{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LINDA L HALE","gend":1,"add":"221 CALL VALLEY RD","city":"SWORDS CREEK","state":"VA","zip":"24649-9998","dob":"1951-08-06","age":"","mstatus":"","insh":11016938,"cliId":"4EH9GM1GE10","pno":2768736356,"cno":2768736356,"email":"","ename":"","eno":"","pphy":"HARMAN, NICHOLAS ","ppno":2768893700,"pcpadd":"495 E Main St","pcpcity":"Lebanon  ","pcpstate":"VA","pcpzip":242664617,"pcpcounty":"","pcpid":"P9058506","pcpname":"C HEALTH PC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"SOUTHWEST","aligned":"Y","ano":"","add2":"","add3":"","madd1":"221 CALL VALLEY RD","madd2":"","madd3":"","mcity":"SWORDS CREEK","mstate":"VA","mzip":"24649-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["H25.813","H40.033","N20.1","R10.31","R82.81","H25.811","N20.0","H25.812"],"date":["2021-05-27","2021-05-27","2021-07-28","2021-07-28","2021-07-28","2021-08-03","2021-07-28","2021-09-21"],"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":[["","24208044605","BESIVANCE","0.006","5","Select","Select",""],["","61314063705","PREDNISOLONE","1% OP","5","Select","Select",""],["","67877054360","CEFDINIR","300MG","14","Select","Select",""],["","68180074006","SILODOSIN","4MG","7","Select","Select",""],["","71930005552","APAP\/CODEINE","300-30MG","10","Select","Select",""],["","61314063705","PREDNISOLONE ","SUS 1% OP","5","Select","Select",""],["","24208044605","BESIVANCE ","SUS 0.006","5","Select","Select",""],["","67877054360","CEFDINIR ","CAP 300MG","14","Select","Select",""],["","68180074006","SILODOSIN ","CAP 4MG","7","Select","Select",""],["","71930005552","APAP\/CODEINE ","TAB 300-30MG","10","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":""}]}]}