{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"PATRICIA A CARTER","gend":1,"add":"435 WESTMORELAND DR  ","city":"STEPHENS CITY  ","state":"VA","zip":"22655-9998","dob":"1955-04-01","age":"","mstatus":"","insh":11013208,"cliId":"3NG6GE4VP45","pno":5408688552,"cno":7035999280,"email":"","ename":"","eno":"","pphy":"DUCK, ROBERT W ","ppno":5407220220,"pcpadd":"812 Amherst St,Ste 101","pcpcity":"Winchester  ","pcpstate":"VA","pcpzip":226013344,"pcpcounty":"","pcpid":"P9059167","pcpname":"VALLEY FAMILY PRACTICE LLC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"NORTHERN & WINCHESTER","aligned":"Y","ano":"","add2":"","add3":"","madd1":"435 WESTMORELAND DR  ","madd2":"","madd3":"","mcity":"STEPHENS CITY  ","mstate":"VA","mzip":"22655-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["I63.9","I42.8","I65.22","E11.65","E78.5","Z00.00","I67.9","F17.210","I42.0","I73.9","E11.9","Z72.0"],"date":["2020-05-07","2021-10-15","2021-01-07","2020-05-07","2020-05-07","2020-11-25","2020-09-24","2020-09-24","2021-09-30","2021-09-30","2021-09-30","2021-01-07"],"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":[["","68645049554","ATORVASTATIN","TAB 80MG","","Select","Select",""],["","68645059090","CLOPIDOGREL","TAB 75MG","","Select","Select",""],["","68645051554","AMLODIPINE","TAB 5MG","","Select","Select",""],["","193658621","MICROLET","MIS LANCETS","","Select","Select",""],["","78077720","ENTRESTO","TAB 49-51MG","","Select","Select",""],["","193731150","CONTOUR","TES NEXT","","Select","Select",""],["","68382009505","CARVEDILOL","TAB 25MG","","Select","Select",""],["","6027754","JANUVIA","TAB 100MG","","Select","Select",""],["","68645058259","METFORMIN","TAB 500MG","","Select","Select",""],["","68645049554","ATORVASTATIN ","TAB 80MG","90","Select","Select",""],["","68645058259","METFORMIN ","TAB 500MG","180","Select","Select",""],["","68645051554","AMLODIPINE ","TAB 5MG","30","Select","Select",""],["","193658621","MICROLET ","MIS LANCETS","100","Select","Select",""],["","68645059090","CLOPIDOGREL ","TAB 75MG","30","Select","Select",""],["","78077720","ENTRESTO ","TAB 49-51MG","60","Select","Select",""],["","193731150","CONTOUR ","TES NEXT","50","Select","Select",""],["","68382009505","CARVEDILOL ","TAB 25MG","90","Select","Select",""],["","6027754","JANUVIA ","TAB 100MG","90","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":[[["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["Yes","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":""}]}]}