{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ABDUL B CHOUDHRY","gend":0,"add":"4208 WHITFORD COURT","city":"GLEN ALLEN","state":"VA","zip":"23060-4145","dob":"1939-10-18","age":"","mstatus":"","insh":"11012590","cliId":"","pno":2027674058,"cno":8044999258,"email":"","ename":"","eno":"","pphy":"LIENG, THANHTRUC T","ppno":8043461780,"pcpadd":"2500 Pocoshock Pl Ste 104","pcpcity":"North Chesterfield","pcpstate":"VA","pcpzip":232356345,"pcpcounty":"","pcpid":"","pcpname":"VPI INNSBROOK PRIMARY CARE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"APARTMENT 1501","add3":"","madd1":"4208 WHITFORD COURT","madd2":"APARTMENT 1501","madd3":"","mcity":"GLEN ALLEN","mstate":"VA","mzip":"23060-4145","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":[["","55111032001","GLIMEPIRIDE ","1MG","180.00","Select","Select",""],["","00116200116","CHLORHEX ","0.12%","473.00","Select","Select",""],["","58160082311","SHINGRIX ","50\/0.5ML","1.00","Select","Select",""],["","70377000812","ROSUVASTATIN ","20MG","90.00","Select","Select",""],["","65702028810","FASTCLIX ","LANCETS","102.00","Select","Select",""],["","65862086001","FAMOTIDINE ","40MG","90.00","Select","Select",""],["","00003089421","ELIQUIS ","5MG","60.00","Select","Select",""],["","50742061510","METOPROL ","25MG ER","90.00","Select","Select",""],["","33342017910","OLMESA ","20MG","90.00","Select","Select",""],["","00406048410","APAP\/CODEINE ","300-30MG","16.00","Select","Select",""],["","00093310905","AMOXICILLIN ","500MG","21.00","Select","Select",""],["","57237016199","OMEPRAZOLE ","20MG","30.00","Select","Select",""],["","00378021610","FUROSEMIDE ","40MG","30.00","Select","Select",""],["","65702071110","ACCU-CHEK ","GUIDE","100.00","Select","Select",""],["","45802000403","HYDROCORT ","2.50%","28.00","Select","Select",""],["","65702073110","ACCU-CHECK ","GUIDE ME","1.00","Select","Select",""],["","65162083366","DICLOFENAC ","1%","500.00","Select","Select",""],["","60505036301","OFLOXACIN ","0.3%OTIC","5.00","Select","Select",""],["","00065853302","CIPRODEX ","0.3-0.1%","7.50","Select","Select",""],["","68382075810","METFORMIN ","500MG","60.00","Select","Select",""],["","59746000103","METHYLPRED ","4MG","21.00","Select","Select",""],["","65862050320","AMOX\/K ","875-125","20.00","Select","Select",""],["","49281012065","FLUZONE ","PF 20-21","0.70","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":""}]}]}