{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"WILLIAM F TURNER","gend":0,"add":"3271 HONEYVILLE RD","city":"STANLEY","state":"VA","zip":"22851-9998","dob":"1958-05-24","age":"","mstatus":"","insh":"11014838","cliId":"","pno":5402440258,"cno":"","email":"","ename":"","eno":"","pphy":"TIMMONS, JOHN","ppno":5406529100,"pcpadd":"505 Williams Ave","pcpcity":"Shenandoah","pcpstate":"VA","pcpzip":228491263,"pcpcounty":"","pcpid":"","pcpname":"PAGE SHENANDOAH HEALTH CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"NORTHERN & WINCHESTER","aligned":"Y","ano":"","add2":"","add3":"","madd1":"3271 HONEYVILLE RD","madd2":"","madd3":"","mcity":"STANLEY","mstate":"VA","mzip":"22851-9998","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":[["","65862035790","CLOPIDOGREL ","75MG","90.00","Select","Select",""],["","16729020001","BUSPIRONE ","5MG","60.00","Select","Select",""],["","68180098003","LISINOPRIL ","10MG","90.00","Select","Select",""],["","65862024608","LEVETIRACETA ","500MG","180.00","Select","Select",""],["","00093005805","TRAMADOL ","50MG","120.00","Select","Select",""],["","68180016011","AZITHROMYCIN ","250MG","6.00","Select","Select",""],["","13668013701","ESCITALOPRAM ","20MG","90.00","Select","Select",""],["","70377003012","ATORVASTATIN ","80MG","90.00","Select","Select",""],["","49884012301","LABETALOL ","200MG","180.00","Select","Select",""],["","68462010630","ONDANSETRON ","8MG","30.00","Select","Select",""],["","00093317431","ALBUTEROL ","E","8.50","Select","Select",""],["","68180072103","AMLODIPINE ","10MG","90.00","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":""}]}]}