{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MICHAEL W PUFFINBERGER SR","gend":0,"add":"120 GOLDEN POND CIRCLE","city":"STEPHENS CITY","state":"VA","zip":"22655-2379","dob":"1961-08-31","age":"","mstatus":"","insh":"11016593","cliId":"","pno":5409740114,"cno":"","email":"","ename":"","eno":"","pphy":"BYRD, JESSICA","ppno":5406780792,"pcpadd":"2913 Valley Ave Ste 200","pcpcity":"Winchester","pcpstate":"VA","pcpzip":226012678,"pcpcounty":"","pcpid":"","pcpname":"APPLE BLOSSOM FAMILY PRACTICE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"NORTHERN & WINCHESTER","aligned":"Y","ano":"","add2":"APT A","add3":"","madd1":"120 GOLDEN POND CIRCLE","madd2":"APT A","madd3":"","mcity":"STEPHENS CITY","mstate":"VA","mzip":"22655-2379","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"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":[]},{"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":[["","55111018015","TIZANIDINE ","4MG","90.00","Select","Select",""],["","59011041010","OXYCONTIN ","10MG CR","56.00","Select","Select",""],["","68462012605","GABAPENTIN ","600MG","150.00","Select","Select",""],["","10702005601","OXYCODONE ","10MG","112.00","Select","Select",""],["","65862017760","CEFDINIR ","300MG","14.00","Select","Select",""],["","65862069790","VENLAFAXINE ","150MG ER","30.00","Select","Select",""],["","00406051205","OXYCOD\/APAP ","5-325MG","20.00","Select","Select",""],["","68382050010","OMEPRAZOLE ","40MG","30.00","Select","Select",""],["","68180098103","LISINOPRIL ","20MG","90.00","Select","Select",""],["","55111012305","ATORVASTATIN ","40MG","90.00","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":""}]}]}