{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BOBBIE J BLANKENSHIP","gend":1,"add":"2017 LONE OAK  CROSSING ","city":"HUDDLESTON  ","state":"VA","zip":"24104-3751","dob":"1986-01-05","age":"","mstatus":"","insh":11014249,"cliId":"9RU7V70DC74","pno":5408712112,"cno":5408712112,"email":"","ename":"","eno":"","pphy":"BLANKS, VIRGINIA L","ppno":5402977181,"pcpadd":"4830 Rucker Rd","pcpcity":"Moneta","pcpstate":"VA","pcpzip":241215281,"pcpcounty":"","pcpid":"P9059188","pcpname":"VILLAGE FAMILY PHYSICIANS INC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"","add3":"","madd1":"2017 LONE OAK  CROSSING ","madd2":"","madd3":"","mcity":"HUDDLESTON  ","mstate":"VA","mzip":"24104-3751","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["J45.909","L30.9","H25.13","Q14.8","Z01.01","F81.9","E78.5","K21.9","R19.7","J30.9","Z68.28"],"date":["2020-11-06","2020-11-06","2021-04-23","2021-04-23","2021-04-23","2020-10-09","2020-10-09","2020-10-09","2020-10-09","2020-10-09","2020-10-09"],"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":[["","29300022019","MONTELUKAST","TAB 10MG","","Select","Select",""],["","55111015930","OMEPRAZOLE","CAP 40MG","","Select","Select",""],["","93505998","ATORVASTATIN","TAB 20MG","","Select","Select",""],["","16714036304","TRI-LINYAH","TAB ","","Select","Select",""],["","49281042050","FLUZONE QUAD","INJ 2020-21","","Select","Select",""],["","555901858","TRI-SPRINTEC","TAB ","","Select","Select",""],["","16714008210","HYDROXYZ HCL","TAB 25MG","","Select","Select",""],["","59746017509","PREDNISONE","TAB 20MG","","Select","Select",""],["","29300022019","MONTELUKAST ","TAB 10MG","30","Select","Select",""],["","16714008210","HYDROXYZ ","TAB 25MG","120","Select","Select",""],["","59746017509","PREDNISONE ","TAB 20MG","10","Select","Select",""],["","59651000305","OMEPRAZOLE ","CAP 40MG","90","Select","Select",""],["","555901858","TRI-SPRINTEC ","TAB ","28","Select","Select",""],["","93505998","ATORVASTATIN ","TAB 20MG","30","Select","Select",""],["","16714036304","TRI-LINYAH ","TAB ","28","Select","Select",""],["","49281042050","FLUZONE ","INJ 2020-21","0.5","Select","Select",""],["","16714008210","HYDROXYZ","25MG","120","Select","Select",""],["","49281042050","FLUZONE","2020-21","0.5","Select","Select",""],["","68180096301","ALBUTEROL","HFA","8.5","Select","Select",""],["","00186091706","PULMICORT","90MCG","1","Select","Select",""],["","68180096301","ALBUTEROL ","AER HFA","8.5","Select","Select",""],["","00186091706","PULMICORT ","INH 90MCG","1","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","",""],["No","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":""}]}]}