{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LORANE D TRUEHEART","gend":1,"add":"1703 WINONA BLVD","city":"GLEN ALLEN","state":"VA","zip":"23060-9998","dob":"1939-02-22","age":"","mstatus":"","insh":"11000452","cliId":"","pno":8042665968,"cno":"","email":"","ename":"","eno":"","pphy":"COLEMAN, PETER RICHARD","ppno":8043531230,"pcpadd":"204 N Hamilton St Ste B","pcpcity":"Richmond","pcpstate":"VA","pcpzip":232212662,"pcpcounty":"","pcpid":"","pcpname":"HAMILTON FAMILY PRACTICE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"APT C","add3":"","madd1":"1703 WINONA BLVD","madd2":"APT C","madd3":"","mcity":"GLEN ALLEN","mstate":"VA","mzip":"23060-9998","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":[]},{"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":[["","99073070827","FREESTYLE    TES LITE","LITE","100.00","Select","Select",""],["","99073013001","FREESTYLE    MIS LANCETS","LANCETS","100.00","Select","Select",""],["","00054429731","FUROSEMIDE ","20MG","180.00","Select","Select",""],["","68382025110","ATORVASTATIN ","40MG","90.00","Select","Select",""],["","68180072103","AMLODIPINE ","10MG","90.00","Select","Select",""],["","43547033610","BENAZEPRIL ","10MG","5.00","Select","Select",""],["","99073071227","FREESTYLE    TES INSULINX","INSULINX","100.00","Select","Select",""],["","51672128202","TRIAMCINOLON ","0.10%","60.00","Select","Select",""],["","29300034901","ALLOPURINOL ","100MG","180.00","Select","Select",""],["","68180096301","ALBUTEROL ","HFA","8.50","Select","Select",""],["","60505014202","GLIPIZIDE ","10MG","180.00","Select","Select",""],["","16729002110","PIOGLITAZONE ","30MG","90.00","Select","Select",""],["","59310057922","PROAIR ","","8.50","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":["",""]}},{"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":""}]}]}