{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"HONG T MAI","gend":1,"add":"3839 TROUTLAND AVENUE NW","city":"ROANOKE","state":"VA","zip":"24017-9998","dob":"1951-12-31","age":"","mstatus":"","insh":"11003957","cliId":"","pno":5403556076,"cno":"","email":"","ename":"","eno":"","pphy":"GARDNER, JAMES H","ppno":5403454946,"pcpadd":"4461 Starkey Rd Ste 201","pcpcity":"Roanoke","pcpstate":"VA","pcpzip":240180622,"pcpcounty":"","pcpid":"","pcpname":"PHYSICIAN ASSOCIATES OF VIRGINIA","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"","add3":"","madd1":"3839 TROUTLAND AVENUE NW","madd2":"","madd3":"","mcity":"ROANOKE","mstate":"VA","mzip":"24017-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["ASIAN\/PACIFIC"]],"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":[["","53885027210","ONETOUCH ","VERIO","100.00","Select","Select",""],["","69452020720","CALCITRIOL ","0.25MCG","36.00","Select","Select",""],["","70377002711","ATORVASTATIN ","10MG","90.00","Select","Select",""],["","59746012106","MECLIZINE ","25MG","50.00","Select","Select",""],["","16729000101","GLIMEPIRIDE ","1MG","45.00","Select","Select",""],["","31722083330","ENTECAVIR ","0.5MG","24.00","Select","Select",""],["","13668011510","LOSARTAN ","100MG","90.00","Select","Select",""],["","65862001005","METFORMIN ","1000MG","180.00","Select","Select",""],["","62175061746","PANTOPRAZOLE ","40MG","28.00","Select","Select",""],["","42385090103","TENOFOVIR ","300MG","90.00","Select","Select",""],["","00406012301","HYDROCO\/APAP ","5-325MG","120.00","Select","Select",""],["","00093221005","SUCRALFATE ","1GM","60.00","Select","Select",""],["","00527193206","CLARITHROMYC ","500MG","28.00","Select","Select",""],["","55111012701","CIPROFLOXACN ","500MG","10.00","Select","Select",""],["","00781261305","AMOXICILLIN ","500MG","56.00","Select","Select",""],["","59762500701","MISOPROSTOL ","100MCG","180.00","Select","Select",""],["","53885004401","ONE ","VERIO FL","1.00","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":""}]}]}