{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"L KEREDSTLUF ","gend":0,"add":"            TS TRAUTS 746                         ","city":"ENON                     ","state":"VA","zip":"22401-9998","dob":"1978-06-13","age":"","mstatus":"","insh":"10115451","cliId":"","pno":"7304582043","cno":"","email":"","ename":"","eno":"","pphy":"ANSARI, NATHER B","ppno":5407859900,"pcpadd":"2306 PLANK RD STE 100,","pcpcity":"Fredericksburg","pcpstate":"VA","pcpzip":224014902,"pcpcounty":"","pcpid":"","pcpname":"PRIMARY AND URGENT CARE LLC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"647 STUART ST                                     ","madd2":"                                                  ","madd3":"","mcity":"ENON                     ","mstate":"VA","mzip":"22401-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G80.9","G91.9","M24.541","R60.9","Z68.26","N13.2","N20.0","K55.30","L03.116","R10.12","K80.20","N26.1","N20.1","L97.529","I87.2","G80.0","A50.59","Q66.89","I73.9","A41.9","G93.41","N13.6","N17.9","Z20.822","Z98.2","N13.30","Q62.11","R65.20","N13.0","N28.89","Z90.49","Z83.3","A41.51","G82.50","A50.6","R26.9","M62.81","M62.411","M62.421","M62.40","R32"," "],"date":["2022-09-01","2021-06-01","2020-06-18","2020-06-18","2020-06-18","2021-11-14","2022-11-30","2021-12-02","2021-05-17","2021-11-13","2022-10-06","2022-03-14","2021-12-02","2021-05-26","2021-11-14","2022-06-16","2021-12-01","2021-12-01","2021-06-29","2021-11-16","2021-11-16","2021-11-16","2021-11-16","2021-11-13","2021-11-13","2021-11-13","2021-11-13","2021-11-14","2021-11-14","2021-11-14","2021-12-02","2021-12-02","2021-11-14","2022-06-16","2022-06-16","2022-01-12","2022-01-12","2022-01-12","2022-01-12","2022-01-12","2022-10-06","2022-11-30"],"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":[["","67877054360","CEFDINIR","CAP 300MG","20","Select","Select",""],["","00228202950","ALPRAZOLAM","TAB 0.5MG","9","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","6","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","30","Select","Select",""],["","67877012450","SILVER","CRE 0.01","50","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":["",""]}},{"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":""}]}]}