{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DEBRA   J SAHR","gend":1,"add":"541 GILES DR","city":"CHESAPEAKE","state":"VA","zip":"23322-9998","dob":"1963-11-08","age":57,"mstatus":"","insh":"900045878*01","cliId":"9UU3CE3NQ96","pno":"757\/560-0045","cno":"757\/560-0045","email":"","ename":"","eno":"","pphy":"BACKENS, MATTHEW V MD","ppno":"757\/499-5550","pcpadd":"351 EDWIN DRIVE SUITE 102","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":23462,"pcpcounty":"","pcpid":126202,"pcpname":"HOLLAND ROAD FAMILY MEDICINE","plan":"OHP","program":"MEDICARE","lob":"DSNP","region":"TIDEWATER","aligned":"Y","ano":7572666899,"add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/473-0919","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":{"indx":["","","",""],"comment":["","","",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["T81.31XA","S31.109A","Z11.52","I10.","Z20.822","G89.29","M54.16","M47.812","R10.9","M54.5","M65.9","M25.532","R60.9","M79.7","Z87.39","M79.645","M19.019","M65.842","M79.89","I25.2","F17.210","E78.5","E11.9","J44.9","Z79.4","Z79.82","Z79.899","Z79.51","Z88.8","Z88.6","Z88.5","M62.838","Z79.891","M54.9","E11.65","L08.9","I25.10","I73.9","M79.604","I20.8","M79.605","S31.109D","Z12.11","L98.499","Z00.01","E11.21","F31.9","Z68.30","R07.9","R06.02","I25.118","R07.2","R06.00","E78.2","I50.32","R05."],"date":["2021-11-10","2021-11-10","2021-02-04","2021-09-21","2021-02-04","2021-06-08","2021-06-08","2021-05-03","2021-04-01","2021-02-05","2021-04-27","2021-04-27","2021-04-27","2021-04-27","2021-04-27","2021-04-27","2021-05-03","2021-04-27","2021-04-27","2021-11-23","2021-04-27","2021-04-27","2021-09-21","2021-11-02","2021-09-21","2021-04-27","2021-04-27","2021-04-27","2021-04-27","2021-04-27","2021-04-27","2021-06-08","2021-06-08","2021-04-27","2021-10-28","2021-10-28","2021-11-23","2021-11-23","2021-05-26","2021-05-26","2021-05-26","2021-10-28","2021-05-23","2021-10-28","2021-10-28","2021-10-28","2021-10-28","2021-10-28","2021-11-02","2021-11-02","2021-11-23","2021-09-21","2021-11-02","2021-09-21","2021-11-23","2021-08-17"],"priorHcc":[null,null,"",null,"","","","","","","","","","","","","","","",null,"","",null,null,null,"","","","","","","","","",null,null,null,null,"","","",null,"",null,null,null,null,null,null,null,null,null,null,null,null,null]}},{"a":[]}]},{"t":"Covid Screening","q":[{"a":[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}]}]},{"t":"Self-Assessment and Social History","q":[{"a":{"indx":["","","","",""],"comment":["","","","",""],"sub":[]}},{"a":{"indx":["","","",""],"comment":["","","",""],"sub":[]}},{"a":{"indx":["","","",""],"comment":["","","",""],"sub":[]}},{"a":{"indx":["","","",""],"comment":["","","",""],"sub":[]}},{"a":{"indx":["","","",""],"comment":["","","",""],"sub":[]}},{"a":{"indx":["","","",""],"comment":["","","",""],"sub":[]}},{"a":{"indx":["","","","","",""],"comment":["","","","","",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["","","","","","",""],"comment":["","","","","","",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["","",""],"comment":["","",""],"score":[0,0,0,0]}},{"a":{"index":-1,"commentTxt":"","arr":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}}]},{"t":"Activities of Daily Living","q":[{"a":[{"indx":["","",""],"comment":["","",""],"sub":[]},{"indx":["","",""],"comment":["","",""],"sub":[]},{"indx":["","",""],"comment":["","",""],"sub":[]},{"indx":["","",""],"comment":["","",""],"sub":[]},{"indx":["","",""],"comment":["","",""],"sub":[]},{"indx":["","",""],"comment":["","",""],"sub":[]},{"indx":["","",""],"comment":["","",""],"sub":[]},{"indx":["","",""],"comment":["","",""],"sub":[]}]}]},{"t":"Medical