{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"WILLIAM C PLUMB","gend":0,"add":"410 BIRCHSIDE CIR","city":"LOCUST GROVE","state":"VA","zip":"22508-9998","dob":"1944-10-15","age":"","mstatus":"","insh":"11000305","cliId":"","pno":5404069682,"cno":"","email":"","ename":"","eno":"","pphy":"BABAR, AHMAD","ppno":7037069897,"pcpadd":"4376 Germanna Hwy","pcpcity":"Locust Grove","pcpstate":"VA","pcpzip":225082008,"pcpcounty":"","pcpid":"","pcpname":"UVA PRIMARY CARE LOCUST GROVE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"","add3":"","madd1":"410 BIRCHSIDE CIR","madd2":"","madd3":"","mcity":"LOCUST GROVE","mstate":"VA","mzip":"22508-9998","pcpfaxno":"(540) 972-3536","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":[["","00173069600","ADVAIR ","250\/50","180.00","Select","Select",""],["","68682099898","DILTIAZEM ","300MG ER","90.00","Select","Select",""],["","68180098103","LISINOPRIL ","20MG","90.00","Select","Select",""],["","50111044101","TRAZODONE ","150MG","30.00","Select","Select",""],["","00378395077","ATORVASTATIN ","10MG","45.00","Select","Select",""],["","00378064110","PREDNISONE ","10MG","6.00","Select","Select",""],["","65862067701","ALPRAZOLAM ","0.5MG","30.00","Select","Select",""],["","68382091634","METHYLPRED ","4MG","21.00","Select","Select",""],["","68180016006","AZITHROMYCIN ","250MG","5.00","Select","Select",""],["","00093406106","FORMOTEROL ","20\/2ML","120.00","Select","Select",""],["","69097083412","SERTRALINE ","50MG","30.00","Select","Select",""],["","65862001501","AMOXICILLIN ","875MG","20.00","Select","Select",""],["","68180030260","CEFUROXIME ","250MG","20.00","Select","Select",""],["","65862053750","LEVOFLOXACIN ","500MG","10.00","Select","Select",""],["","00115168774","BUDESONIDE ","0.25MG\/2","60.00","Select","Select",""],["","43547040111","FUROSEMIDE ","20MG","360.00","Select","Select",""],["","00378967130","IPRATROPIUM\/ ","ALBUTER","90.00","Select","Select",""],["","24658031205","DOXYCYCL ","100MG","20.00","Select","Select",""],["","65862049101","QUETIAPINE ","100MG","60.00","Select","Select",""],["","60505614700","CEFEPIME ","2GM","8.00","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":""}]}]}