{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"VIRGINIA L EDWARDS","gend":1,"add":"1400 ST JAMES STREET","city":"RICHMOND","state":"VA","zip":"23220-2537","dob":"1955-04-23","age":"","mstatus":"","insh":"11014256","cliId":"","pno":8043854950,"cno":"","email":"","ename":"","eno":"","pphy":"LATHAM-SOLOMON, VICKI","ppno":8043258801,"pcpadd":"6439 Iron Bridge Rd","pcpcity":"North Chesterfield","pcpstate":"VA","pcpzip":232345205,"pcpcounty":"","pcpid":"","pcpname":"BON SECOURS CANAL CROSSING INTERNAL MEDICINE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"APARTMENT D","add3":"","madd1":"1400 ST JAMES STREET","madd2":"APARTMENT D","madd3":"","mcity":"RICHMOND","mstate":"VA","mzip":"23220-2537","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":[["","16729017301","AMITRIPTYLIN ","50MG","90.00","Select","Select",""],["","31722070190","LOSARTAN ","50MG","90.00","Select","Select",""],["","16729003510","ANASTROZOLE ","1MG","90.00","Select","Select",""],["","50742061701","METOPROL ","100MG ER","180.00","Select","Select",""],["","52268020101","SUTAB ","","24.00","Select","Select",""],["","68180063509","ATORVASTATIN ","10MG","90.00","Select","Select",""],["","50228018001","GABAPENTIN ","300MG","60.00","Select","Select",""],["","65162062710","TRAMADOL ","50MG","28.00","Select","Select",""],["","00781286810","OMEPRAZOLE ","20MG","90.00","Select","Select",""],["","58160082311","SHINGRIX ","50\/0.5ML","1.00","Select","Select",""],["","00116200116","CHLORHEX ","0.12%","473.00","Select","Select",""],["","00005197102","PREVNAR ","","0.50","Select","Select",""],["","31722099601","HYDROCO\/APAP ","5-325MG","20.00","Select","Select",""],["","67877032105","IBUPROFEN ","800MG","21.00","Select","Select",""],["","58160084252","BOOSTRIX ","","0.50","Select","Select",""],["","00093310953","AMOXICILLIN ","500MG","15.00","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":""}]}]}