{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DORIS SHELTON","gend":1,"add":"651 QUARRY ST","city":"BRISTOL","state":"VA","zip":"24201-9998","dob":"1954-05-29","age":"","mstatus":"","insh":"11016873","cliId":"","pno":4233835050,"cno":2764695664,"email":"","ename":"","eno":"","pphy":"HOLLAND, JOHN A","ppno":4346962165,"pcpadd":"1508 K V Rd","pcpcity":"Victoria","pcpstate":"VA","pcpzip":239742624,"pcpcounty":"","pcpid":"","pcpname":"GREATER PRINCE WILLIAM COMMUNITY HEALTH CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"SOUTHWEST","aligned":"Y","ano":"","add2":"","add3":"","madd1":"651 QUARRY ST","madd2":"","madd3":"","mcity":"BRISTOL","mstate":"VA","mzip":"24201-9998","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":[["","33342006310","VALSARTAN ","80MG","90.00","Select","Select",""],["","64380080707","IBUPROFEN ","800MG","180.00","Select","Select",""],["","12496120803","SUBOXONE ","8-2MG","56.00","Select","Select",""],["","00093078710","ATENOLOL ","25MG","90.00","Select","Select",""],["","67877043103","ARIPIPRAZOLE ","5MG","30.00","Select","Select",""],["","27241009803","DULOXETINE ","30MG","60.00","Select","Select",""],["","42806040021","METHYLPRED ","4MG","21.00","Select","Select",""],["","67877024901","QUETIAPINE ","50MG","180.00","Select","Select",""],["","68462010530","ONDANSETRON ","4MG","12.00","Select","Select",""],["","69097084805","ESCITALOPRAM ","10MG","30.00","Select","Select",""],["","13668001101","CITALOPRAM ","40MG","90.00","Select","Select",""],["","53489012002","DOXYCYCL ","100MG","20.00","Select","Select",""],["","00245036030","KLOR-CON ","20MEQ","15.00","Select","Select",""],["","00093317431","ALBUTEROL ","E","25.50","Select","Select",""],["","00054429731","FUROSEMIDE ","20MG","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":""}]}]}