{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ELENA D DAULTON","gend":1,"add":"152 LONG MEADOWS LANE","city":"MIDDLETOWN","state":"VA","zip":"22645-1914","dob":"1997-04-06","age":"","mstatus":"","insh":"11010822","cliId":"","pno":7575131819,"cno":"","email":"","ename":"","eno":"","pphy":"GRANT, JOEL T","ppno":5408684100,"pcpadd":"160 Warrior Dr","pcpcity":"Stephens City","pcpstate":"VA","pcpzip":226554044,"pcpcounty":"","pcpid":"","pcpname":"STEPHENS CITY FAMILY MEDICINE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"NORTHERN & WINCHESTER","aligned":"Y","ano":"","add2":"","add3":"","madd1":"152 LONG MEADOWS LANE","madd2":"","madd3":"","mcity":"MIDDLETOWN","mstate":"VA","mzip":"22645-1914","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":[["","65162071110","GUANFACINE ","1MG","30.00","Select","Select",""],["","68645052254","SERTRALINE ","50MG","30.00","Select","Select",""],["","59746017509","PREDNISONE ","20MG","20.00","Select","Select",""],["","62332002231","FLUOXETINE ","10MG","30.00","Select","Select",""],["","47781066590","LEVOTHYROXIN ","175MCG","90.00","Select","Select",""],["","62756018488","OXCARBAZEPIN ","300MG","45.00","Select","Select",""],["","00472024260","PERMETHRIN ","5%","60.00","Select","Select",""],["","65862044930","VALACYCLOVIR ","1GM","14.00","Select","Select",""],["","65862019899","GABAPENTIN ","100MG","90.00","Select","Select",""],["","65162027250","SMZ\/TMP ","800-160","10.00","Select","Select",""],["","72305017530","EUTHYROX ","175MCG","90.00","Select","Select",""],["","29300011101","LAMOTRIGINE ","25MG","180.00","Select","Select",""],["","68462029855","CLOTRIM\/BETA ","DIPROP","45.00","Select","Select",""],["","00172392670","DIAZEPAM ","5MG","2.00","Select","Select",""],["","67877021905","CEPHALEXIN ","500MG","40.00","Select","Select",""],["","42799080601","IVERMECTIN ","3MG","12.00","Select","Select",""],["","00487030101","ALBUTEROL ","0.63MG\/3","90.00","Select","Select",""],["","00781268701","DEXMETHYLPH ","30MG ER","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":""}]}]}