{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KEVIN   SCOTT PARKER","gend":0,"add":"3713 APPALACHIAN CT","city":"VIRGINIA BEACH","state":"VA","zip":"23452-9998","dob":"1963-12-06","age":"","mstatus":"","insh":"1724727*02","cliId":"","pno":"757\/708-3992","cno":"757\/708-3992","email":"","ename":"","eno":"","pphy":"BYMAN, ERIC MD","ppno":"757\/333-7625","pcpadd":"4501 N WITCHDUCK ROAD SUITE B","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":23455,"pcpcounty":"","pcpid":126202,"pcpname":"INDEPENDENCE FAMILY MEDICINE","plan":"OHP","program":"ACA","lob":"Individual","region":"TIDEWATER","aligned":"","ano":"757\/486-7543","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/333-7639","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M54.5","M54.6","R07.81","R91.8","J84.10","R91.1","E03.9","E78.5","Z68.28","D68.9","I26.99","R07.9","Z00.00","D68.59","Z12.11","L23.7","Z01.118","K21.9","Z68.29","Z84.81","D48.5","L57.0","D22.9","D23.9","D09.9"],"date":["2020-01-28","2020-01-28","2020-01-28","2020-02-06","2020-02-06","2020-02-06","2021-08-31","2021-08-31","2020-09-21","2020-02-27","2020-02-21","2020-02-21","2021-08-31","2020-03-12","2021-05-23","2020-03-16","2020-03-16","2020-03-16","2020-03-16","2020-02-19","2021-07-23","2021-09-10","2021-07-13","2021-09-10","2021-09-10"],"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":[]},{"a":[]}]},{"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":[]},{"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":[[["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","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":""}]}]}