{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BARBARA J PRYOR","gend":1,"add":"310 PEACE LILLY LANE APT 304","city":"RICHMOND","state":"VA","zip":"23223-9998","dob":"1940-02-13","age":"","mstatus":"","insh":"11002870","cliId":"","pno":8043981552,"cno":8049829063,"email":"","ename":"","eno":"","pphy":"KUSHINKA, JEFFREY T","ppno":8048287700,"pcpadd":"1001 E Marshall St Fl 3","pcpcity":"Richmond","pcpstate":"VA","pcpzip":232985075,"pcpcounty":"","pcpid":"","pcpname":"MCV AMBULATORY CARE CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"310 PEACE LILLY LANE APT 304","madd2":"","madd3":"","mcity":"RICHMOND","mstate":"VA","mzip":"23223-9998","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":[["","68382065005","ISOSORB ","30MG ER","90.00","Select","Select",""],["","51672129802","KETOCONAZOLE ","2%","30.00","Select","Select",""],["","00003089321","ELIQUIS ","2.5MG","180.00","Select","Select",""],["","68180072103","AMLODIPINE ","10MG","90.00","Select","Select",""],["","00378395277","ATORVASTATIN ","40MG","90.00","Select","Select",""],["","70436000904","CINACALCET ","90MG","90.00","Select","Select",""],["","68382097001","CHLORTHALID ","25MG","90.00","Select","Select",""],["","76385011150","CARVEDILOL ","6.25MG","180.00","Select","Select",""],["","55513007530","SENSIPAR ","90MG","90.00","Select","Select",""],["","69097085902","TERBINAFINE ","250MG","90.00","Select","Select",""],["","49884093547","DICLOFENAC ","1%","200.00","Select","Select",""],["","68180051703","LISINOPRIL ","40MG","90.00","Select","Select",""],["","65862024608","LEVETIRACETA ","500MG","180.00","Select","Select",""],["","59746028490","PANTOPRAZOLE ","40MG","90.00","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":""}]}]}