History","q":[{"a":{"indx":[],"comment":[],"sub":{"indx":["","","","","","","",""],"comment":[""],"sub":[]}}},{"index":-1,"comment":"","sub":[]},{"a":[{"indx":["","","","","",""],"comment":["","","","","",""],"sub":[]},{"indx":["","","","","",""],"comment":["","","","","",""],"sub":[]},{"indx":["","","","","",""],"comment":["","","","","",""],"sub":[]},{"indx":["","","","","",""],"comment":["","","","","",""],"sub":[]},{"indx":["","","","","",""],"comment":["","","","","",""],"sub":[]}]},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}]},{"a":[{"indx":["","",""],"comment":["","",""],"sub":[]},{"indx":["","",""],"comment":["","",""],"sub":[]},{"indx":["","",""],"comment":["","",""],"sub":[]},{"indx":["","",""],"comment":["","",""],"sub":[]},{"indx":["","",""],"comment":["","",""],"sub":[]},{"indx":["","",""],"comment":["","",""],"sub":[]}]}]},{"t":"Family History","q":[{"index":-1,"comment":"","sub":[]}]},{"t":"Preventive Care","q":[{"arr":[]},{"a":{"indx":["","","","",""],"comment":["","","","",""],"sub":[]}},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}}]},{"t":"Allergies \/ Medications","q":[{"a":{"index":-1,"commentTxt":"","arr":[]}},{"a":{"comment":"","sub":[["","65862016001","ZOLPIDEM","TAB 10MG","30","Select","Select",""],["","591024105","LORAZEPAM","TAB 1MG","60","Select","Select",""],["","68180051703","LISINOPRIL","TAB 40MG","30","Select","Select",""],["","169266211","TRESIBA","INJ 100UNIT","20","Select","Select",""],["","378932232","WIXELA INHUB","AER 500\/50","180","Select","Select",""],["","10702005601","OXYCODONE","TAB 10MG","180","Select","Select",""],["","68382014114","TOPIRAMATE","TAB 200MG","10","Select","Select",""],["","27241009903","DULOXETINE","CAP 60MG","60","Select","Select",""],["","53885027150","ONETOUCH","TES VERIO","150","Select","Select",""],["","781569031","EZETIMIBE","TAB 10MG","30","Select","Select",""],["","63304072090","DILTIAZEM","CAP 240MG ER","90","Select","Select",""],["","713072737","MOMETASONE","OIN 0.001","45","Select","Select",""],["","555097402","AMPHET\/DEXTR","TAB 30MG","90","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","68382050010","OMEPRAZOLE","CAP 40MG","180","Select","Select",""],["","68462012605","GABAPENTIN","TAB 600MG","135","Select","Select",""],["","55111012405","ATORVASTATIN","TAB 80MG","9","Select","Select",""],["","53885000810","ONETOUCH DEL","MIS PLUS 33G","300","Select","Select",""],["","591024105","LORAZEPAM ","","-60","Select","Select",""],["","169266211","TRESIBA ","","20","Select","Select",""],["","555097402","AMPHETAMINE\/DEXTROAMPHETAMINE","","90","Select","Select",""],["","53885000810","ONETOUCH DELICA PLUS LANCETS EXTRA FINE 33G ","","300","Select","Select",""],["","713072737","MOMETASONE FUROATE ","","135","Select","Select",""],["","27241009903","DULOXETINE HYDROCHLORIDE","","60","Select","Select",""],["","10702005601","OXYCODONE HYDROCHLORIDE","","180","Select","Select",""],["","53885027150","ONETOUCH VERIO TEST STRIPS","","150","Select","Select",""],["","13668000801","ZOLPIDEM TARTRATE","","30","Select","Select",""],["","68682099798","DILTIAZEM HYDROCHLORIDE ER","","90","Select","Select",""],["","781569031","EZETIMIBE ","","30","Select","Select",""],["","66993001968","ALBUTEROL SULFATE HFA","","18","Select","Select",""],["","55111012405","ATORVASTATIN CALCIUM ","","9","Select","Select",""],["","73070010315","INSULIN ASPART FLEXPEN","","9","Select","Select",""],["","8290320109","BD PEN NEEDLE\/SHORT\/ULTRA-FINE\/31G X 8MM","","300","Select","Select",""],["","169266015","TRESIBA FLEXTOUCH","","-24","Select","Select",""],["","8290320550","BD PEN NEEDLE\/NANO 2ND GEN\/32G X 5\/32\"","","200","Select","Select",""],["","69452015120","VITAMIN D ","","8","Select","Select",""],["","53885000810","ONETOUCH DELICA PLUS LANCETS EXTRA FINE 33G","","300","Select","Select",""],["","00713072737","MOMETASONE FUROATE","","135","Select","Select",""],["","55111012405","ATORVASTATIN CALCIUM","","7","Select","Select",""],["","70010075401","METHOCARBAMOL","","90","Select","Select",""],["","69097052444","DICLOFENAC SODIUM","","100","Select","Select",""],["","69452015120","VITAMIN D","","8","Select","Select",""],["","00143980305","DOXYCYCLINE HYCLATE","","30","Select","Select",""],["","57599000200","FREESTYLE LIBRE 14 DAY\/READER\/FLASH MONITORING SYSTEM","","1","Select","Select",""],["","57599000101","FREESTYLE LIBRE 14 DAY\/SENSOR\/FLASH MONITORING SYSTEM","","1","Select","Select",""],["","00591352530","LIDOCAINE","","30","Select","Select",""],["","00781185220","AMOXICILLIN\/CLAVULANATE POTASSIUM","","20","Select","Select",""],["","00143992801","CIPROFLOXACIN HYDROCHLORIDE","","20","Select","Select",""],["","69547035302","NARCAN","","-2","Select","Select",""],["","57237000511","FLUCONAZOLE","","1","Select","Select",""],["","00597015230","JARDIANCE","","30","Select","Select",""],["","00186077760","BRILINTA","90MG","60","Select","Select",""],["","63304044330","FENOFIBRATE","43MG","90","Select","Select",""],["","68462016405","CARVEDILOL","12.5MG","-90","Select","Select",""],["","42799012001","BUMETANIDE","1MG","-90","Select","Select",""],["","00173071720","ADVAIR HFA","230\/21","12","Select","Select",""],["","29300046810","CLONIDINE HYDROCHLORIDE","0.1MG","180","Select","Select",""],["","00186037220","SYMBICORT","80-4.5","10","Select","Select",""],["","00310737220","BUDESONIDE\/FORMOTEROL FUMARATE DIHYDRATE","80-4.5","10","Select","Select",""],["","43598043611","NITROGLYCERIN","0.4MG","25","Select","Select",""],["","53885001110","ONETOUCH DELICA PLUS LANCETS FINE 30G","PLUS 30G","200","Select","Select",""],["","53885059501","ONETOUCH DELICA LANCETS FINE 30G","30G","-200","Select","Select",""],["","00378932232","WIXELA INHUB                                                          ","AER 500\/50","-60","Select","Select",""],["","64125090505","LORAZEPAM                                                             ","TAB 1MG","60","Select","Select",""],["","00169266211","TRESIBA                                                               ","INJ 100UNIT","-20","Select","Select",""],["","27241009903","DULOXETINE HYDROCHLORIDE                                              ","CAP 60MG","22","Select","Select",""],["","00713072715","MOMETASONE FUROATE                                                    ","OIN 0.001","135","Select","Select",""],["","10702005601","OXYCODONE HYDROCHLORIDE                                               ","TAB 10MG","180","Select","Select",""],["","65862016001","ZOLPIDEM TARTRATE                                                     ","TAB 10MG","30","Select","Select",""],["","68462012605","GABAPENTIN                                                            ","TAB 600MG","135","Select","Select",""],["","68682099798","DILTIAZEM HYDROCHLORIDE ER                                            ","CAP 240MG ER","90","Select","Select",""],["","53885000810","ONETOUCH DELICA PLUS LANCETS EXTRA FINE 33G                           ","MIS PLUS 33G","300","Select","Select",""],["","53885027150","ONETOUCH VERIO TEST STRIPS                                            ","TES VERIO","150","Select","Select",""],["","68180051703","LISINOPRIL                                                            ","TAB 40MG","30","Select","Select",""],["","66993001968","ALBUTEROL SULFATE HFA                                                 ","AER HFA","18","Select","Select",""],["","00555097402","AMPHETAMINE\/DEXTROAMPHETAMINE                                         ","TAB 30MG","90","Select","Select",""],["","55111012405","ATORVASTATIN CALCIUM                                                  ","TAB 80MG","7","Select","Select",""],["","00169266015","TRESIBA FLEXTOUCH                                                     ","INJ 100UNIT","-6","Select","Select",""],["","00781569031","EZETIMIBE                                                             ","TAB 10MG","30","Select","Select",""],["","68382050010","OMEPRAZOLE                                                            ","CAP 40MG","180","Select","Select",""],["","68462011060","TOPIRAMATE                                                            ","TAB 200MG","60","Select","Select",""],["","57599000200","FREESTYLE LIBRE 14 DAY\/READER\/FLASH MONITORING SYSTEM                 ","MIS READER","1","Select","Select",""],["","00591352530","LIDOCAINE                                                             ","PAD 0.05","30","Select","Select",""],["","69452015120","VITAMIN D                                                             ","CAP 50000UNT","8","Select","Select",""],["","73070010315","INSULIN ASPART FLEXPEN                                                ","INJ FLEXPEN","-15","Select","Select",""],["","08290320109","BD PEN NEEDLE\/SHORT\/ULTRA-FINE\/31G X 8MM                              ","MIS 31GX8MM","-100","Select","Select",""],["","08290320550","BD PEN NEEDLE\/NANO 2ND GEN\/32G X 5\/32\"                                ","MIS 32GX5\/32","200","Select","Select",""],["","69547035302","NARCAN                                                                ","SPR ","-2","Select","Select",""],["","69097052444","DICLOFENAC SODIUM                                                     ","GEL 0.01","100","Select","Select",""],["","00781185220","AMOXICILLIN\/CLAVULANATE POTASSIUM                                     ","TAB 875-125","20","Select","Select",""],["","00143992801","CIPROFLOXACIN HYDROCHLORIDE                                           ","TAB 500MG","20","Select","Select",""],["","00597015337","JARDIANCE                                                             ","TAB 25MG","30","Select","Select",""],["","00143980305","DOXYCYCLINE HYCLATE                                                   ","CAP 100MG","-30","Select","Select",""],["","57237000511","FLUCONAZOLE                                                           ","TAB 150MG","1","Select","Select",""],["","57599000101","FREESTYLE LIBRE 14 DAY\/SENSOR\/FLASH MONITORING SYSTEM                 ","KIT SENSOR","1","Select","Select",""],["","70010075401","METHOCARBAMOL                                                         ","TAB 500MG","90","Select","Select",""],["","00186077760","BRILINTA                                                              ","TAB 90MG","-60","Select","Select",""],["","53885001110","ONETOUCH DELICA PLUS LANCETS FINE 30G                                 ","MIS PLUS 30G","200","Select","Select",""],["","63304044330","FENOFIBRATE                                                           ","CAP 43MG","90","Select","Select",""],["","68462016405","CARVEDILOL                                                            ","TAB 12.5MG","-90","Select","Select",""],["","42799012001","BUMETANIDE                                                            ","TAB 1MG","90","Select","Select",""],["","00186037220","SYMBICORT                                                             ","AER 80-4.5","-10","Select","Select",""],["","43598043611","NITROGLYCERIN                                                         ","SUB 0.4MG","25","Select","Select",""],["","53885059501","ONETOUCH DELICA LANCETS FINE 