{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"VALORIE E THOMAS","gend":1,"add":"4800 BAILEY RIDGE LANE, APT. 4","city":"PRINCE GEORGE","state":"VA","zip":"23875-9998","dob":"1963-12-19","age":"","mstatus":"","insh":"11012163","cliId":"","pno":8047909959,"cno":8045168648,"email":"","ename":"","eno":"","pphy":"BOHANNON, ARLINE","ppno":8048289357,"pcpadd":"1250 E Marshall St","pcpcity":"Richmond","pcpstate":"VA","pcpzip":232985023,"pcpcounty":"","pcpid":"","pcpname":"VCUHS LUCY CORR VILLAGE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"4800 BAILEY RIDGE LANE, APT. 4","madd2":"","madd3":"","mcity":"PRINCE GEORGE","mstate":"VA","mzip":"23875-9998","pcpfaxno":"(804) 828-5466","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":[["","00093031105","LOPERAMIDE ","2MG","60.00","Select","Select",""],["","62175061743","PANTOPRAZOLE ","40MG","30.00","Select","Select",""],["","00603533815","PREDNISONE ","10MG","21.00","Select","Select",""],["","00093506110","HYDROXYZ ","25MG","20.00","Select","Select",""],["","65162062711","TRAMADOL ","50MG","60.00","Select","Select",""],["","08290320122","BD  PEN NEEDL","32GX4MM","30.00","Select","Select",""],["","50228018005","GABAPENTIN ","300MG","12.00","Select","Select",""],["","57664047758","METOPROL ","50MG","60.00","Select","Select",""],["","24979002802","DILTIAZEM ","240MG ER","30.00","Select","Select",""],["","68001016100","PROMETHAZINE ","12.5MG","30.00","Select","Select",""],["","00121057616","METOCLOPRAM ","10\/10ML","300.00","Select","Select",""],["","00088221905","LANTUS ","100\/ML","15.00","Select","Select",""],["","00832046560","NYAMYC ","100000","60.00","Select","Select",""],["","68180096301","ALBUTEROL ","HFA","8.50","Select","Select",""],["","59310057922","PROAIR ","","8.50","Select","Select",""],["","53885044801","ONETOUCH ","ULTRA 2","1.00","Select","Select",""],["","16729011917","MONTELUKAST ","10MG","30.00","Select","Select",""],["","43598043611","NITROGLYCERN ","0.4MG","25.00","Select","Select",""],["","60505082901","FLUTICASONE ","50MCG","16.00","Select","Select",""],["","69315011801","FUROSEMIDE ","80MG","90.00","Select","Select",""],["","00185005501","METOLAZONE ","5MG","30.00","Select","Select",""],["","00173088210","BREO ","200-25","60.00","Select","Select",""],["","73070010315","INSULIN ","FLEXPEN","15.00","Select","Select",""],["","65862020299","LOSARTAN ","50MG","30.00","Select","Select",""],["","65862035705","CLOPIDOGREL ","75MG","30.00","Select","Select",""],["","00955105027","SEVELAMER ","800MG","180.00","Select","Select",""],["","72217000606","PEN  NEEDLES  ","32GX5\/32","100.00","Select","Select",""],["","00781214501","AMPICILLIN ","500MG","21.00","Select","Select",""],["","00591352511","LIDOCAINE ","5%","60.00","Select","Select",""],["","08222720031","GNP ","32GX5\/32","100.00","Select","Select",""],["","00093314705","CEPHALEXIN ","500MG","12.00","Select","Select",""],["","16729017117","AMITRIPTYLIN ","10MG","30.00","Select","Select",""],["","50484001030","SANTYL ","250\/GM","30.00","Select","Select",""],["","45802016000","DICLOFENAC ","1%","100.00","Select","Select",""],["","42571016242","AMOX\/K ","875-125","14.00","Select","Select",""],["","59762040105","SUCRALFATE ","1GM","30.00","Select","Select",""],["","68462018022","MUPIROCIN ","2%","22.00","Select","Select",""],["","60505257908","ATORVASTATIN ","20MG","30.00","Select","Select",""],["","00406055201","OXYCODONE ","5MG","60.00","Select","Select",""],["","08290326895","BD ","SNGL USE","100.00","Select","Select",""],["","68001024617","ONDANSETRON ","4MG ODT","12.00","Select","Select",""],["","00574200815","NYSTOP ","100000","60.00","Select","Select",""],["","00527122106","MEMANTINE ","HCL 5MG","60.00","Select","Select",""],["","51672129802","KETOCONAZOLE ","2%","60.00","Select","Select",""],["","00781261305","AMOXICILLIN ","500MG","21.00","Select","Select",""],["","49230064551","VELPHORO ","500MG","150.00","Select","Select",""],["","00024592505","ADMELOG ","100U\/ML","15.00","Select","Select",""],["","57237000511","FLUCONAZOLE ","150MG","1.00","Select","Select",""],["","56151014401","TRUPLUS ","30G","100.00","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":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"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":""}]}]}