{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CANDACE   M WISNIEWSKI","gend":1,"add":"9324 PHILLIP AVE","city":"NORFOLK","state":"VA","zip":"23503-9998","dob":"1981-06-27","age":"","mstatus":"","insh":"1088417*01","cliId":"","pno":"757\/470-4527","cno":"","email":"","ename":"","eno":"","pphy":"WATSON, NICOLE M NP","ppno":"757\/395-1300","pcpadd":"1975 GLENN MITCHELL DR STE 202","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":23456,"pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Family Medicine Physicians - Little Neck","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/226-0247","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R56.9","F19.10","G40.409","F90.2","F41.9","M25.511","G89.29","M25.512","F31.81","F43.12","S83.512A","M25.562","Z48.89","Z98.890","M24.662","V58.89","G89.18","M25.661","M62.81","Z00.00","Z12.4","R10.2","F12.10","F43.10","R26.9","M22.42","M24.562","Z01.810","S83.511A","F31.9","F90.9","S83.511D","S83.231D","M25.462","F43.21","Z47.89","G43.819","G47.9","R23.2","F14.10","S83.231A","M94.261","R26.89","Z01.818","R53.83","E16.2","M25.361","M23.8X1","S83.211A","M25.561","B34.9","Z20.822","Z11.3","Z11.4","N76.0","B96.89","R06.81","F32.9","Z72.821","M76.31","G40.909","Z98.818","K08.89","F17.200","M25.311","S46.012A","M23.41"],"date":["2021-04-07","2019-02-03","2021-04-07","2021-12-08","2020-11-18","2020-01-10","2019-12-12","2020-01-10","2021-12-15","2020-01-22","2020-04-07","2020-09-11","2021-06-03","2020-09-04","2020-07-09","2021-07-21","2021-01-15","2021-07-14","2021-07-21","2021-04-05","2021-04-05","2021-04-05","2021-04-05","2021-12-15","2021-07-21","2020-02-25","2020-09-29","2021-01-12","2021-01-15","2021-05-18","2021-05-18","2021-07-21","2021-07-21","2020-01-13","2020-07-20","2021-01-25","2020-12-08","2020-12-08","2020-12-08","2020-01-17","2021-01-04","2021-01-04","2021-03-08","2020-01-17","2020-11-18","2020-11-18","2021-01-25","2021-01-15","2021-01-15","2021-01-15","2021-04-01","2021-04-01","2019-05-21","2019-05-21","2019-05-21","2019-05-21","2019-08-14","2019-08-14","2019-08-14","2020-11-19","2020-12-08","2019-02-11","2019-02-11","2019-02-11","2019-12-17","2019-12-17","2021-01-15"],"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":""}]}]}