{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ELLEN E TURNER","gend":1,"add":"265 PINEVIEW ROAD LOT 25","city":"DANVILLE","state":"VA","zip":"24540-9998","dob":"1943-03-01","age":"","mstatus":"","insh":"11010194","cliId":"","pno":4346853335,"cno":"","email":"","ename":"","eno":"","pphy":"BRIDGES, STEVEN D","ppno":5406350700,"pcpadd":"1020 TERRACE DRIVE","pcpcity":"MARION","pcpstate":"VA","pcpzip":243544392,"pcpcounty":"","pcpid":"","pcpname":"FAMILY HEALTHCARE CENTER OF DANVILLE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"","add3":"","madd1":"265 PINEVIEW ROAD LOT 25","madd2":"","madd3":"","mcity":"DANVILLE","mstate":"VA","mzip":"24540-9998","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":[["","31722071290","PANTOPRAZOLE ","20MG","30.00","Select","Select",""],["","16729032015","OLMESA ","5MG","30.00","Select","Select",""],["","23155019101","BUPROPION ","75MG","60.00","Select","Select",""],["","68382056410","METOPROL ","25MG ER","30.00","Select","Select",""],["","00527133010","BACLOFEN ","10MG","90.00","Select","Select",""],["","00487950160","ALBUTEROL ","0.08%","360.00","Select","Select",""],["","00093720210","PRAVASTATIN ","40MG","30.00","Select","Select",""],["","31722052110","HYDRALAZINE ","50MG","60.00","Select","Select",""],["","71093012005","GABAPENTIN ","100MG","30.00","Select","Select",""],["","42858075040","BUPRENORPHIN ","5MCG\/HR","4.00","Select","Select",""],["","65862001305","SERTRALINE ","100MG","30.00","Select","Select",""],["","00456122830","NAMZARIC ","28-10MG","30.00","Select","Select",""],["","67877019810","AMLODIPINE ","5MG","30.00","Select","Select",""],["","53746011005","HYDROCO\/APAP ","10-325MG","120.00","Select","Select",""],["","64764017130","DEXILANT ","30MG DR","30.00","Select","Select",""],["","59310057922","PROAIR ","","8.50","Select","Select",""],["","00173068220","VENTOLIN ","","18.00","Select","Select",""],["","16714069803","VALACYCLOVIR ","500MG","21.00","Select","Select",""],["","60432026415","FLUTICASONE ","50MCG","16.00","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":""}]}]}