{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CATHERINE D PEEBLES","gend":1,"add":"1025 W Grace St Apt 513","city":"Richmond","state":"VA","zip":"23220-3634","dob":"1955-07-01","age":"","mstatus":"","insh":"11008314","cliId":"","pno":8045224640,"cno":"","email":"","ename":"","eno":"","pphy":"ELLIOTT, CHARMAINE N","ppno":8046441665,"pcpadd":"9000 Stony Point Pkwy","pcpcity":"Richmond","pcpstate":"VA","pcpzip":232351900,"pcpcounty":"","pcpid":"","pcpname":"PRIMARY HEALTCARE ASSOCIATES","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"1025 W Grace St Apt 513","madd2":"","madd3":"","mcity":"Richmond","mstate":"VA","mzip":"23220-3634","pcpfaxno":"(804) 327-8810","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":[["","65862056090","PANTOPRAZOLE ","40MG","90.00","Select","Select",""],["","67877019910","AMLODIPINE ","10MG","30.00","Select","Select",""],["","67877022201","GABAPENTIN ","100MG","270.00","Select","Select",""],["","60505258008","ATORVASTATIN ","40MG","30.00","Select","Select",""],["","33342017910","OLMESA ","20MG","30.00","Select","Select",""],["","68180065208","DOXYCYC ","100MG","20.00","Select","Select",""],["","68180067711","OSELTAMIVIR ","75MG","10.00","Select","Select",""],["","00143980350","DOXYCYCL ","100MG","20.00","Select","Select",""],["","67877032105","IBUPROFEN ","800MG","20.00","Select","Select",""],["","16571020111","DICLOFENAC ","75MG DR","14.00","Select","Select",""],["","50458057930","XARELTO ","20MG","30.00","Select","Select",""],["","57664037718","TRAMADOL ","50MG","21.00","Select","Select",""],["","00054001729","PREDNISONE ","10MG","13.00","Select","Select",""],["","60505082901","FLUTICASONE ","50MCG","16.00","Select","Select",""],["","70010077005","METHOCARBAM ","750MG","42.00","Select","Select",""],["","59310057922","PROAIR ","","8.50","Select","Select",""],["","00173068220","VENTOLIN ","","18.00","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":""}]}]}