{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JESSICA   R LIDGETT","gend":1,"add":"514 NORFOLK AVE","city":"VIRGINIA BEACH","state":"VA","zip":"23451-9998","dob":"1976-02-06","age":"","mstatus":"","insh":"2183687*01","cliId":"","pno":"757\/619-6346","cno":"757\/619-6346","email":"","ename":"","eno":"","pphy":"LOCK, RACHEL DO","ppno":"757\/395-2500","pcpadd":"1024 FIRST COLONIAL RD STE 102","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":23454,"pcpcounty":"","pcpid":117368,"pcpname":"SMG - Sentara Family Medicine Physicians - First Colonial","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":["D72.829","J30.1","Z78.9","N92.4","N94.4","R93.89","N80.0","N95.1","J44.9","D12.2","D12.3","K64.8","R19.4","K59.09","R10.32","K63.5","NO DATA","K29.71","K31.7","K44.9","R10.13","R14.0","M25.572","M76.72","G57.52","Z98.1","M51.36","M25.552","G47.30","N30.00","L21.9","Z51.81","Z79.891","Z01.419","N93.9","Z12.39","Z12.4","R61.","R10.84","K80.20","E66.9","E78.2","G56.03","R51.9","F33.0","F40.00","F41.0","J18.9","J45.21","J20.9","F17.200","M54.40","G89.29","Z01.818","R41.82","R68.89","E78.5","K58.1","R09.02","M51.16","Z98.890","H92.02","M54.16","Z68.32","S91.301A","M79.672","Z72.0","G57.12","Z71.3","E66.09","Z68.33","N89.8","R29.898","R06.00","J45.30","J30.2","K21.9","G47.8","G25.81","R59.0","J41.1","Z79.899","E78.1","M51.37","G47.34","F33.9","M51.17","R20.0","F40.01","F17.290","Z79.51","R25.2","Z03.818","Z11.59","Z20.822","K59.00","J45.40","M96.1","G47.33","J30.9","G47.63","R79.89","K29.00","G57.51","R09.81","R09.89","F41.9","R07.89","F32.9","R21.","L29.9","E55.9","M54.5","R68.84","M79.641","M79.642","M25.531"],"date":["2020-06-22","2020-06-16","2020-11-11","2021-01-06","2021-01-06","2021-01-06","2021-01-06","2020-11-11","2021-02-12","2021-01-28","2021-01-28","2021-01-28","2021-05-12","2021-01-28","2021-01-28","2021-01-28","2021-01-28","2021-01-28","2021-01-28","2021-01-28","2021-01-28","2021-01-28","2021-03-09","2021-03-17","2021-03-17","2020-12-29","2020-01-30","2020-01-14","2020-07-20","2020-08-13","2020-07-28","2020-08-18","2021-05-17","2020-10-20","2020-10-20","2020-10-20","2020-10-20","2020-10-20","2021-05-12","2021-01-12","2021-02-24","2021-02-24","2021-05-05","2021-05-05","2021-07-26","2021-07-26","2021-07-26","2020-03-09","2020-03-22","2020-03-22","2020-03-22","2020-06-30","2020-06-30","2020-12-08","2021-02-01","2021-03-30","2021-05-27","2021-03-30","2021-07-28","2020-01-30","2020-12-29","2020-05-18","2021-02-11","2020-07-10","2020-07-19","2020-07-19","2021-02-12","2020-09-15","2020-09-15","2020-09-15","2020-09-15","2021-01-06","2021-01-04","2021-02-12","2021-02-12","2021-02-12","2021-02-12","2021-02-12","2021-02-12","2021-02-12","2021-02-12","2021-05-17","2021-05-27","2020-01-30","2020-06-02","2020-01-30","2020-01-30","2020-12-29","2020-01-30","2020-01-30","2020-01-30","2020-05-28","2020-08-25","2020-08-25","2021-01-25","2020-12-28","2020-04-21","2021-02-11","2020-06-05","2020-06-05","2020-06-05","2020-12-28","2021-02-17","2021-02-22","2020-01-07","2020-01-07","2020-01-07","2020-01-07","2020-01-07","2020-08-13","2020-08-13","2020-08-13","2020-09-08","2020-09-08","2020-09-08","2020-09-08","2020-09-08"],"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":""}]}]}