{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" ENELRADSNIGGIH","gend":1,"add":" KRAP 301DRAVELUOB","city":"STAUNTON","state":"VA","zip":"24401-9998","dob":"1955-04-17","age":"","mstatus":"","insh":"10112975","cliId":"","pno":"7504564940","cno":"","email":"","ename":"","eno":"","pphy":"ALEXANDER, KERRY A","ppno":5408866259,"pcpadd":"42 Lambert StSte 511","pcpcity":"Staunton","pcpstate":"VA","pcpzip":244012437,"pcpcounty":"","pcpid":"","pcpname":"STAUNTON MEDICAL ASSOCIATES","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"","add3":"","madd1":"103 PARK BOULEVARD","madd2":"","madd3":"","mcity":"STAUNTON","mstate":"VA","mzip":"24401-9998","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":[["","62175061743","PANTOPRAZOLE","TAB 40MG","30.00","Select","Select",""],["","13668001105","CITALOPRAM","TAB 40MG","90.00","Select","Select",""],["","68180052001","LISINOP\/HCTZ","TAB 20-25MG","30.00","Select","Select",""],["","68180071909","AMLODIPINE","TAB 2.5MG","30.00","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","21.00","Select","Select",""],["","53885039310","ONETOUCH","MIS LANCETS","100.00","Select","Select",""],["","70436005901","BUPROPION","TAB 150MG SR","180.00","Select","Select",""],["","65162018810","NAPROXEN","TAB 250MG","20.00","Select","Select",""],["","00093005805","TRAMADOL","TAB 50MG","14.00","Select","Select",""],["","65862032904","ALENDRONATE","TAB 70MG","4.00","Select","Select",""],["","65862057490","MONTELUKAST","TAB 10MG","90.00","Select","Select",""],["","00093720298","PRAVASTATIN","TAB 40MG","90.00","Select","Select",""],["","59746012206","MECLIZINE","TAB 12.5MG","30.00","Select","Select",""],["","60505025203","TIZANIDINE","TAB 4MG","90.00","Select","Select",""],["","00069046903","CHANTIX","PAK 1MG","56.00","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":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"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":""}]}]}