{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DENISE M WINFREE","gend":1,"add":"1506 COALTER ST","city":"RICHMOND","state":"VA","zip":"23223-9998","dob":"1962-01-24","age":"","mstatus":"","insh":"11002166","cliId":"","pno":8049302322,"cno":"","email":"","ename":"","eno":"","pphy":"PEEBLES, RICHARD C","ppno":8048223480,"pcpadd":"110 N Robinson StSte 400","pcpcity":"Richmond","pcpstate":"VA","pcpzip":232204462,"pcpcounty":"","pcpid":"","pcpname":"RETREAT INTERNAL MEDICINE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"1506 COALTER ST","madd2":"","madd3":"","mcity":"RICHMOND","mstate":"VA","mzip":"23223-9998","pcpfaxno":"(804) 822-3484","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":[["","65862001705","AMOXICILLIN ","500MG","30.00","Select","Select",""],["","10702005601","OXYCODONE ","10MG","90.00","Select","Select",""],["","68462018147","CLOTRIMAZOLE ","1%","45.00","Select","Select",""],["","59746033090","DONEPEZIL ","10MG","90.00","Select","Select",""],["","00378427677","VALACYCLOVIR ","1GM","90.00","Select","Select",""],["","29300012510","MELOXICAM ","15MG","30.00","Select","Select",""],["","68462019005","NAPROXEN ","500MG","15.00","Select","Select",""],["","68180072103","AMLODIPINE ","10MG","90.00","Select","Select",""],["","69097052444","DICLOFENAC ","1%","100.00","Select","Select",""],["","61314064610","NEO\/POLY\/HC ","1% OTIC","10.00","Select","Select",""],["","52817033200","CYCLOBENZAPR ","10MG","90.00","Select","Select",""],["","43386009019","GAVILYTE-G ","","4,000.00","Select","Select",""],["","65862007930","TERBINAFINE ","250MG","30.00","Select","Select",""],["","68462079817","TRIAMCINOLON ","0.50%","15.00","Select","Select",""],["","00574206130","CICLOPIROX ","0.77%","30.00","Select","Select",""],["","65862001905","CEPHALEXIN ","500MG","21.00","Select","Select",""],["","50484001030","SANTYL ","250\/GM","30.00","Select","Select",""],["","57237000511","FLUCONAZOLE ","150MG","1.00","Select","Select",""],["","59746000103","METHYLPRED ","4MG","42.00","Select","Select",""],["","69547035302","NARCAN ","","2.00","Select","Select",""],["","45802026937","PERMETHRIN ","5%","60.00","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":""}]}]}