{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CHRISTOPHER FRENCH","gend":0,"add":"206 NORTH SHORE CIRCLE","city":"NORTH","state":"VA","zip":"23128-2055","dob":"1966-02-12","age":"","mstatus":"","insh":"11013784","cliId":"","pno":8043843291,"cno":"","email":"","ename":"","eno":"","pphy":"DAIT, MARIANNE T","ppno":8046426171,"pcpadd":"856 J Clyde Morris Blvd Ste A","pcpcity":"Newport News","pcpstate":"VA","pcpzip":236011318,"pcpcounty":"","pcpid":"","pcpname":"RIVERSIDE HAYES MEDICAL CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"206 NORTH SHORE CIRCLE","madd2":"","madd3":"","mcity":"NORTH","mstate":"VA","mzip":"23128-2055","pcpfaxno":"(804) 642-5656","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":[["","43547034106","RISPERIDONE ","1MG","90.00","Select","Select",""],["","70954002110","PRAZOSIN ","5MG","30.00","Select","Select",""],["","68001041508","DULOXETINE ","60MG","60.00","Select","Select",""],["","43975028010","AMPHET\/DEXTR ","20MG ER","30.00","Select","Select",""],["","69097084615","CYCLOBENZAPR ","10MG","30.00","Select","Select",""],["","00024586903","TOUJEO ","300IU\/ML","4.50","Select","Select",""],["","08470353001","UNIFINE ","31GX8MM","100.00","Select","Select",""],["","16729013616","CLONAZEPAM ","0.5MG","90.00","Select","Select",""],["","65162019050","NAPROXEN ","500MG","20.00","Select","Select",""],["","00603243832","BENZTROPINE ","1MG","60.00","Select","Select",""],["","86227012155","SURE ","31GX5\/16","100.00","Select","Select",""],["","53746010901","HYDROCO\/APAP ","5-325MG","10.00","Select","Select",""],["","68180098003","LISINOPRIL ","10MG","90.00","Select","Select",""],["","72205000399","ROSUVASTATIN ","10MG","30.00","Select","Select",""],["","51991029301","OXCARBAZEPIN ","300MG","180.00","Select","Select",""],["","59746000103","METHYLPRED ","4MG","21.00","Select","Select",""],["","68462026830","ATOMOXETINE ","40MG","30.00","Select","Select",""],["","00555032402","HYDROXYZ ","100MG","30.00","Select","Select",""],["","65162027210","SMZ\/TMP ","800-160","14.00","Select","Select",""],["","00088222033","LANTUS ","100\/ML","10.00","Select","Select",""],["","67877022205","GABAPENTIN ","100MG","60.00","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":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","",""],[""],[""],[""],[""]],"comment":[["","",""],[""],[""],[""],[""]],"sub":[]}}},{"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":""}]}]}