{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"PATRICIA M CHAMBERS","gend":1,"add":"1406 MASON STREET","city":"SOUTH BOSTON","state":"VA","zip":"24592-9998","dob":"1976-11-07","age":"","mstatus":"","insh":"11013898","cliId":"","pno":4342725397,"cno":4342729864,"email":"","ename":"","eno":"","pphy":"ABAITEY, DEBORAH","ppno":4345178022,"pcpadd":"101 Aubreys Loop Ste C","pcpcity":"South Boston","pcpstate":"VA","pcpzip":245925054,"pcpcounty":"","pcpid":"","pcpname":"SENTARA SOUTHSIDE ANESTHESIOLOGY ASSOCIATES","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"","add3":"","madd1":"1406 MASON STREET","madd2":"","madd3":"","mcity":"SOUTH BOSTON","mstate":"VA","mzip":"24592-9998","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":[["","00406012505","HYDROCO\/APAP ","10-325MG","120.00","Select","Select",""],["","29300043001","ZONISAMIDE ","100MG","360.00","Select","Select",""],["","65862020190","LOSARTAN ","25MG","90.00","Select","Select",""],["","65862085901","FAMOTIDINE ","20MG","90.00","Select","Select",""],["","51991074790","DULOXETINE ","30MG","30.00","Select","Select",""],["","69097015907","MELOXICAM ","15MG","30.00","Select","Select",""],["","68462029301","VERAPAMIL ","180MG ER","180.00","Select","Select",""],["","64764017530","DEXILANT ","60MG DR","30.00","Select","Select",""],["","33342008845","RIZATRIPTAN ","10MG","9.00","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":""}]}]}