{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MARY F ORANGE","gend":1,"add":"1382 BUFFALO RUN","city":"THAXTON","state":"VA","zip":"24174-9998","dob":"1973-12-16","age":"","mstatus":"","insh":"11010450","cliId":"","pno":5404922960,"cno":"","email":"","ename":"","eno":"","pphy":"COHEN, LEONARD J","ppno":5405866818,"pcpadd":"1615 Oakwood St","pcpcity":"BEDFORD","pcpstate":"VA","pcpzip":245231249,"pcpcounty":"","pcpid":"","pcpname":"CMG VILLAGE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"","add3":"","madd1":"1382 BUFFALO RUN","madd2":"","madd3":"","mcity":"THAXTON","mstate":"VA","mzip":"24174-9998","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":[["","70377000315","SIMVASTATIN ","20MG","90.00","Select","Select",""],["","00228202950","ALPRAZOLAM ","0.5MG","30.00","Select","Select",""],["","69097083412","SERTRALINE ","50MG","30.00","Select","Select",""],["","00115165903","PROPRANOLOL ","10MG","180.00","Select","Select",""],["","14539067501","HYDROXYZ ","50MG","90.00","Select","Select",""],["","51991074890","DULOXETINE ","60MG","60.00","Select","Select",""],["","50111056101","TRAZODONE ","100MG","60.00","Select","Select",""],["","51991029401","OXCARBAZEPIN ","600MG","270.00","Select","Select",""],["","43547034206","RISPERIDONE ","2MG","30.00","Select","Select",""],["","63304069301","CLINDAMYCIN ","300MG","40.00","Select","Select",""],["","65862039010","ONDANSETRON ","4MG ODT","10.00","Select","Select",""],["","16729020201","BUSPIRONE ","10MG","60.00","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":""}]}]}