{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MILFORD FLETCHER","gend":0,"add":"237 S 17TH AVE APT A","city":"HOPEWELL","state":"VA","zip":"23860-9998","dob":"1957-07-07","age":"","mstatus":"","insh":"11003429","cliId":"","pno":8043525780,"cno":"","email":"","ename":"","eno":"","pphy":"MIRANDA, ALTORY M","ppno":8045546132,"pcpadd":"2237 Rose Family Dr","pcpcity":"Midlothian","pcpstate":"VA","pcpzip":231124187,"pcpcounty":"","pcpid":"","pcpname":"HOPEWELL HEALTH CARE CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"237 S 17TH AVE APT A","madd2":"","madd3":"","mcity":"HOPEWELL","mstate":"VA","mzip":"23860-9998","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":[["","65162027210","SMZ\/TMP ","800-160","28.00","Select","Select",""],["","42858010401","OXYCOD\/APAP ","10-325MG","120.00","Select","Select",""],["","53885004601","ONETOUCH ","ULTRA 2","1.00","Select","Select",""],["","16729013501","ALLOPURINOL ","300MG","90.00","Select","Select",""],["","33342030111","ESZOPICLONE ","3MG","30.00","Select","Select",""],["","62037056001","POT  CHLORIDE","10MEQ ER","120.00","Select","Select",""],["","68180097501","LEVOTHYROXIN ","200MCG","90.00","Select","Select",""],["","65862059801","TAMSULOSIN ","0.4MG","180.00","Select","Select",""],["","00185005501","METOLAZONE ","5MG","5.00","Select","Select",""],["","55111019690","CLOPIDOGREL ","75MG","90.00","Select","Select",""],["","00093101042","MUPIROCIN ","2%","22.00","Select","Select",""],["","69238131409","PREGABALIN ","150MG","120.00","Select","Select",""],["","00054429731","FUROSEMIDE ","20MG","360.00","Select","Select",""],["","00456120130","LINZESS ","145MCG","30.00","Select","Select",""],["","00310737020","BUDES\/FORMOT ","160-4.5","10.20","Select","Select",""],["","00186037020","SYMBICORT ","160-4.5","10.20","Select","Select",""],["","00597010061","SPIRIVA ","2.5MCG","4.00","Select","Select",""],["","00088222033","LANTUS ","100\/ML","20.00","Select","Select",""],["","16729022501","SPIRONOLACT ","25MG","90.00","Select","Select",""],["","27241009903","DULOXETINE ","60MG","90.00","Select","Select",""],["","68382009401","CARVEDILOL ","12.5MG","60.00","Select","Select",""],["","65862021150","MINOCYCLINE ","100MG","20.00","Select","Select",""],["","16714049401","AMOX\/K ","500-125","30.00","Select","Select",""],["","16714084401","AMIODARONE ","200MG","90.00","Select","Select",""],["","67877021901","CEPHALEXIN ","500MG","14.00","Select","Select",""],["","00071101668","LYRICA ","150MG","120.00","Select","Select",""],["","00487020103","IPRATROPIUM\/ ","ALBUTER","270.00","Select","Select",""],["","00186077760","BRILINTA ","90MG","60.00","Select","Select",""],["","72647033104","METHYLPRED ","4MG","21.00","Select","Select",""],["","00310621030","FARXIGA ","10MG","90.00","Select","Select",""],["","00078065920","ENTRESTO ","24-26MG","60.00","Select","Select",""],["","64380076921","PEG-3350\/KCL ","\/SODIUM","4,000.00","Select","Select",""],["","69238110005","DOXYCYCL ","100MG","20.00","Select","Select",""],["","00093317431","ALBUTEROL ","E","8.50","Select","Select",""],["","59746017506","PREDNISONE ","20MG","6.00","Select","Select",""],["","68180063709","ATORVASTATIN ","40MG","90.00","Select","Select",""],["","00002751001","HUMALOG ","100\/ML","10.00","Select","Select",""],["","00085720601","DULERA ","100-5MCG","13.00","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":""}]}]}