{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"RUTH D HARDING","gend":1,"add":"110 WILSON LANE","city":"WEEMS","state":"VA","zip":"22576-9998","dob":"1935-11-10","age":"","mstatus":"","insh":"11009967","cliId":"","pno":8044353444,"cno":8044362331,"email":"","ename":"","eno":"","pphy":"CUBBAGE, BRIAN K","ppno":8044353133,"pcpadd":"30 Shady Ln","pcpcity":"White Stone","pcpstate":"VA","pcpzip":225782601,"pcpcounty":"","pcpid":"","pcpname":"WHITE STONE FAMILY PRACTICE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"110 WILSON LANE","madd2":"","madd3":"","mcity":"WEEMS","mstate":"VA","mzip":"22576-9998","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":[["","50924097110","SOFTCLIX ","LANCETS","100.00","Select","Select",""],["","65702071110","ACCU-CHEK ","GUIDE","100.00","Select","Select",""],["","65702073110","ACCU-CHECK ","GUIDE ME","1.00","Select","Select",""],["","68645058259","METFORMIN ","500MG","90.00","Select","Select",""],["","68382009205","CARVEDILOL ","3.125MG","60.00","Select","Select",""],["","16714010105","GEMFIBROZIL ","600MG","180.00","Select","Select",""],["","57237001760","DULOXETINE ","20MG","30.00","Select","Select",""],["","68645055154","LISINOPRIL ","5MG","90.00","Select","Select",""],["","31722000290","VENLAFAXINE ","37.5 ER","90.00","Select","Select",""],["","55111032001","GLIMEPIRIDE ","1MG","90.00","Select","Select",""],["","68645014059","FAMOTIDINE ","20MG","90.00","Select","Select",""],["","59762219807","AZITHROMYCIN ","250MG","6.00","Select","Select",""],["","00781261305","AMOXICILLIN ","500MG","28.00","Select","Select",""],["","53885024510","ONETOUCH ","ULTRA BL","100.00","Select","Select",""],["","65162083366","DICLOFENAC ","1%","100.00","Select","Select",""],["","43598021055","SSD ","1%","50.00","Select","Select",""],["","00054327099","FLUTICASONE ","50MCG","48.00","Select","Select",""],["","00143314250","DOXYCYCL ","100MG","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":""}]}]}