{
    "version": "0.4",
    "data": [
        {
            "t": "Demographics",
            "q": [
                {
                    "name": "Charles E Wilkinson",
                    "gend": 0,
                    "currentgend": "",
                    "add": "18 HERITAGE WY",
                    "city": "Saco",
                    "state": "ME",
                    "zip": "04072",
                    "dob": "1953-09-11",
                    "age": "",
                    "mstatus": "",
                    "insh": "10000072020",
                    "cliId": "",
                    "pno": "2073913292",
                    "cno": "2072295643",
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                    "ename": "",
                    "eno": "",
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                    "pcpadd": "InterMed,100 Foden Rd Ste 203",
                    "pcpcity": "South Portland",
                    "pcpstate": "ME",
                    "pcpzip": "04106",
                    "pcpcounty": "",
                    "pcpid": "",
                    "pcpname": "INTERMED",
                    "plan": "Martin's Point",
                    "program": "Medicare",
                    "lob": "GA - 2026",
                    "region": "",
                    "aligned": "",
                    "ano": "",
                    "add2": "",
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                    "pcpfaxno": "2075238590",
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                    "currentgendcomment": "",
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        {
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                            "I129",
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                        "date": [
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                            "2024-11-21",
                            "2024-11-21",
                            "2024-11-21",
                            "2024-05-20",
                            "2025-01-14",
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                            "2024-02-22",
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                            "2023-10-12",
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                            "2025-12-13",
                            "2025-12-19",
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                            "2023-07-11",
                            "2024-02-15",
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            "t": "Medical History",
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                    "a": []
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                {
                    "a": []
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                    "a": []
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        {
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                    "a": []
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        {
            "t": "Preventive Care",
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                    "a": []
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                {
                    "a": []
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                    "a": []
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            "t": "Allergies \/ Medications",
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                    "a": {
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                                "Gavilyte-N",
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                                "",
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                                "Select",
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                            ],
                            [
                                "",
                                "",
                                "Methylphenidate",
                                "20 MG",
                                "",
                                "Select",
                                "Select",
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                                "",
                                "PREGABALIN",
                                "75 MG",
                                "",
                                "Select",
                                "Select",
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                            [
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                                "DOXYCYCLINE HYCLATE",
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                                "Select",
                                "Select",
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                                "METFORMIN",
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                                "",
                                "Select",
                                "Select",
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                            [
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                                "",
                                "TRIAMCINOLONE ACET",
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                                "Select",
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                            [
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                                "",
                                "LORAZEPAM",
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                                "",
                                "Select",
                                "Select",
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                            [
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                                "SULFAMETHOXAZOLE\/TRIMETHOPRIM",
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                                "Select",
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                            [
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                                "",
                                "IPRATROPIUM",
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                                "",
                                "Select",
                                "Select",
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                            [
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                                "",
                                "CARBIDOPA-LEVODOPA",
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                                "",
                                "Select",
                                "Select",
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                            [
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                                "",
                                "CARBIDOPA\/LEVODOPA",
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                                "",
                                "Select",
                                "Select",
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                            [
                                "",
                                "",
                                "AREXVY",
                                "",
                                "",
                                "Select",
                                "Select",
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                            [
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                                "ALBUTEROL HFA",
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                                "Select",
                                "Select",
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                                "COMIRNATY",
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                                "",
                                "Select",
                                "Select",
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                            [
                                "",
                                "",
                                "PEG",
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                                "Select",
                                "Select",
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                                "",
                                "Select",
                                "Select",
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                                "BD NANO",
                                "",
                                "",
                                "Select",
                                "Select",
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                                "METFORMIN HCL ER",
                                "",
                                "",
                                "Select",
                                "Select",
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                                "VYVANSE",
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                                "",
                                "Select",
                                "Select",
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                                "PAXLOVID",
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                                "Select",
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                    "a": []
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                    "a": []
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                {
                    "a": []
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                },
                {
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                    "a": []
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                    "a": []
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                    "a": []
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                    "a": []
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                {
                    "a": []
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                {
                    "a": []
                },
                {
                    "a": []
                },
                {
                    "a": []
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                {
                    "a": []
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                {
                    "a": []
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                {
                    "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": ""
                }
            ]
        }
    ]
}