{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"GAIL GREER","gend":1,"add":"382 HORTON ROAD","city":"JONESVILLE","state":"VA","zip":"24263-9998","dob":"1960-02-15","age":"","mstatus":"","insh":"11016949","cliId":"","pno":2765942034,"cno":"","email":"","ename":"","eno":"","pphy":"NEWBERRY, BRIAN S","ppno":2766798890,"pcpadd":"96 15th St NWSte 104","pcpcity":"Norton","pcpstate":"VA","pcpzip":242731625,"pcpcounty":"","pcpid":"","pcpname":"RESIDENCY CLINIC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"SOUTHWEST","aligned":"Y","ano":"","add2":"","add3":"","madd1":"382 HORTON ROAD","madd2":"","madd3":"","mcity":"JONESVILLE","mstate":"VA","mzip":"24263-9998","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":[["","72305010030","EUTHYROX ","100MCG","30.00","Select","Select",""],["","16729018201","HYDROCHLOROT ","12.5MG","30.00","Select","Select",""],["","00487020103","IPRATROPIUM\/ ","ALBUTER","90.00","Select","Select",""],["","68645058054","AMLODIPINE ","10MG","60.00","Select","Select",""],["","68645019059","METOPROL ","50MG","180.00","Select","Select",""],["","16714008311","HYDROXYZ ","50MG","30.00","Select","Select",""],["","00093505898","ATORVASTATIN ","40MG","90.00","Select","Select",""],["","68645051954","ESCITALOPRAM ","10MG","90.00","Select","Select",""],["","59746017210","PREDNISONE ","5MG","30.00","Select","Select",""],["","00487950125","ALBUTEROL ","0.08%","75.00","Select","Select",""],["","47781065190","LEVOTHYROXIN ","100MCG","90.00","Select","Select",""],["","55111018015","TIZANIDINE ","4MG","30.00","Select","Select",""],["","00173085910","BREO ","100-25","60.00","Select","Select",""],["","00186037020","SYMBICORT ","160-4.5","30.60","Select","Select",""],["","00005197102","PREVNAR ","","0.50","Select","Select",""],["","59310057922","PROAIR ","","25.50","Select","Select",""],["","68645055154","LISINOPRIL ","5MG","90.00","Select","Select",""],["","49281042150","FLUZONE ","2021-22","0.50","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":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"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":""}]}]}