{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"HARVEY J TURNER","gend":0,"add":"6601 VERITAS WAY","city":"NORTH CHESTERFIEL","state":"VA","zip":"23234-6180","dob":"1954-04-28","age":"","mstatus":"","insh":"11003834","cliId":"","pno":8043867589,"cno":"","email":"","ename":"","eno":"","pphy":"KAPOOR, SHAILENDRA","ppno":8047416200,"pcpadd":"13540 Hull Street Rd","pcpcity":"Midlothian","pcpstate":"VA","pcpzip":231122107,"pcpcounty":"","pcpid":"","pcpname":"ST FRANCIS FAMILY MEDICINE CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"APARTMENT 2C","add3":"","madd1":"6601 VERITAS WAY","madd2":"APARTMENT 2C","madd3":"","mcity":"NORTH CHESTERFIEL","mstate":"VA","mzip":"23234-6180","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":[["","00591544305","PREDNISONE ","20MG","12.00","Select","Select",""],["","10702005701","OXYCODONE ","20MG","120.00","Select","Select",""],["","59310058020","PROAIR ","","1.00","Select","Select",""],["","68462031960","RANOLAZINE ","500MG ER","60.00","Select","Select",""],["","68180098003","LISINOPRIL ","10MG","30.00","Select","Select",""],["","55111012205","ATORVASTATIN ","20MG","30.00","Select","Select",""],["","00254200801","COLCHICINE ","0.6MG","15.00","Select","Select",""],["","00781185220","AMOX\/K ","875-125","14.00","Select","Select",""],["","00781808926","AZITHROMYCIN ","250MG","6.00","Select","Select",""],["","00054418625","DEXAMETHASON ","6MG","10.00","Select","Select",""],["","65862042005","SMZ\/TMP ","800-160","28.00","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":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"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":""}]}]}