{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ROBERT FRANK","gend":0,"add":"606 PHEBUS ST APT218","city":"PORTSMOUTH","state":"VA","zip":"23704-9998","dob":"1938-05-16","age":"","mstatus":"","insh":"11005207","cliId":"","pno":7576705940,"cno":7576172792,"email":"","ename":"","eno":"","pphy":"BAUMGARTEN, MARGARET Y","ppno":7573976344,"pcpadd":"825 Fairfax Ave Hofheimer Hall 1st Floor Suite 118","pcpcity":"Norfolk","pcpstate":"VA","pcpzip":235071914,"pcpcounty":"","pcpid":"","pcpname":"PORTSMOUTH FAMILY MEDICINE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"TIDEWATER","aligned":"Y","ano":"","add2":"","add3":"","madd1":"4130 Queenswood Dr Apt C","madd2":"","madd3":"","mcity":"Portsmouth","mstate":"VA","mzip":"23703-1826","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":[["","68382013201","TAMSULOSIN ","0.4MG","90.00","Select","Select",""],["","65862014930","FINASTERIDE ","5MG","90.00","Select","Select",""],["","65862009520","CEFPODOXIME ","100MG","14.00","Select","Select",""],["","43547027509","DONEPEZIL ","5MG","90.00","Select","Select",""],["","65862053820","LEVOFLOXACIN ","750MG","5.00","Select","Select",""],["","00406051205","OXYCOD\/APAP ","5-325MG","24.00","Select","Select",""],["","00591544305","PREDNISONE ","20MG","5.00","Select","Select",""],["","00093314705","CEPHALEXIN ","500MG","28.00","Select","Select",""],["","13107003134","MIRTAZAPINE ","15MG","60.00","Select","Select",""],["","69543013611","TRAMADOL ","50MG","20.00","Select","Select",""],["","00093031401","KETOROLAC ","10MG","14.00","Select","Select",""],["","00093321992","KETOCONAZOLE ","2%","60.00","Select","Select",""],["","65862042005","SMZ\/TMP ","800-160","14.00","Select","Select",""],["","55111012701","CIPROFLOXACN ","500MG","20.00","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":""}]}]}