{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BARBARA RAGLAND","gend":1,"add":"16713 COURTHOUSE RD","city":"DINWIDDIE","state":"VA","zip":"23841-9998","dob":"1959-10-19","age":"","mstatus":"","insh":"11003756","cliId":"","pno":8047222308,"cno":"","email":"","ename":"","eno":"","pphy":"BUSH, JAMES A","ppno":8045201110,"pcpadd":"815 W POYTHRESS ST","pcpcity":"HOPEWELL","pcpstate":"VA","pcpzip":238602532,"pcpcounty":"","pcpid":"","pcpname":"HOPEWELL MEDICAL CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"16713 COURTHOUSE RD","madd2":"","madd3":"","mcity":"DINWIDDIE","mstate":"VA","mzip":"23841-9998","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":[["","00406012305","HYDROCO\/APAP ","5-325MG","10.00","Select","Select",""],["","23155010405","METFORMIN ","1000MG","180.00","Select","Select",""],["","68462039710","OMEPRAZOLE ","40MG","90.00","Select","Select",""],["","00378001805","METOPROL ","25MG","180.00","Select","Select",""],["","29300013601","CLONIDINE ","0.2MG","90.00","Select","Select",""],["","16729000517","SIMVASTATIN ","20MG","90.00","Select","Select",""],["","00406048410","APAP\/CODEINE ","300-30MG","20.00","Select","Select",""],["","16571020150","DICLOFENAC ","75MG DR","180.00","Select","Select",""],["","68462012705","GABAPENTIN ","800MG","270.00","Select","Select",""],["","65162062711","TRAMADOL ","50MG","40.00","Select","Select",""],["","70710122600","AMITRIPTYLIN ","25MG","90.00","Select","Select",""],["","00781707787","METRONIDAZOL ","0.75%VAG","70.00","Select","Select",""],["","67877021901","CEPHALEXIN ","500MG","21.00","Select","Select",""],["","52817033200","CYCLOBENZAPR ","10MG","20.00","Select","Select",""],["","51672131201","MUPIROCIN ","2%","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":["",""],"sub":{"indx":[["","",""],[""],[""],[""],[""]],"comment":[["","",""],[""],[""],[""],[""]],"sub":[]}}},{"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":""}]}]}