{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CINDY COTTRELL","gend":1,"add":"3251 THE LOOP RD","city":"Richmond","state":"va","zip":"23231-9998","dob":"1950-09-22","age":"","mstatus":"","insh":"11001407","cliId":"","pno":8042219697,"cno":8042580856,"email":"","ename":"","eno":"","pphy":"SPARROW JR, CHARLES K","ppno":8047951144,"pcpadd":"2660 New Market Rd","pcpcity":"Henrico","pcpstate":"VA","pcpzip":232317408,"pcpcounty":"","pcpid":"","pcpname":"CHICKAHOMINY FAMILY PRACTICE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"3251 THE LOOP RD","madd2":"","madd3":"","mcity":"Richmond","mstate":"va","mzip":"23231-9998","pcpfaxno":"(804) 795-1052","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":[["","13107006001","APAP\/CODEINE ","300-60MG","90.00","Select","Select",""],["","27241009803","DULOXETINE ","30MG","30.00","Select","Select",""],["","69238183407","LEVOTHYROXIN ","100MCG","30.00","Select","Select",""],["","00228202996","ALPRAZOLAM ","0.5MG","60.00","Select","Select",""],["","59310057922","PROAIR ","","25.50","Select","Select",""],["","00597007541","SPIRIVA ","HANDIHLR","30.00","Select","Select",""],["","43598043611","NITROGLYCERN ","0.4MG","25.00","Select","Select",""],["","00406012305","HYDROCO\/APAP ","5-325MG","90.00","Select","Select",""],["","00310737020","BUDES\/FORMOT ","160-4.5","10.20","Select","Select",""],["","00172572960","FAMOTIDINE ","40MG","90.00","Select","Select",""],["","00406055201","OXYCODONE ","5MG","10.00","Select","Select",""],["","68180072103","AMLODIPINE ","10MG","30.00","Select","Select",""],["","65862001705","AMOXICILLIN ","500MG","30.00","Select","Select",""],["","00093317431","ALBUTEROL ","E HFA INH","8.50","Select","Select",""],["","69547035302","NARCAN ","","2.00","Select","Select",""],["","64980043810","ATENOLOL ","50MG","30.00","Select","Select",""],["","69097052444","DICLOFENAC ","1%","100.00","Select","Select",""],["","70461001903","FLUAD ","2019-20","0.50","Select","Select",""],["","00005197102","PREVNAR ","","0.50","Select","Select",""],["","00591544305","PREDNISONE ","20MG","10.00","Select","Select",""],["","62175011843","OMEPRAZOLE ","20MG","90.00","Select","Select",""],["","68382031910","TRAMADOL ","50MG","90.00","Select","Select",""],["","65862050320","AMOX\/K ","875-125","21.00","Select","Select",""],["","65862018730","ONDANSETRON ","4MG","30.00","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":""}]}]}