{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"VELVET T HERRON","gend":1,"add":"102 SOLDIER AVENUE","city":"RUSTBURG","state":"VA","zip":"24588-3464","dob":"1969-05-04","age":"","mstatus":"","insh":"11010039","cliId":"","pno":2763467214,"cno":"","email":"","ename":"","eno":"","pphy":"COUCH, JILL","ppno":2765463001,"pcpadd":"185 REDWOOD AVE STE 102 ROOM 2037","pcpcity":"PENNINGTON GAP","pcpstate":"VA","pcpzip":242772599,"pcpcounty":"","pcpid":"","pcpname":"JONESVILLE FAMILY HEALTH CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"","add3":"","madd1":"102 SOLDIER AVENUE","madd2":"","madd3":"","mcity":"RUSTBURG","mstate":"VA","mzip":"24588-3464","pcpfaxno":"(276) 546-9702","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":[["","12496120803","SUBOXONE ","8-2MG","45.00","Select","Select",""],["","65862086001","FAMOTIDINE ","40MG","30.00","Select","Select",""],["","00054429731","FUROSEMIDE ","20MG","30.00","Select","Select",""],["","23155050001","HYDROXYZ ","10MG","120.00","Select","Select",""],["","00597007541","SPIRIVA ","HANDIHLR","90.00","Select","Select",""],["","33342008845","RIZATRIPTAN ","10MG","12.00","Select","Select",""],["","16729044315","BUPROPN ","150MG XL","17.00","Select","Select",""],["","67877024901","QUETIAPINE ","50MG","30.00","Select","Select",""],["","00093317431","ALBUTEROL ","E","8.50","Select","Select",""],["","00527058610","DICYCLOMINE ","10MG","360.00","Select","Select",""],["","51224000760","METFORMIN ","500MG ER","180.00","Select","Select",""],["","00093221005","SUCRALFATE ","1GM","120.00","Select","Select",""],["","29300012510","MELOXICAM ","15MG","90.00","Select","Select",""],["","62175011843","OMEPRAZOLE ","20MG","90.00","Select","Select",""],["","59310057922","PROAIR ","","8.50","Select","Select",""],["","10702000310","PROMETHAZINE ","25MG","10.00","Select","Select",""],["","00591354060","BUPROPION ","100MG SR","180.00","Select","Select",""],["","47781035703","BUPREN\/NALOX ","8-2MG","36.00","Select","Select",""],["","52817033010","CYCLOBENZAPR ","5MG","42.00","Select","Select",""],["","69097084805","ESCITALOPRAM ","10MG","30.00","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":""}]}]}