{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"YOUNG I SONG","gend":0,"add":"634 RIVER BEND COURT","city":"NEWPORT NEWS","state":"VA","zip":"23602-9998","dob":"1968-08-18","age":"","mstatus":"","insh":"11015832","cliId":"","pno":7578423002,"cno":"","email":"","ename":"","eno":"","pphy":"GEYER WESSLER, PATRICIA LEE","ppno":7575943800,"pcpadd":"10510 Jefferson Ave Ste A","pcpcity":"Newport News","pcpstate":"VA","pcpzip":236013102,"pcpcounty":"","pcpid":"","pcpname":"RIVERSIDE BRENTWOOD MEDICAL CENTER FAMILY MEDICINE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"TIDEWATER","aligned":"Y","ano":"","add2":"APT 203","add3":"","madd1":"634 RIVER BEND COURT","madd2":"APT 203","madd3":"","mcity":"NEWPORT NEWS","mstate":"VA","mzip":"23602-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["ASIAN\/PACIFIC"]],"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":[["","00406831501","MORPHINE ","15MG ER","60.00","Select","Select",""],["","42858000201","OXYCODONE ","10MG","60.00","Select","Select",""],["","59746017310","PREDNISONE ","10MG","30.00","Select","Select",""],["","68645014059","FAMOTIDINE ","20MG","60.00","Select","Select",""],["","68645056354","IBUPROFEN ","800MG","20.00","Select","Select",""],["","00591352530","LIDOCAINE ","5%","30.00","Select","Select",""],["","00143992801","CIPROFLOXACN ","500MG","20.00","Select","Select",""],["","00093005805","TRAMADOL ","50MG","60.00","Select","Select",""],["","65162083366","DICLOFENAC ","1%","400.00","Select","Select",""],["","00143314250","DOXYCYCL ","100MG","20.00","Select","Select",""],["","69097084507","CYCLOBENZAPR ","5MG","30.00","Select","Select",""],["","59762374301","CLINDAMYCIN ","1%","30.00","Select","Select",""],["","69315090401","LORAZEPAM ","0.5MG","30.00","Select","Select",""],["","58160082311","SHINGRIX ","50\/0.5ML","1.00","Select","Select",""],["","59746011506","PROCHLORPER ","10MG","90.00","Select","Select",""],["","70010075401","METHOCARBAM ","500MG","40.00","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":""}]}]}