{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JEFFREY BARBER","gend":0,"add":"30156 WILDERNESS RD  ","city":"JONESVILLE  ","state":"VA","zip":"24263-9998","dob":"1961-03-08","age":"","mstatus":"","insh":11010788,"cliId":"6DH1UW7UW11","pno":2763461158,"cno":2763461158,"email":"","ename":"","eno":"","pphy":"ALMATARI, ABDULLATIEF","ppno":2765463001,"pcpadd":"127 Health Care Dr,Ste 12","pcpcity":"Pennington Gap ","pcpstate":"VA","pcpzip":242772853,"pcpcounty":"","pcpid":"P9058765","pcpname":"JONESVILLE FAMILY HEALTH CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"SOUTHWEST","aligned":"Y","ano":"","add2":"","add3":"","madd1":"PO BOX 299  ","madd2":"","madd3":"","mcity":"JONESVILLE  ","mstate":"VA","mzip":"24263-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["R06.02","I10","J43.9","K21.9","S39.012A","F17.209","M81.8"],"date":["2020-03-18","2021-09-16","2021-03-10","2021-09-16","2020-09-10","2020-09-10","2021-09-16"],"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":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}}]},{"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":{"comment":"","sub":[["","60505006501","OMEPRAZOLE","CAP 20MG","","Select","Select",""],["","68180072003","AMLODIPINE","TAB 5MG","","Select","Select",""],["","68180037603","LOSARTAN POT","TAB 25MG","","Select","Select",""],["","93317431","ALBUTEROL SUL","FAT E","","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","","Select","Select",""],["","33332032001","AFLURIA QUAD","INJ 2020-21","","Select","Select",""],["","59310057922","PROAIR HFA","AER ","","Select","Select",""],["","52817033010","CYCLOBENZAPR","TAB 5MG","","Select","Select",""],["","60505006501","OMEPRAZOLE ","CAP 20MG","21","Select","Select",""],["","68180037603","LOSARTAN ","TAB 25MG","180","Select","Select",""],["","68180072003","AMLODIPINE ","TAB 5MG","30","Select","Select",""],["","52817033010","CYCLOBENZAPR ","TAB 5MG","60","Select","Select",""],["","93317431","ALBUTEROL ","FAT E","25.5","Select","Select",""],["","59310057922","PROAIR ","AER ","8.5","Select","Select",""],["","33332032001","AFLURIA ","2020-21","0.5","Select","Select",""],["","68180037603","LOSARTAN","25MG","180","Select","Select",""],["","59310057922","PROAIR","","8.5","Select","Select",""],["","33332032001","AFLURIA","2020-21","0.5","Select","Select",""]]}},{"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","",""],["No","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["N\/A","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":""}]}]}