30G                                      ","MIS 30G","-200","Select","Select",""],["","99073013001","FREESTYLE LANCETS                                                     ","MIS LANCETS","200","Select","Select",""],["","29300046810","CLONIDINE HYDROCHLORIDE                                               ","TAB 0.1MG","180","Select","Select",""],["","00173071720","ADVAIR HFA                                                            ","AER 230\/21","12","Select","Select",""],["","73070010011","INSULIN ASPART                                                        ","INJ 100\/ML","30","Select","Select",""],["","00310737220","BUDESONIDE\/FORMOTEROL FUMARATE DIHYDRATE                              ","AER 80-4.5","10","Select","Select",""]]}},{"a":{"index":-1,"commentTxt":"","arr":[]}},{"a":{"indx":[],"comment":[],"sub":{"indx":["","","","","","","",""],"comment":[""],"sub":[]}}},{"a":[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}]}]},{"t":"Review of Systems and Diagnoses","q":[{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}]}},{"a":{"indx":["",""],"comment":["",""],"score":[0,0,0,0]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}]}},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":["",""]},{"a":[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["","",""],"comment":["","",""],"sub":[]}]},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":[{"indx":["","","",""],"comment":["","","",""],"sub":[]},{"indx":["","","",""],"comment":["","","",""],"sub":[]},{"subGroup":[{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]}]}]},{"a":{"indx":["","","",""],"comment":["","","",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":{"indx":["","","","","","","","","",""],"comment":["","","","","","","","","",""],"sub":[]}},{"a":{"indx":["","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}]}},{"a":{"indx":["","","","","",""],"comment":["","","","","",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}]}},{"a":[{"indx":["",""],"comment":["",""],"sub":[]}]}]},{"t":"Pain","q":[{"a":{"indx":["",""],"comment":["",""],"sub":[[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}],[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}]]}}]},{"t":"Vital Signs","q":[{"a":["","","","","",""]},{"a":["","","","",{"txt":""},{"malnutrition":[]}]}]},{"t":"Exam Review","q":[{"a":[{"indx":["",""],"comment":["",""],"sub":[]}]},{"a":[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}]},{"a":[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}]},{"a":[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}]},{"a":[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}]},{"a":[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}]},{"a":[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}]},{"a":[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}]},{"a":[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}]},{"a":[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}]},{"a":[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}]},{"a":[{"indx":["",""],"comment":["",""],"sub":[]}]},{"a":[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}]}]},{"t":"Screenings Needed","q":[[["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""]]]},{"t":"Mini-Cog","q":[{"a":[]}]},{"t":"Home Safety & Personal Goals","q":[{"a":{"indx":["","","","",""],"comment":["","","","",""],"score":[0,0,0,0]}},{"a":[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}]},{"a":[""]},{"a":[""]},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}}]},{"t":"Active Problem Conditions","q":[{"a":[]}]},{"t":"Patient Summary","q":[{"a1":"","a2":"","a3":"","a4":"","a5":"","a6":"","a7":[],"a8":"","a9":"In Person","a10":[],"a11":"","a12":""}]}]}