{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" MAZLAHIGAVNAYIGORB B","gend":1,"add":"YROKCIH 211WS ELCRIC ","city":"VIENNA","state":"VA","zip":"22180-5706","dob":"1941-05-12","age":"","mstatus":"","insh":"10113829","cliId":"","pno":"2230794502","cno":"7038642462","email":"","ename":"","eno":"","pphy":"GOGINENI, SREE LAKSHMI","ppno":"7032556010          ","pcpadd":"124 Park St SE Ste 203, ","pcpcity":"124 Park St SE Ste 203,","pcpstate":"VA","pcpzip":"221804654","pcpcounty":"","pcpid":"","pcpname":"CAPTIAL AREA INTERNAL MEDICINE INC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"NORTHERN & WINCHESTER","aligned":"Y","ano":"","add2":"APT SW","add3":"","madd1":"112 HICKORY CIRCLE SW","madd2":"APT SW","madd3":"","mcity":"VIENNA","mstate":"VA","mzip":"22180-5706","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["ASIAN\/PACIFIC"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":[],"date":[],"priorHcc":[]}}]},{"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":[["","00597015330","JARDIANCE","TAB 25MG","90.00","Select","Select",""],["","00310621030","FARXIGA","TAB 10MG","90.00","Select","Select",""],["","69238115409","EZETIMIBE","TAB 10MG","90.00","Select","Select",""],["","53885027210","ONETOUCH","TES VERIO","100.00","Select","Select",""],["","67877056110","METFORMIN","TAB 500MG","180.00","Select","Select",""],["","55111032101","GLIMEPIRIDE","TAB 2MG","180.00","Select","Select",""],["","70377002911","ATORVASTATIN","TAB 40MG","90.00","Select","Select",""],["","00469260130","MYRBETRIQ","TAB 25MG","90.00","Select","Select",""],["","68180098003","LISINOPRIL","TAB 10MG","90.00","Select","Select",""],["","00006027731","JANUVIA","TAB 100MG","90.00","Select","Select",""],["","68180072003","AMLODIPINE","TAB 5MG","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":""}]}]}