{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ROBERT M HOWARD JR","gend":0,"add":"282 SHILOH AVE","city":"WAYNESBORO","state":"VA","zip":"22980-9998","dob":"1971-11-18","age":"","mstatus":"","insh":"11006293","cliId":"","pno":5408360977,"cno":"","email":"","ename":"","eno":"","pphy":"TAYLOR, ROBERT P","ppno":5409498241,"pcpadd":"25 NORTHRIDGE LANE","pcpcity":"LEXINGTON","pcpstate":"VA","pcpzip":244503399,"pcpcounty":"","pcpid":"","pcpname":"CFM ASSOCIATED PHYSICIANS WAYNESBORO","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"","add3":"","madd1":"282 SHILOH AVE","madd2":"","madd3":"","mcity":"WAYNESBORO","mstate":"VA","mzip":"22980-9998","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":[["","52817018210","CLONIDINE ","0.3MG","180.00","Select","Select",""],["","00591037101","LOXAPINE ","25MG","5.00","Select","Select",""],["","62756014202","METFORMIN ","500MG ER","20.00","Select","Select",""],["","16729018317","HYDROCHLOROT ","25MG","180.00","Select","Select",""],["","00378606001","DILTIAZEM ","60MG ER","60.00","Select","Select",""],["","68180072103","AMLODIPINE ","10MG","30.00","Select","Select",""],["","58657060601","LABETALOL ","200MG","60.00","Select","Select",""],["","68180037703","LOSARTAN ","50MG","90.00","Select","Select",""],["","53489014401","SPIRONO\/HCTZ ","25\/25","30.00","Select","Select",""],["","68180052002","LISINOP\/HCTZ ","20-25MG","60.00","Select","Select",""],["","62037099901","POT  CL MICRO","20MEQ ER","60.00","Select","Select",""],["","00245531911","KLOR-CON ","20MEQ ER","180.00","Select","Select",""],["","64980028001","GLIPIZIDE ","5MG","90.00","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":""}]}]}