{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DOROTHY M JONES","gend":1,"add":"600 WINSTON CHURCHHILL DR","city":"HOPEWELL","state":"VA","zip":"23860-9998","dob":"1949-09-27","age":"","mstatus":"","insh":"11007526","cliId":"","pno":8046150004,"cno":8043983316,"email":"","ename":"","eno":"","pphy":"MOHIUDDIN, ABDUL","ppno":8044588583,"pcpadd":"1012 Winston Churchill Dr","pcpcity":"Hopewell","pcpstate":"VA","pcpzip":238605141,"pcpcounty":"","pcpid":"","pcpname":"TWIN RIVERS MEDICAL CLINIC PC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"600 WINSTON CHURCHHILL DR","madd2":"","madd3":"","mcity":"HOPEWELL","mstate":"VA","mzip":"23860-9998","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":[["","67877056110","METFORMIN ","500MG","31.00","Select","Select",""],["","69097012815","AMLODIPINE ","10MG","31.00","Select","Select",""],["","00527135001","LEVOTHYROXIN ","175MCG","31.00","Select","Select",""],["","65862020399","LOSARTAN ","100MG","29.00","Select","Select",""],["","60505258008","ATORVASTATIN ","40MG","30.00","Select","Select",""],["","00093736898","LOSARTAN\/HCT ","100-25","31.00","Select","Select",""],["","65862001205","SERTRALINE ","50MG","31.00","Select","Select",""],["","68462012605","GABAPENTIN ","600MG","93.00","Select","Select",""],["","16252051501","CIPROFLOXACN ","500MG","6.00","Select","Select",""],["","68382080510","TRAZODONE ","50MG","30.00","Select","Select",""],["","68001028108","DICLOFENAC ","75MG DR","62.00","Select","Select",""],["","16729018317","HYDROCHLOROT ","25MG","31.00","Select","Select",""],["","00185003451","TIZANIDINE ","2MG","15.00","Select","Select",""],["","56151014701","TRUPLUS ","33G","100.00","Select","Select",""],["","56151146001","TRUE ","GLUCOSE","100.00","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":""}]}]}