{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JASON HOOKER","gend":0,"add":"626 PAGE DR UNIT C","city":"HAMPTON","state":"VA","zip":"23669-9998","dob":"1982-04-13","age":"","mstatus":"","insh":"2195261*01","cliId":"","pno":"","cno":"","email":"","ename":"","eno":"","pphy":"EDDY, JANET MD","ppno":"804\/786-2505","pcpadd":"700 DINWIDDIE AVE","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":23224,"pcpcounty":"","pcpid":"","pcpname":"THE DAILY PLANET INC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/783-2514","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.2","F32.2","F14.21","F11.21","R10.9","G47.00","F14.20","S23.3XXA","S33.5XXA","S43.491A","S43.492A","S80.01XA","S63.591A","F10.24","F10.920","E87.6","T65.92XA","R73.9","F10.20","F43.10","L21.9","Z72.0","M54.2","S01.81XA","S93.492A","E66.01","Z68.41","I82.409","R19.5","R10.84","R19.7","S39.91XA","R07.81","Z88.2","Z87.891","E66.9","F10.129","F14.23","V62.84","S61.411A","V89.2XXA","Y92.414","I10.","J45.909","M25.561","R53.83","Z20.828","V58.89","F31.81","F41.1","F14.10","F12.10","F11.10","F17.210","R74.0","M79.672","R10.31","S92.032A","M79.89","R03.0","J10.1","E78.5","Z48.02"],"date":["2019-07-28","2020-06-25","2020-02-27","2020-03-05","2021-10-04","2020-06-25","2021-11-16","2021-12-17","2021-12-17","2021-12-17","2021-12-17","2021-12-17","2021-12-17","2019-06-03","2019-07-28","2019-07-28","2019-07-28","2019-07-28","2019-08-15","2020-02-27","2020-05-21","2020-05-21","2020-04-23","2021-09-08","2021-05-19","2021-05-19","2021-10-04","2021-05-26","2021-10-04","2021-10-04","2020-01-17","2021-10-04","2021-10-04","2021-10-04","2021-10-04","2021-10-04","2019-07-19","2019-07-19","2019-07-28","2021-09-08","2021-09-08","2021-09-08","2019-07-28","2019-07-28","2019-07-28","2019-07-28","2020-04-14","2021-09-18","2019-07-28","2019-07-28","2019-07-28","2019-07-28","2019-07-28","2019-07-28","2019-12-05","2020-03-26","2020-03-26","2021-05-26","2021-05-26","2021-05-26","2020-01-13","2020-03-12","2021-09-18"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}}]},{"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":[]},{"a":[]},{"a":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"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":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":[]},{"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":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":[]}]},{"t":"Mini-Cog","q":[{"a":[]},{"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":"","a13":""}]}]}