{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"WILLIAM H ROBERTS SR","gend":0,"add":"3427 DOGWOOD ROAD","city":"CRITZ","state":"VA","zip":"24082-3110","dob":"1949-04-12","age":"","mstatus":"","insh":"11000894","cliId":"","pno":2766944631,"cno":"","email":"","ename":"","eno":"","pphy":"COLE, RICHARD C","ppno":2766944466,"pcpadd":"18877 JEB STUART HWY","pcpcity":"STUART","pcpstate":"VA","pcpzip":241711019,"pcpcounty":"","pcpid":"","pcpname":"PIONEER HEALTH SERVICES OF PATRICK COUNTY","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"","add3":"","madd1":"3427 DOGWOOD ROAD","madd2":"","madd3":"","mcity":"CRITZ","mstate":"VA","mzip":"24082-3110","pcpfaxno":"(276) 694-2909","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":[["","59762033302","LATANOPROST ","0.01%","2.50","Select","Select",""],["","16714059001","DIGOXIN ","0.125MG","90.00","Select","Select",""],["","69238111801","BUSPIRONE ","15MG","270.00","Select","Select",""],["","53746051105","SPIRONOLACT ","25MG","90.00","Select","Select",""],["","42858066045","FENOFIBRATE ","160MG","30.00","Select","Select",""],["","00456141030","BYSTOLIC ","10MG","90.00","Select","Select",""],["","59746038506","TERAZOSIN ","5MG","90.00","Select","Select",""],["","00832532510","POT  CL MICRO","20MEQ ER","180.00","Select","Select",""],["","45963014205","BUPROPN ","300MG XL","90.00","Select","Select",""],["","43547040350","FUROSEMIDE ","80MG","180.00","Select","Select",""],["","57237012401","WARFARIN ","5MG","135.00","Select","Select",""],["","16714007106","BACLOFEN ","10MG","180.00","Select","Select",""],["","55111023005","PRAVASTATIN ","20MG","90.00","Select","Select",""],["","65862067705","ALPRAZOLAM ","0.5MG","180.00","Select","Select",""],["","16714071503","OMEPRAZOLE ","20MG","180.00","Select","Select",""],["","68382013510","LOSARTAN ","25MG","90.00","Select","Select",""],["","00527132401","DIGOX ","0.125MG","90.00","Select","Select",""],["","68462024805","RANITIDINE ","150MG","60.00","Select","Select",""],["","00185505001","METOLAZONE ","2.5MG","28.00","Select","Select",""],["","52565001480","TRIAMCINOLON ","0.10%","80.00","Select","Select",""],["","00093314705","CEPHALEXIN ","500MG","6.00","Select","Select",""],["","00143211250","DOXYCYCL ","100MG","20.00","Select","Select",""],["","00054327099","FLUTICASONE ","50MCG","48.00","Select","Select",""],["","43598043611","NITROGLYCERN ","0.4MG","25.00","Select","Select",""],["","00078065920","ENTRESTO ","24-26MG","60.00","Select","Select",""],["","00093317431","ALBUTEROL ","E","8.50","Select","Select",""],["","57237004105","PENICILLN ","500MG","30.00","Select","Select",""],["","00406012405","HYDROCO\/APAP ","7.5-325","20.00","Select","Select",""],["","68462015713","ONDANSETRON ","4MG ODT","12.00","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":""}]}]}