{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ALLEN M PHILLIPPI","gend":0,"add":"220 SQUIRREL RD","city":"GRETNA","state":"VA","zip":"24557-9998","dob":"1989-08-25","age":"","mstatus":"","insh":"11010829","cliId":"","pno":4342518437,"cno":"","email":"","ename":"","eno":"","pphy":"WINFIELD II, ALBERT C","ppno":4347930700,"pcpadd":"441 Piney Forest Rd Ste E","pcpcity":"DANVILLE","pcpstate":"VA","pcpzip":245404154,"pcpcounty":"","pcpid":"","pcpname":"HEALING TOUCH THERAPY INC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"","add3":"","madd1":"220 SQUIRREL RD","madd2":"","madd3":"","mcity":"GRETNA","mstate":"VA","mzip":"24557-9998","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":[["","47335032683","NALTREXONE ","50MG","15.00","Select","Select",""],["","16729044416","BUPROPN ","300MG XL","30.00","Select","Select",""],["","00115165901","PROPRANOLOL ","10MG","62.00","Select","Select",""],["","00093317431","ALBUTEROL ","E","8.50","Select","Select",""],["","13668022090","ARIPIPRAZOLE ","20MG","31.00","Select","Select",""],["","16729020216","BUSPIRONE ","10MG","124.00","Select","Select",""],["","60505006501","OMEPRAZOLE ","20MG","62.00","Select","Select",""],["","69315013601","BENZTROPINE ","0.5MG","31.00","Select","Select",""],["","69097091707","BUPROPION ","75MG","30.00","Select","Select",""],["","69097012715","AMLODIPINE ","5MG","30.00","Select","Select",""],["","00781261305","AMOXICILLIN ","500MG","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":""}]}]}