{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"WILLIAM D BROWN","gend":0,"add":"49 EAST MAIN STREE APT 5","city":"PULASKI","state":"VA","zip":"24301-9998","dob":"1952-06-04","age":"","mstatus":"","insh":"11010025","cliId":"","pno":5403945213,"cno":2762271665,"email":"","ename":"","eno":"","pphy":"OSEMOBOR, EHIKIOYA","ppno":5408350500,"pcpadd":"2832 TOWN CENTER DRIVE","pcpcity":"DUBLIN","pcpstate":"VA","pcpzip":240846069,"pcpcounty":"","pcpid":"","pcpname":"LEON J BROWN JR MD","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"","add3":"","madd1":"49 EAST MAIN STREE APT 5","madd2":"","madd3":"","mcity":"PULASKI","mstate":"VA","mzip":"24301-9998","pcpfaxno":"(540) 307-5070","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":[["","31722070210","LOSARTAN ","100MG","30.00","Select","Select",""],["","59762219803","AZITHROMYCIN ","250MG","6.00","Select","Select",""],["","16714012303","OMEPRAZOLE ","40MG","30.00","Select","Select",""],["","62332007990","VALSART\/HCTZ ","80-12.5","60.00","Select","Select",""],["","00378005201","PINDOLOL ","5MG","90.00","Select","Select",""],["","60505017007","PRAVASTATIN ","40MG","90.00","Select","Select",""],["","16714087601","ATORVASTATIN ","40MG","30.00","Select","Select",""],["","52268001201","SUPREP ","PREP KIT","354.00","Select","Select",""],["","00143980350","DOXYCYCL ","100MG","42.00","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":""}]}]}