno":"","pphy":"BRIDEAU, DONALD J","ppno":7037976970,"pcpadd":"6355 Walker Ln","pcpcity":"Alexandria","pcpstate":"VA","pcpzip":223103251,"pcpcounty":"","pcpid":"P9120145","pcpname":"INOVA MEDICAL GROUP MOUNT VERNON","plan":"VPHP - VIRGINIA PREMIER","program":"Medicare","lob":"DSNP","region":"NORTHERN\/WINCHESTER","aligned":"Y","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["ASIAN\/PACIFIC"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["E78.2","I10","E03.9","E11.37X1","Z79.4","M32.0","E87.8","T46.6X5A","D64.9","R94.5","E11.65","N39.46","E13.9","K92.1","K59.00","Z91.89","J44.9","G20","I48.0","I50.9","I13.10","N18.4","I70.1","N25.81","H43.11","E11.21","R80.9","E11.8","E78.5","I16.0","N17.9","E87.1","E87.2","I69.354","Z20.828","I12.9","R13.12","F02.80","I25.10","R29.810","E86.9","R06.02","R22.32","I67.82","I63.81","R41.82","R09.89","Z74.3","Z95.0","R05","I44.2","M79.89","N18.9","N25.9","D63.1","R79.89","D50.9","N17.0","E11.649","E11.22","E11.69","M54.5","Z86.73","Z79.82","E11.3511","E11.3512","H40.001","E11.3553","I11.0","I25.119","R13.10","K14.8","R60.0","R10.9","E11.9","R30.9","I50.30","E11.29","M62.81","Z68.28","Z12.39","Z12.11","E55.9","K21.0","Z12.5","I48.92","I51.9","J00","R33.9","E11.3513","J06.9","A41.9","J18.9","G93.41","N39.0","Z16.24","E87.0","G24.01","D63.8","I45.2","G93.89","R63.3","Z03.818","R06.00","N30.00","B96.20","Z51.5","N40.0","R54","L85.3","L29.9","K59.09","R25.9","E11.319"],"date":["2020-04-14","2021-02-18","2020-04-14","2020-03-16","2021-02-28","2020-08-17","2020-08-17","2020-08-17","2020-10-29","2020-04-14","2020-10-29","2021-02-18","2021-02-18","2021-02-18","2020-07-01","2020-05-06","2021-01-19","2021-02-18","2021-01-19","2021-02-18","2020-05-06","2021-01-19","2021-01-19","2021-01-19","2021-02-18","2020-10-28","2020-09-02","2020-11-18","2020-10-30","2020-07-11","2020-06-10","2020-07-11","2020-10-28","2020-05-31","2020-10-22","2020-10-30","2020-05-31","2020-05-31","2020-10-22","2020-05-31","2020-05-31","2020-05-31","2020-05-31","2020-10-22","2020-05-31","2020-10-27","2020-05-31","2020-05-31","2020-10-30","2020-10-22","2020-09-02","2020-06-01","2020-06-10","2020-06-02","2020-10-30","2020-06-02","2020-06-08","2020-06-08","2020-07-11","2021-01-19","2020-10-30","2020-07-11","2020-11-18","2020-07-11","2020-12-30","2020-12-30","2020-12-30","2020-12-30","2020-06-19","2020-06-19","2020-10-30","2020-06-26","2020-06-26","2020-07-01","2020-09-10","2020-07-02","2020-07-06","2020-07-06","2020-07-09","2020-07-15","2020-07-15","2020-07-15","2020-08-13","2020-09-10","2020-08-31","2020-09-02","2020-09-02","2020-09-10","2020-09-10","2020-09-15","2020-10-28","2020-10-22","2020-10-30","2020-10-30","2020-10-28","2020-10-22","2020-10-28","2020-10-22","2020-10-22","2020-10-22","2020-10-22","2020-10-22","2020-10-29","2020-10-29","2020-10-27","2020-10-26","2020-10-29","2020-10-30","2020-11-18","2020-03-03","2021-01-19","2021-01-19","2021-02-18","2021-02-18"],"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":""}]}]}