{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TAMEKA R GLASS","gend":1,"add":"800 HALIFAX ROAD","city":"DANVILLE","state":"VA","zip":"24540-4858","dob":"1975-09-10","age":"","mstatus":"","insh":"11003334","cliId":"","pno":4343340498,"cno":4344214699,"email":"","ename":"","eno":"","pphy":"TURNER, WESLEY CHAD","ppno":4347914122,"pcpadd":"705 Main St","pcpcity":"Danville","pcpstate":"VA","pcpzip":245411803,"pcpcounty":"","pcpid":"","pcpname":"HEALTH CENTER OF PIEDMONT DANVILLE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"LOT 35","add3":"","madd1":"800 Halifax Rd Lot 35","madd2":"","madd3":"","mcity":"Danville","mstate":"VA","mzip":"24540-4858","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":[["","65862052890","VENLAFAXINE ","75MG ER","30.00","Select","Select",""],["","63402020830","APTIOM ","800MG","30.00","Select","Select",""],["","00131248035","VIMPAT ","200MG","60.00","Select","Select",""],["","68462011060","TOPIRAMATE ","200MG","180.00","Select","Select",""],["","43547034150","RISPERIDONE ","1MG","30.00","Select","Select",""],["","64380080707","IBUPROFEN ","800MG","16.00","Select","Select",""],["","16729018201","HYDROCHLOROT ","12.5MG","90.00","Select","Select",""],["","69097082707","BENZTROPINE ","1MG","30.00","Select","Select",""],["","68462013901","OXCARBAZEPIN ","600MG","270.00","Select","Select",""],["","00093314705","CEPHALEXIN ","500MG","20.00","Select","Select",""],["","00116200116","CHLORHEX ","0.12%","473.00","Select","Select",""],["","68382007901","HALOPERIDOL ","5MG","60.00","Select","Select",""],["","51862094305","DIAZEPAM ","10MG","2.00","Select","Select",""],["","00378718505","METFORMIN ","500MG","180.00","Select","Select",""],["","68462019005","NAPROXEN ","500MG","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":""}]}]}