{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JOSEPH D STIGGER","gend":0,"add":"5653 ROLLING HILLS DRIVE","city":"DUBLIN","state":"VA","zip":"24084-2540","dob":"1974-04-26","age":"","mstatus":"","insh":"11000183","cliId":"","pno":5407310260,"cno":5408353717,"email":"","ename":"","eno":"","pphy":"SIMPSON, MICHAEL R","ppno":7579552828,"pcpadd":"885 Kempsville RdSte 320","pcpcity":"Norfolk","pcpstate":"VA","pcpzip":235023800,"pcpcounty":"","pcpid":"","pcpname":"LEWIS GALE PHYSICIANS LLC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"APT 2","add3":"","madd1":"5653 ROLLING HILLS DRIVE","madd2":"APT 2","madd3":"","mcity":"DUBLIN","mstate":"VA","mzip":"24084-2540","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":[["","31722052001","HYDRALAZINE ","25MG","90.00","Select","Select",""],["","29300011416","LAMOTRIGINE ","200MG","30.00","Select","Select",""],["","00406851501","OXYCODONE ","15MG","144.00","Select","Select",""],["","67877024901","QUETIAPINE ","50MG","60.00","Select","Select",""],["","69315011710","FUROSEMIDE ","40MG","30.00","Select","Select",""],["","65862019399","FLUOXETINE ","20MG","30.00","Select","Select",""],["","24510013010","XTAMPZA ","27MG","60.00","Select","Select",""],["","68462016505","CARVEDILOL ","25MG","60.00","Select","Select",""],["","16729044416","BUPROPN ","300MG XL","30.00","Select","Select",""],["","68180051701","LISINOPRIL ","40MG","30.00","Select","Select",""],["","68382066101","SPIRONOLACT ","50MG","30.00","Select","Select",""],["","65862029690","ROSUVASTATIN ","40MG","30.00","Select","Select",""],["","00121057732","LACTULOSE ","10GM\/15","270.00","Select","Select",""],["","71093011105","GABAPENTIN ","600MG","120.00","Select","Select",""],["","16729000517","SIMVASTATIN ","20MG","30.00","Select","Select",""],["","16729043315","EZETIMIBE ","10MG","30.00","Select","Select",""],["","68180096301","ALBUTEROL ","HFA","8.50","Select","Select",""],["","00597010061","SPIRIVA ","2.5MCG","4.00","Select","Select",""],["","62037099910","POT  CL MICRO","20MEQ ER","30.00","Select","Select",""],["","70954001910","PRAZOSIN ","1MG","30.00","Select","Select",""],["","66993058697","FLUTIC\/SALME ","500\/50","60.00","Select","Select",""],["","65862018601","CLINDAMYCIN ","300MG","30.00","Select","Select",""],["","43547040610","CLONAZEPAM ","0.5MG","60.00","Select","Select",""],["","69238110005","DOXYCYCL ","100MG","20.00","Select","Select",""],["","00173069600","ADVAIR ","250\/50","60.00","Select","Select",""],["","45963043864","ENULOSE ","10GM\/15","2,700.00","Select","Select",""],["","57237009960","CEFDINIR ","300MG","20.00","Select","Select",""],["","65862039010","ONDANSETRON ","4MG ODT","30.00","Select","Select",""],["","50228043605","NAPROXEN ","500MG","10.00","Select","Select",""],["","68180012201","CEPHALEXIN ","500MG","21.00","Select","Select",""],["","55111015810","OMEPRAZOLE ","20MG","30.00","Select","Select",""],["","67877046390","PREGABALIN ","50MG","21.00","Select","Select",""],["","62756001740","TESTOST ","100MG\/ML","10.00","Select","Select",""],["","16571066401","METRONIDAZOL ","500MG","30.00","Select","Select",""],["","43547036209","LOSARTAN ","100MG","1.00","Select","Select",""],["","42858049340","BUPRENORPHIN ","10MCG\/HR","4.00","Select","Select",""],["","00032122401","CREON ","24000UNT","150.00","Select","Select",""],["","10702000310","PROMETHAZINE ","25MG","39.00","Select","Select",""],["","52817018100","CLONIDINE ","0.2MG","26.00","Select","Select",""],["","57237023305","SMZ-TMP ","800-160","20.00","Select","Select",""],["","00121086816","NYSTATIN ","100000","280.00","Select","Select",""],["","00054418425","DEXAMETHASON ","4MG","5.00","Select","Select",""],["","33342006015","CLOPIDOGREL ","75MG","8.00","Select","Select",""],["","00904637861","CIPROFLOXACN ","500MG","20.00","Select","Select",""],["","00406012305","HYDROCO\/APAP ","5-325MG","28.00","Select","Select",""],["","00591544301","PREDNISONE ","20MG","14.00","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":""}]}]}