{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"HEATHER  M SHIFFLETT","gend":1,"add":"17 E JOHNSON ST","city":"HARRISONBURG","state":"VA","zip":"22802-9998","dob":"1981-11-08","age":"","mstatus":"","insh":"20062812*01","cliId":"","pno":5407739487,"cno":5407739487,"email":"","ename":"","eno":"","pphy":"HOMEWOOD, LAURA MD","ppno":4342434720,"pcpadd":"2955 IVY RD STE 104,","pcpcity":"CHARLOTTESVILLE","pcpstate":"VA","pcpzip":"22903-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4349821841,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["U07.1","R10.31","F14.20","S39.012A","G40.909","F32.9","F43.10","Z90.49","Z90.710","Z88.5","Z88.8","R10.9","M54.5","R00.0","A59.01","N28.1","R10.84","F41.0","N83.201","G89.29","Z76.5","Z53.29","S32.010A","Z03.818","R05.","F17.210","Z90.721","Z87.42","Z87.442","Z79.899","Z90.79","Z72.0","Z98.51","Z88.6","R30.0","R10.2","R10.11","Z82.49","Z83.3","Z82.61","Z91.018","R11.0","G43.909","Z86.16","R11.2","Z20.822","F31.9","F20.9","F90.9","R11.10","F99.","Z98.1","Z91.041","S13.4XXA","S32.000A","N23.","K08.89","F31.5","R46.89","S39.92XA","M54.16","M51.36","S32.000S","F14.21","R19.7","Z53.20","K37.","N30.90","R35.0","R50.9","Z88.2","N83.8","R10.30","Z90.711","M79.605","M79.89","R10.13","M54.41"],"date":["2021-01-23","2021-09-22","2021-10-01","2021-09-18","2021-09-18","2021-09-18","2021-10-05","2021-09-22","2021-09-22","2021-10-05","2021-10-05","2021-09-22","2021-09-22","2021-06-01","2021-06-20","2021-07-11","2021-08-08","2021-08-18","2021-08-29","2021-09-19","2021-09-19","2021-09-22","2021-10-05","2021-07-01","2021-07-02","2021-10-05","2021-07-18","2021-07-02","2021-09-22","2021-10-05","2021-01-28","2021-07-02","2021-09-22","2021-10-05","2021-07-02","2021-07-14","2021-09-22","2021-09-22","2021-09-22","2021-09-22","2021-10-05","2021-09-22","2021-01-28","2021-01-28","2021-09-22","2021-07-01","2021-10-05","2021-10-05","2021-09-06","2021-09-06","2021-09-22","2021-09-22","2021-09-22","2021-10-06","2021-10-06","2021-02-07","2021-02-07","2021-03-22","2021-07-18","2021-10-05","2022-01-10","2022-01-10","2022-01-10","2022-01-10","2021-01-15","2021-07-18","2021-06-06","2021-06-06","2021-07-02","2021-07-02","2021-07-02","2021-07-14","2021-08-19","2021-07-18","2021-06-03","2021-06-03","2021-07-11","2021-10-03"],"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":[]},{"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":""}]}]}