{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"M   ECYOJSKNABUE ","gend":1,"add":"GNOL 4391NL NEERG ","city":"HAMPTON","state":"VA","zip":"23663-9998","dob":"1980-02-19","age":"","mstatus":"","insh":"7590310*07","cliId":"","pno":"49\/7573733-5","cno":"","email":"","ename":"","eno":"","pphy":"WELSH, CATHERINE C NP","ppno":"757\/736-3700","pcpadd":"2104 EXECUTIVE DRIVE","pcpcity":"HAMPTON","pcpstate":"VA","pcpzip":23666,"pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Family Medicine Physicians - Peninsula Towne","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M48.02","M54.12","M54.13","Z79.891","E03.9","D50.8","R53.83","Z13.220","Z13.1","E03.8","Z12.39","N89.8","Z11.3","R11.0","R13.10","R11.2","Z79.1","Z98.84","M25.552","M50.823","M50.822","Z01.419","K91.2","Z79.3","R03.0","E86.0","M92.70","M79.671","M19.071","S46.001A","I10.","F17.210","Z96.642","Z79.890","R53.1","M75.110","M25.511","B34.9","Z20.822","N76.0","M16.12","Z47.1","M75.111","S43.431A","M70.72","R23.8","L81.8","M17.11","M25.561","E06.3","R35.0","Z23.","S80.01XA","M50.321","R13.14","K29.40"],"date":["2019-07-16","2019-07-16","2019-07-16","2019-07-16","2021-08-03","2020-03-20","2020-01-13","2021-07-01","2020-01-13","2021-11-03","2021-07-01","2021-10-13","2021-10-13","2020-11-16","2019-08-21","2019-08-21","2019-08-21","2021-07-08","2021-12-02","2019-02-05","2019-02-05","2020-07-08","2019-03-07","2021-07-08","2020-11-16","2020-12-03","2021-07-06","2021-07-06","2021-07-06","2021-07-08","2021-07-08","2021-07-08","2021-07-08","2021-07-08","2021-07-08","2021-07-12","2021-07-12","2021-10-02","2021-10-02","2021-01-18","2021-01-28","2021-01-28","2021-08-25","2021-08-25","2021-11-12","2020-09-03","2020-09-03","2021-06-10","2021-06-10","2021-11-03","2019-02-14","2019-03-13","2019-04-13","2019-03-26","2019-10-16","2019-10-16"],"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":""}]}]}