{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JAMES A EPPS","gend":0,"add":"VA HOME FOR ADULTS","city":"CHESAPEAKE","state":"VA","zip":"23324-3715","dob":"1958-08-05","age":"","mstatus":"","insh":"11000107","cliId":"","pno":8044436088,"cno":"","email":"","ename":"","eno":"","pphy":"MARKOVIC, VLADIMIR","ppno":7575339108,"pcpadd":"3415 Granby St","pcpcity":"Norfolk","pcpstate":"VA","pcpzip":235041421,"pcpcounty":"","pcpid":"","pcpname":"PORTSMOUTH COMMUNITY HEALTH CENTER INC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"TIDEWATER","aligned":"Y","ano":"","add2":"2701 BORDER ROAD","add3":"","madd1":"VA HOME FOR ADULTS","madd2":"2701 BORDER ROAD","madd3":"","mcity":"CHESAPEAKE","mstate":"VA","mzip":"23324-3715","pcpfaxno":"(757) 622-6381","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":[["","00169750111","NOVOLOG ","100\/ML","20.00","Select","Select",""],["","50111043403","TRAZODONE ","100MG","31.00","Select","Select",""],["","56151172301","INSULIN ","1ML\/30G","100.00","Select","Select",""],["","70370108001","INGREZZA ","80MG","30.00","Select","Select",""],["","00378004710","METOPROL ","100MG","62.00","Select","Select",""],["","57237016199","OMEPRAZOLE ","20MG","31.00","Select","Select",""],["","00228212850","CLONIDINE ","0.2MG","31.00","Select","Select",""],["","68180051703","LISINOPRIL ","40MG","60.00","Select","Select",""],["","56151146304","TRUE ","GLUCOSE","50.00","Select","Select",""],["","67877019905","AMLODIPINE ","10MG","31.00","Select","Select",""],["","68382011505","RISPERIDONE ","2MG","62.00","Select","Select",""],["","76385010410","BENZTROPINE ","1MG","60.00","Select","Select",""],["","00088221905","LANTUS ","100\/ML","15.00","Select","Select",""],["","65862001001","METFORMIN ","1000MG","58.00","Select","Select",""],["","60505257808","ATORVASTATIN ","10MG","31.00","Select","Select",""],["","00378623205","CITALOPRAM ","20MG","30.00","Select","Select",""],["","00169183311","NOVOLIN ","U-100","10.00","Select","Select",""],["","08290320122","BD  PEN NEEDL","32GX4MM","100.00","Select","Select",""],["","08290306546","NORMAL ","0.90%","600.00","Select","Select",""],["","00338350841","CEFAZOLIN ","","600.00","Select","Select",""],["","08496280801","EASY ","LANC\/28G","100.00","Select","Select",""],["","08290306414","HEPARIN ","10UNT\/ML","150.00","Select","Select",""],["","60758090810","POLYMYXIN ","TRIMETHP","10.00","Select","Select",""],["","58160088752","FLUARIX ","2021-22","0.50","Select","Select",""],["","33332032001","AFLURIA ","2020-21","0.50","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":["",""],"sub":{"indx":[["","",""],[""],[""],[""],[""]],"comment":[["","",""],[""],[""],[""],[""]],"sub":[]}}},{"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":""}]}]}