{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ATINAUJRETSEL ","gend":1,"add":"RWOL 435EVIRD Y","city":"ABINGDON","state":"VA","zip":24210,"dob":"1931-10-17","age":"","mstatus":"","insh":"00118278","cliId":"","pno":"2667293803","cno":"","email":"","ename":"","eno":"","pphy":"CAMARGO, EDGAR","ppno":2766230839,"pcpadd":"308 W MAIN ST","pcpcity":"SALTVILLE","pcpstate":"VA","pcpzip":24370,"pcpcounty":"","pcpid":"","pcpname":"SALTVILLE MEDICAL CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"SOUTHWEST","aligned":"Y","ano":"","add2":"APARTMENT E BOX 13","add3":"","madd1":"534 LOWRY DRIVE","madd2":"APARTMENT E BOX 13","madd3":"","mcity":"ABINGDON","mstate":"VA","mzip":"24210-3083","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":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"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":[["","62175018046","PANTOPRAZOLE","TAB 20MG","90.00","Select","Select",""],["","59762531001","PRAZOSIN","CAP 1MG","90.00","Select","Select",""],["","00406831501","MORPHINE","TAB 15MG ER","30.00","Select","Select",""],["","67877042805","GABAPENTIN","TAB 600MG","120.00","Select","Select",""],["","00378057701","AMILOR\/HCTZ","TAB 18384","90.00","Select","Select",""],["","55111012701","CIPROFLOXACN","TAB 500MG","20.00","Select","Select",""],["","31722094901","OXYCOD\/APAP","TAB 5-325MG","120.00","Select","Select",""],["","65862070060","CEFUROXIME","TAB 500MG","10.00","Select","Select",""],["","43547035311","LISINOPRIL","TAB 10MG","90.00","Select","Select",""],["","68462025301","ROPINIROLE","TAB 0.25MG","30.00","Select","Select",""],["","64380086108","POT  CHLORIDE","TAB 10MEQ ER","90.00","Select","Select",""],["","67877021905","CEPHALEXIN","CAP 500MG","28.00","Select","Select",""],["","64380074208","BUSPIRONE","TAB 10MG","60.00","Select","Select",""],["","68180071160","CEFDINIR","CAP 300MG","20.00","Select","Select",""],["","00172572860","FAMOTIDINE","TAB 20MG","180.00","Select","Select",""],["","00781571010","POT  CL MICRO","TAB 10MEQ ER","90.00","Select","Select",""],["","50383070016","FLUTICASONE","SPR 50MCG","16.00","Select","Select",""],["","66530024940","FLUOROURACIL","CRE 0.05","40.00","Select","Select",""],["","67877025115","TRIAMCINOLON","CRE 0.001","45.00","Select","Select",""],["","00603533731","PREDNISONE","PAK 5MG","48.00","Select","Select",""],["","27241009706","DULOXETINE","CAP 20MG","30.00","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":""}]}]}