{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"GRACIELA GARCIA","gend":1,"add":"2805 W. LANDING RD","city":"VIRGINIA BEACH","state":"VA","zip":"23456-9998","dob":"1959-06-17","age":"","mstatus":"","insh":"11007887","cliId":"","pno":7575029864,"cno":"","email":"","ename":"","eno":"","pphy":"BRITT, CHARLENE MARIE","ppno":7573636800,"pcpadd":"816 Independence Blvd Ste 100","pcpcity":"Virginia Beach","pcpstate":"VA","pcpzip":234556010,"pcpcounty":"","pcpid":"","pcpname":"SENTARA FAMILY MED PHYSICIANS & PRIMARY CARE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"TIDEWATER","aligned":"Y","ano":"","add2":"","add3":"","madd1":"2805 W. LANDING RD","madd2":"","madd3":"","mcity":"VIRGINIA BEACH","mstate":"VA","mzip":"23456-9998","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":[["","68180012202","CEPHALEXIN ","500MG","14.00","Select","Select",""],["","00002143480","TRULICITY ","1.5\/0.5","2.00","Select","Select",""],["","68645051654","AMLODIPINE ","10MG","90.00","Select","Select",""],["","68645057559","GLIPIZIDE ","10MG","180.00","Select","Select",""],["","68645051054","HYDROCHLOROT ","25MG","90.00","Select","Select",""],["","72205000390","ROSUVASTATIN ","10MG","60.00","Select","Select",""],["","68645058259","METFORMIN ","500MG","180.00","Select","Select",""],["","00088222033","LANTUS ","100\/ML","40.00","Select","Select",""],["","00781518192","LEVOTHYROXIN ","50MCG","90.00","Select","Select",""],["","00143992701","CIPROFLOXACN ","250MG","10.00","Select","Select",""],["","68382009405","CARVEDILOL ","12.5MG","180.00","Select","Select",""],["","13668011590","LOSARTAN ","100MG","90.00","Select","Select",""],["","00002771559","BASAGLAR ","100UNIT","15.00","Select","Select",""],["","72305007530","EUTHYROX ","75MCG","90.00","Select","Select",""],["","00093092810","LOVASTATIN ","40MG","90.00","Select","Select",""],["","10702001801","OXYCODONE ","5MG","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":""}]}]}