{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TIFFANEY COOPER","gend":1,"add":"6603 PRYER LN APT G","city":"NORFOLK","state":"VA","zip":"23502-9998","dob":"1986-10-01","age":"","mstatus":"","insh":"4641426*01","cliId":"","pno":"757\/323-1370","cno":"","email":"","ename":"","eno":"","pphy":"JAVIER, ROSA M MD","ppno":"757\/395-1900","pcpadd":"5460 WESLEYAN DR","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":23455,"pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Family Medicine Physicians - Wesleyan","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/995-7373","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K04.7","E05.90","R00.2","R63.4","G25.2","K08.89","J45.20","D50.0","R51.","G43.909","Z00.00","I10.","Z23.","D50.9","E55.9","G43.009","F41.9","R53.83","K04.01","Z14.1","Z87.891","Z88.1","Z88.8","K02.9","J11.1","L20.9","A08.4","N64.4","L03.211","H60.12","N93.9","N92.0","N94.6","Z01.419","Z11.3","S70.312A","Z12.39","M25.569","L29.9","D22.9","Z28.21","Z71.9","B37.9","T36.95XA","G43.719","E84.9","Z88.6","R13.10","N89.8","K08.9"],"date":["2021-02-12","2021-09-17","2020-03-31","2020-03-31","2020-03-31","2021-09-18","2020-12-11","2021-10-28","2020-07-20","2020-07-28","2019-11-11","2021-09-18","2019-11-11","2020-09-14","2019-11-11","2019-11-11","2021-08-17","2021-09-13","2021-07-13","2021-07-13","2021-09-18","2021-09-18","2021-09-18","2021-07-13","2019-01-05","2019-07-03","2020-02-05","2020-05-22","2021-03-18","2021-03-18","2019-01-03","2019-01-11","2021-09-03","2021-08-13","2020-07-30","2020-11-18","2021-08-13","2021-08-17","2019-08-01","2019-08-01","2019-08-01","2019-08-01","2021-02-12","2021-02-12","2019-02-11","2021-09-18","2021-09-18","2021-09-18","2019-10-02","2021-07-07"],"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":""}]}]}