{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JESSICA A DESSER","gend":1,"add":"301 N CAMERON STREET","city":"WINCHESTER","state":"VA","zip":"22601-6018","dob":"1982-07-21","age":"","mstatus":"","insh":"11016729","cliId":"","pno":5408775213,"cno":"","email":"","ename":"","eno":"","pphy":"QAZI, LINA N","ppno":5406678724,"pcpadd":"1867 AMHERST ST","pcpcity":"WINCHESTER","pcpstate":"VA","pcpzip":226012801,"pcpcounty":"","pcpid":"","pcpname":"AMHERST FAMILY PRACTICE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"NORTHERN & WINCHESTER","aligned":"Y","ano":"","add2":"SUITE 103","add3":"","madd1":"301 N CAMERON STREET","madd2":"SUITE 103","madd3":"","mcity":"WINCHESTER","mstate":"VA","mzip":"22601-6018","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":[["","16729028010","ARIPIPRAZOLE ","10MG","90.00","Select","Select",""],["","00115166003","PROPRANOLOL ","20MG","180.00","Select","Select",""],["","51672128902","NYSTATIN ","100000","30.00","Select","Select",""],["","00378181377","LEVOTHYROXIN ","125MCG","90.00","Select","Select",""],["","69097083512","SERTRALINE ","100MG","180.00","Select","Select",""],["","59651036205","IBUPROFEN ","800MG","28.00","Select","Select",""],["","68180016013","AZITHROMYCIN ","250MG","6.00","Select","Select",""],["","00172392770","DIAZEPAM ","10MG","2.00","Select","Select",""],["","65862042005","SMZ\/TMP ","800-160","20.00","Select","Select",""],["","00093101042","MUPIROCIN ","2%","22.00","Select","Select",""],["","45802006336","TRIAMCINOLON ","0.03%","80.00","Select","Select",""],["","13107005999","APAP\/CODEINE ","300-30MG","10.00","Select","Select",""],["","00093321915","KETOCONAZOLE ","2%","30.00","Select","Select",""],["","70710113908","FLUCONAZOLE ","150MG","1.00","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":""}]}]}