{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JOHN   M GOLDEN","gend":0,"add":"9110 OMAH ST","city":"RICHMOND","state":"VA","zip":"23237-9998","dob":"1968-11-13","age":"","mstatus":"","insh":"1383979*01","cliId":"","pno":"804\/216-1774","cno":"804\/216-1774","email":"","ename":"","eno":"","pphy":"BECKWITH, DOUGLAS E MD","ppno":"804\/796-2373","pcpadd":"12901 BRIGGS RD","pcpcity":"CHESTER","pcpstate":"VA","pcpzip":23831,"pcpcounty":"","pcpid":106393,"pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"757\/325-5724","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["C79.51","M84.454A","Z95.810","K21.9","I25.5","I50.22","I13.0","F17.210","E78.5","F41.1","Z95.5","I25.10","Z79.899","Z79.02","Z79.82","Z88.0","Z91.041","C15.9","M54.9","Z72.0","G89.3","R13.10","R93.3","Z68.34","G45.9","I63.50","M54.41","K59.03","R11.0","R63.0","F32.9","F41.9","Z51.5","I82.413","I82.433","I26.99","M79.89","K80.10","K80.20","R07.9","M89.9","C79.9","I13.10","C15.4","C15.5","I34.8","Z68.32","D64.9","Z79.01","Z51.11","I82.4Y3","S81.809A","Z68.30","M25.551","G62.0","G89.29","T45.1X5A","D62.","S32.301A","K22.9","R10.13","X58.XXXA","Y92.89","Y93.89","N18.3","I10.","R63.4","I42.9","Z51.81","D69.6","Z68.33","L97.912","R60.0","Z68.25","Z68.27","I31.3","R11.2","Z43.1","Z45.2","K12.30","I51.7","I50.9","I77.810","R47.81","R53.1","R20.0","I82.4Z9","J84.10","R29.898","Z01.818","Z68.29","Z68.26","I95.9","R64.","M89.8X9","Z71.89","Z68.22","Z45.02","Z93.1","NO DATA","I25.2","I21.4","Z68.41","R94.31","K44.9","L97.812","L97.222","I87.333","Z87.09","Z68.24","R10.11","M25.511","R52.","R53.83","F33.2","Z68.42","Z68.36","M54.5","M25.512","Z68.35","Z68.31","E86.0"],"date":["2021-06-22","2020-09-20","2021-06-22","2020-09-20","2021-06-22","2020-09-20","2020-09-20","2021-06-22","2021-06-23","2021-06-23","2020-09-20","2021-06-23","2021-05-26","2020-09-20","2020-09-20","2020-09-20","2020-09-20","2021-06-23","2020-09-22","2020-09-22","2021-06-22","2020-11-16","2020-10-05","2020-10-21","2021-02-03","2021-01-13","2021-05-06","2021-05-06","2021-05-06","2021-05-06","2021-02-18","2021-04-12","2021-06-22","2021-02-25","2021-02-25","2021-04-14","2021-05-12","2020-08-17","2020-08-17","2020-09-22","2021-06-13","2020-09-23","2020-09-23","2020-10-05","2020-10-05","2021-01-13","2021-02-04","2021-06-23","2021-01-13","2021-06-09","2021-05-12","2021-05-12","2021-03-03","2021-05-06","2021-05-06","2021-05-06","2021-05-06","2021-06-22","2020-09-20","2020-09-20","2021-06-13","2020-09-20","2020-09-20","2020-09-20","2020-09-22","2021-06-23","2020-09-22","2021-05-12","2021-05-26","2021-02-03","2021-02-17","2021-05-11","2021-05-03","2021-05-12","2021-04-14","2021-06-13","2021-06-13","2021-06-13","2021-03-05","2020-12-28","2021-01-13","2021-01-13","2021-01-13","2021-01-13","2021-06-22","2021-01-13","2021-06-23","2021-01-27","2021-01-27","2021-02-04","2021-03-31","2021-04-28","2021-06-22","2021-06-22","2021-06-22","2021-06-22","2021-06-23","2021-06-23","2021-06-23","2021-06-23","2021-06-23","2020-08-06","2020-08-06","2020-09-20","2020-09-21","2021-03-18","2021-03-18","2021-03-18","2021-03-18","2021-06-09","2020-07-20","2020-07-20","2020-09-21","2020-12-09","2020-01-30","2020-01-30","2020-10-01","2020-11-04","2020-10-07","2020-10-07","2020-11-18","2021-06-03"],"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","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["Yes","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":""}]}]}