{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CHERYL L MCDONALD","gend":1,"add":"33232 EVERGREEN DR","city":"NEW CHURCH","state":"VA","zip":"23415-9998","dob":"1951-07-09","age":"","mstatus":"","insh":"11012201","cliId":"","pno":7577092332,"cno":"","email":"","ename":"","eno":"","pphy":"HOSHINO, DAVID K","ppno":7578245676,"pcpadd":"8034 Lankford Hwy","pcpcity":"Oak Hall","pcpstate":"VA","pcpzip":234162148,"pcpcounty":"","pcpid":"","pcpname":"ATLANTIC COMMUNITY HEALTH CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"TIDEWATER","aligned":"Y","ano":"","add2":"","add3":"","madd1":"33232 EVERGREEN DR","madd2":"","madd3":"","mcity":"NEW CHURCH","mstate":"VA","mzip":"23415-9998","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":[["","49281072010","FLUBLOK ","2020-21","0.50","Select","Select",""],["","69097084507","CYCLOBENZAPR ","5MG","90.00","Select","Select",""],["","00193731221","CONTOUR ","NEXT","300.00","Select","Select",""],["","08484081028","PRODIGY ","28G","300.00","Select","Select",""],["","68645055254","LISINOPRIL ","10MG","90.00","Select","Select",""],["","16729044416","BUPROPN ","300MG XL","90.00","Select","Select",""],["","94030000204","EMBRACE ","THIN 30G","300.00","Select","Select",""],["","72205000530","ROSUVASTATIN ","40MG","90.00","Select","Select",""],["","61314012605","KETOROLAC ","0.50%","5.00","Select","Select",""],["","63304069301","CLINDAMYCIN ","300MG","30.00","Select","Select",""],["","50228018005","GABAPENTIN ","300MG","180.00","Select","Select",""],["","65702040810","ACCU-CHEK ","AVIVA PL","300.00","Select","Select",""],["","91237000128","ALCOHOL ","","300.00","Select","Select",""],["","60758061525","GATIFLOXACIN ","0.50%","2.50","Select","Select",""],["","98302014807","COMFORT ","33GX4MM","400.00","Select","Select",""],["","00093505798","ATORVASTATIN ","80MG","90.00","Select","Select",""],["","00169255013","TRESIBA ","200UNIT","54.00","Select","Select",""],["","68645057054","CITALOPRAM ","20MG","180.00","Select","Select",""],["","98302000160","ULTRA ","31G","300.00","Select","Select",""],["","78742026442","RELION ","THIN 30G","300.00","Select","Select",""],["","50484001030","SANTYL ","250\/GM","30.00","Select","Select",""],["","58160082311","SHINGRIX ","50\/0.5ML","1.00","Select","Select",""],["","42806031250","DOXYCYCL ","100MG","20.00","Select","Select",""],["","43547040211","FUROSEMIDE ","40MG","180.00","Select","Select",""],["","60758011905","PREDNISOLONE ","1% OP","10.00","Select","Select",""],["","55111014512","FLUCONAZOLE ","150MG","1.00","Select","Select",""],["","42806040021","METHYLPRED ","4MG","21.00","Select","Select",""],["","98302000100","SIMPLE ","LANCING","1.00","Select","Select",""],["","73070010315","INSULIN ","FLEXPEN","30.00","Select","Select",""],["","00002143480","TRULICITY ","1.5\/0.5","6.00","Select","Select",""],["","57599055201","CONTROL ","MID","1.00","Select","Select",""],["","50632000744","PEN  NEEDLES  ","33GX4MM","400.00","Select","Select",""],["","57599013901","PRECISION ","GLUC\/KET","1.00","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":""}]}]}