{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CONNIE A JONES","gend":1,"add":"126 STRATFORD PLACE","city":"MADISON HEIGHTS","state":"VA","zip":"24572-9998","dob":"1968-10-26","age":"","mstatus":"","insh":"11017002","cliId":"","pno":4345441498,"cno":"","email":"","ename":"","eno":"","pphy":"KADREE, MARGARET A","ppno":4349475967,"pcpadd":"320 Federal St","pcpcity":"Lynchburg","pcpstate":"VA","pcpzip":245042306,"pcpcounty":"","pcpid":"","pcpname":"JOHNSON HEALTH CENTER INTEGRATED SERVICES","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"","add3":"","madd1":"1185 GEBBES MOUNTAIN ROAD","madd2":"","madd3":"","mcity":"AMHERST","mstate":"VA","mzip":"24521-3224","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":[["","31722070210","LOSARTAN ","100MG","90.00","Select","Select",""],["","21922000909","DICLOFENAC ","1%","100.00","Select","Select",""],["","13668042990","PANTOPRAZOLE ","40MG","90.00","Select","Select",""],["","51224012230","AZITHROMYCIN ","500MG","3.00","Select","Select",""],["","43547040111","FUROSEMIDE ","20MG","90.00","Select","Select",""],["","00003089421","ELIQUIS ","5MG","60.00","Select","Select",""],["","53489014310","SPIRONOLACT ","25MG","30.00","Select","Select",""],["","00093317431","ALBUTEROL ","E","8.50","Select","Select",""],["","59746017509","PREDNISONE ","20MG","7.00","Select","Select",""],["","65862006299","METOPROL ","25MG","180.00","Select","Select",""],["","69097012815","AMLODIPINE ","10MG","180.00","Select","Select",""],["","65862085901","FAMOTIDINE ","20MG","180.00","Select","Select",""],["","00487020103","IPRATROPIUM\/ ","ALBUTER","360.00","Select","Select",""],["","68382077305","EZETIMIBE ","10MG","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":["",""],"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":""}]}]}