{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BHALCHANDRA G TIKEKAR","gend":0,"add":"2503 BRANDERMILL PL","city":"CHARLOTTESVILLE","state":"VA","zip":"22911-8255","dob":"1930-05-27","age":"","mstatus":"","insh":"11010723","cliId":"","pno":4349738867,"cno":"","email":"","ename":"","eno":"","pphy":"CAVANAUGH, BRITTANY P","ppno":5406613004,"pcpadd":"661 UNIVERSITY LN","pcpcity":"ORANGE","pcpstate":"VA","pcpzip":229602243,"pcpcounty":"","pcpid":"","pcpname":"UVA PRIMARY CARE RIVERSIDE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"","add3":"","madd1":"2503 BRANDERMILL PL","madd2":"","madd3":"","mcity":"CHARLOTTESVILLE","mstate":"VA","mzip":"22911-8255","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["ASIAN\/PACIFIC"]],"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":[["","50458057930","XARELTO ","20MG","90.00","Select","Select",""],["","68180012101","CEPHALEXIN ","250MG","21.00","Select","Select",""],["","43547040111","FUROSEMIDE ","20MG","90.00","Select","Select",""],["","00168020437","LIDOCAINE ","5%","35.44","Select","Select",""],["","50111043301","TRAZODONE ","50MG","90.00","Select","Select",""],["","49281012165","FLUZONE ","2021-22","0.70","Select","Select",""],["","69315090501","LORAZEPAM ","1MG","180.00","Select","Select",""],["","69315031228","PROCTO-MED ","HC 2.5%","28.00","Select","Select",""],["","68645014059","FAMOTIDINE ","20MG","120.00","Select","Select",""],["","29300022019","MONTELUKAST ","10MG","90.00","Select","Select",""],["","67877019705","AMLODIPINE ","2.5MG","90.00","Select","Select",""],["","65162027250","SMZ\/TMP ","800-160","60.00","Select","Select",""],["","45802005505","TRIAMCINOLON ","0.10%","454.00","Select","Select",""],["","68382032010","POT  CHLORIDE","10MEQ ER","90.00","Select","Select",""],["","42571012290","LEVOCETIRIZI ","5MG","90.00","Select","Select",""],["","16714085302","METOPROL ","50MG ER","180.00","Select","Select",""],["","00093720210","PRAVASTATIN ","40MG","90.00","Select","Select",""],["","42571016142","AMOX\/K ","500-125","20.00","Select","Select",""],["","42806031250","DOXYCYCL ","100MG","60.00","Select","Select",""],["","55111015330","ONDANSETRON ","4MG","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":""}]}]}