{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DIANNA M KYLE","gend":1,"add":"1 TUPELO CIR","city":"HAMPTON","state":"VA","zip":"23666-9998","dob":"1943-09-28","age":"","mstatus":"","insh":"11016546","cliId":"","pno":7578131087,"cno":7578700712,"email":"","ename":"","eno":"","pphy":"PANCHAL, CHAITALI MAULIK","ppno":7575944431,"pcpadd":"12420 Warwick Blvd Ste 4A","pcpcity":"Newport News","pcpstate":"VA","pcpzip":236063053,"pcpcounty":"","pcpid":"","pcpname":"RIVERSIDE PRIMARY CARE HIDENWOOD","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"TIDEWATER","aligned":"Y","ano":"","add2":"","add3":"","madd1":"1 TUPELO CIR","madd2":"","madd3":"","mcity":"HAMPTON","mstate":"VA","mzip":"23666-9998","pcpfaxno":"(757) 594-2936","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":[["","68180035109","SERTRALINE ","25MG","30.00","Select","Select",""],["","69238131309","PREGABALIN ","100MG","90.00","Select","Select",""],["","29300039805","AMLODIPINE ","10MG","90.00","Select","Select",""],["","68382005101","MELOXICAM ","15MG","30.00","Select","Select",""],["","68546032512","COPAXONE ","40MG\/ML","12.00","Select","Select",""],["","31722070290","LOSARTAN ","100MG","90.00","Select","Select",""],["","16714063301","ALENDRONATE ","70MG","4.00","Select","Select",""],["","60505258009","ATORVASTATIN ","40MG","90.00","Select","Select",""],["","59746021106","CYCLOBENZAPR ","5MG","30.00","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":""}]}]}