{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"STACY   D WALTON","gend":1,"add":"4740 LITTLE JOHN DR APT A1","city":"NORFOLK","state":"VA","zip":"23513-9998","dob":"1983-08-28","age":"","mstatus":"","insh":"2804824*01","cliId":"","pno":"757\/233-2068","cno":"","email":"","ename":"","eno":"","pphy":"TUCKER, MICHAEL MD","ppno":"757\/625-3777","pcpadd":"110 KINGSLEY LANE SUITE 411","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23505,"pcpcounty":"","pcpid":"","pcpname":"MICHAEL L TUCKER MD FAMILY PRACTICE","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/625-7411","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["O21.9","O99.89","R82.71","J06.9","Z3A.08","L25.9","N76.0","R09.02","U07.1","Z87.891","O34.211","Z37.0","O99.214","E66.9","O99.52","J45.909","Z79.899","Z79.52","Z3A.39","Z30.2","Z28.21","Z01.419","Z20.828","R05.","R68.83","R53.83","NO DATA","R51.9","R43.0","R63.0","J96.01","Z33.1","R10.2","N85.7","J45.50","L50.9","R11.2","Z12.39","Z11.3","J30.9","O21.0","N30.01","O26.892","J45.901","Z3A.26","G89.18","Z00.00","I10.","R73.09","Z20.2","J12.89","R00.0","Z68.41","J20.9","Z79.51"],"date":["2019-03-06","2019-03-06","2019-03-06","2021-08-27","2019-03-06","2020-07-07","2020-10-20","2021-08-30","2021-09-06","2021-08-30","2019-09-30","2019-09-30","2019-09-30","2021-08-27","2019-09-30","2021-09-04","2019-09-30","2019-09-30","2019-09-30","2019-09-30","2019-09-30","2021-02-12","2021-08-24","2021-08-24","2021-08-24","2021-08-24","2021-09-01","2021-08-24","2021-08-24","2021-08-24","2021-09-06","2019-02-02","2019-12-18","2019-12-18","2021-08-19","2020-03-03","2021-08-27","2020-02-10","2020-02-10","2020-07-02","2019-03-09","2019-03-09","2019-07-04","2019-07-04","2019-07-04","2019-10-01","2019-11-19","2019-11-19","2019-11-19","2020-08-21","2021-08-31","2021-08-27","2021-08-27","2020-04-17","2021-08-30"],"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":""}]}]}