{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"GRACIE FAKONDO","gend":1,"add":"210 ALPINE DR, SE","city":"LEESBURG","state":"VA","zip":"20175-9998","dob":"1936-09-19","age":"","mstatus":"","insh":"11017187","cliId":"","pno":3015320693,"cno":7035953170,"email":"","ename":"","eno":"","pphy":"AGGARWAL, RAJIV K","ppno":5712233833,"pcpadd":"19415 Deerfield Ave Ste 103","pcpcity":"Lansdowne","pcpstate":"VA","pcpzip":201768470,"pcpcounty":"","pcpid":"","pcpname":"LANSDOWNE TRAVEL AND FAMILY MEDICINE LLC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"NORTHERN & WINCHESTER","aligned":"Y","ano":"","add2":"","add3":"","madd1":"210 ALPINE DR, SE","madd2":"","madd3":"","mcity":"LEESBURG","mstate":"VA","mzip":"20175-9998","pcpfaxno":"(571) 223-3834","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":[["","67877019705","AMLODIPINE ","2.5MG","90.00","Select","Select",""],["","29300017116","MEMANTINE ","HCL 5MG","180.00","Select","Select",""],["","68645058359","METFORMIN ","850MG","90.00","Select","Select",""],["","00597002402","COMBIVENT ","20-100","4.00","Select","Select",""],["","59746017509","PREDNISONE ","20MG","12.00","Select","Select",""],["","68180029706","DULOXETINE ","40MG","180.00","Select","Select",""],["","50111078810","AZITHROMYCIN ","500MG","7.00","Select","Select",""],["","29300012613","BISOPROL ","5MG","15.00","Select","Select",""],["","68180044501","QUETIAPINE ","25MG","90.00","Select","Select",""],["","00487980125","IPRATROPIUM ","0.02%INH","187.50","Select","Select",""],["","31722070290","LOSARTAN ","100MG","90.00","Select","Select",""],["","00173085910","BREO ","100-25","180.00","Select","Select",""],["","13668008190","MONTELUKAST ","10MG","30.00","Select","Select",""],["","42806040021","METHYLPRED ","4MG","21.00","Select","Select",""],["","68180096301","ALBUTEROL ","HFA","8.50","Select","Select",""],["","00093100301","BUSPIRONE ","15MG","30.00","Select","Select",""],["","00173087410","ARNUITY ","100MCG","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":""}]}]}