{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"L AICRAMNEDLOH ","gend":1,"add":"    DR KEERC MAHNRAF 3212                         ","city":"WARSAW                   ","state":"VA","zip":"22572-9998","dob":"1966-06-01","age":"","mstatus":"","insh":"00118672","cliId":"","pno":"9340835434","cno":"","email":"","ename":"","eno":"","pphy":"TSUI, ALLEN Y","ppno":8044435378,"pcpadd":"1362 TAPPAHANNOCK BLVD,","pcpcity":"Tappahannock","pcpstate":"VA","pcpzip":225609309,"pcpcounty":"","pcpid":"","pcpname":"TAPPAHANNOCK PRIMARY CARE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"2123 FARNHAM CREEK RD                             ","madd2":"                                                  ","madd3":"","mcity":"WARSAW                   ","mstate":"VA","mzip":"22572-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R53.81","K59.00","I10","R39.81","R15.9","Z01.818","F79","R41.82","Z23","Z00.00","Z13.39","Z13.1","Z13.220","Z11.59","N39.0","R26.9","K59.09","R03.0","R14.0","R50.9","R00.0","E27.9","G80.8","F78","Z79.899","R22.31","R76.9","Z13.89","Z13.6","Z68.20","R60.9"," ","E78.2","N39.46","Z12.11","E03.9"],"date":["2019-11-05","2022-04-11","2022-10-25","2022-11-10","2022-11-10","2019-03-12","2022-11-10","2018-11-01","2022-10-10","2022-10-10","2022-10-10","2022-10-10","2021-10-11","2021-10-11","2018-10-19","2019-04-09","2018-11-01","2018-11-01","2018-11-01","2018-11-01","2018-11-01","2018-11-01","2018-11-01","2018-11-01","2018-11-01","2018-12-12","2018-10-02","2018-05-25","2018-05-25","2018-05-25","2018-11-30","2022-11-10","2022-10-10","2022-10-10","2022-10-10","2022-10-10"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"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":{"comment":"","sub":[["","62175044231","POLYETH","POW 3350 NF","527","Select","Select",""]]}},{"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":["",""]}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"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":""}]}]}