{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ROBERT TERRY","gend":0,"add":"907 N 26TH ST APT A","city":"RICHMOND","state":"VA","zip":"23223-9998","dob":"1950-02-10","age":"","mstatus":"","insh":"11002963","cliId":"","pno":8046831841,"cno":"","email":"","ename":"","eno":"","pphy":"JENKINS, JAMES P","ppno":8047800840,"pcpadd":"115 PARK ST SE","pcpcity":"VIENNA","pcpstate":"VA","pcpzip":221804653,"pcpcounty":"","pcpid":"","pcpname":"VERNON J HARRIS EAST END COMMUNITY HEALTH CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"907 N 26TH ST APT A","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":[["","57599000101","FREESTYLE    KIT SENSOR","SENSOR","2.00","Select","Select",""],["","43598043611","NITROGLYCERN ","0.4MG","25.00","Select","Select",""],["","69097015907","MELOXICAM ","15MG","30.00","Select","Select",""],["","42858010301","OXYCOD\/APAP ","7.5-325","48.00","Select","Select",""],["","16714074002","FENOFIBRATE ","134MG","27.00","Select","Select",""],["","45802041954","AMMONIUM ","12%","225.00","Select","Select",""],["","33342004810","IRBESARTAN ","150MG","90.00","Select","Select",""],["","53885024510","ONETOUCH ","ULTRA BL","100.00","Select","Select",""],["","69097094312","GABAPENTIN ","300MG","90.00","Select","Select",""],["","50458057930","XARELTO ","20MG","90.00","Select","Select",""],["","47781060730","DISULFIRAM ","250MG","90.00","Select","Select",""],["","59651000305","OMEPRAZOLE ","40MG","90.00","Select","Select",""],["","00088221905","LANTUS ","100\/ML","15.00","Select","Select",""],["","59310057922","PROAIR ","","8.50","Select","Select",""],["","57237001401","TAMSULOSIN ","0.4MG","90.00","Select","Select",""],["","00023320503","LUMIGAN ","0.01%","7.50","Select","Select",""],["","00713067131","KETOCONAZOLE ","2%","90.00","Select","Select",""],["","29300024310","AMLODIPINE ","10MG","30.00","Select","Select",""],["","69584061150","METHOCARBAM ","500MG","30.00","Select","Select",""],["","65162019050","NAPROXEN ","500MG","20.00","Select","Select",""],["","24208046325","LATANOPROST ","0.01%","7.50","Select","Select",""],["","57599000200","FREESTYLE    MIS READER","READER","1.00","Select","Select",""],["","00186037220","SYMBICORT ","80-4.5","30.60","Select","Select",""],["","08290320109","BD  PEN NEEDL","31GX8MM","100.00","Select","Select",""],["","49483060250","IBUPROFEN ","400MG","60.00","Select","Select",""],["","57664050658","METOPROL ","25MG","30.00","Select","Select",""],["","08470353001","UNIFINE ","31GX8MM","100.00","Select","Select",""],["","00093317431","ALBUTEROL ","E","8.50","Select","Select",""],["","00597007541","SPIRIVA ","HANDIHLR","90.00","Select","Select",""],["","00093742698","MONTELUKAST ","10MG","90.00","Select","Select",""],["","00310737020","BUDES\/FORMOT ","160-4.5","30.60","Select","Select",""],["","00054327099","FLUTICASONE ","50MCG","16.00","Select","Select",""],["","70436000203","POT  CHLORIDE","10MEQ ER","28.00","Select","Select",""],["","51672131201","MUPIROCIN ","2%","30.00","Select","Select",""],["","08222095855","PEN  NEEDLES  ","31GX8MM","100.00","Select","Select",""],["","00093224001","CEPHALEXIN ","500MG","30.00","Select","Select",""],["","53746010901","HYDROCO\/APAP ","5-325MG","12.00","Select","Select",""],["","69097084615","CYCLOBENZAPR ","10MG","12.00","Select","Select",""],["","51672127103","DESOXIMETAS ","0.05%","360.00","Select","Select",""],["","00591544310","PREDNISONE ","20MG","15.00","Select","Select",""],["","65862017760","CEFDINIR ","300MG","20.00","Select","Select",""],["","57664050083","MIRTAZAPINE ","30MG","30.00","Select","Select",""],["","43547030203","ARIPIPRAZOLE ","2MG","30.00","Select","Select",""],["","68462010630","ONDANSETRON ","8MG","30.00","Select","Select",""],["","70377002911","ATORVASTATIN ","40MG","90.00","Select","Select",""],["","00173068220","VENTOLIN ","","18.00","Select","Select",""],["","49884093547","DICLOFENAC ","1%","100.00","Select","Select",""],["","31722093612","OMEGA-3-ACID ","1GM","360.00","Select","Select",""],["","00406048401","APAP\/CODEINE ","300-30MG","5.00","Select","Select",""],["","31722070290","LOSARTAN ","100MG","90.00","Select","Select",""],["","65862053820","LEVOFLOXACIN ","750MG","3.00","Select","Select",""],["","69547035302","NARCAN ","","2.00","Select","Select",""],["","53489011905","DOXYCYCL ","100MG","20.00","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":""}]}]}