{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JUDY THOMPSON","gend":1,"add":"322 N COURT AVE","city":"COVINGTON","state":"VA","zip":"24426-9998","dob":"1946-10-08","age":"","mstatus":"","insh":"11001352","cliId":"","pno":5406913314,"cno":"","email":"","ename":"","eno":"","pphy":"HENDERSON, PATRICIA W","ppno":5408626750,"pcpadd":"1 ARH LANE SUITE 800","pcpcity":"LOW MOOR","pcpstate":"VA","pcpzip":244570001,"pcpcounty":"","pcpid":"","pcpname":"JACKSON RIVER FAMILY PRACTICE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"APT C","add3":"","madd1":"322 N COURT AVE","madd2":"APT C","madd3":"","mcity":"COVINGTON","mstate":"VA","mzip":"24426-9998","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":[["","67877022210","GABAPENTIN ","100MG","90.00","Select","Select",""],["","69097012715","AMLODIPINE ","5MG","90.00","Select","Select",""],["","00093220405","METOCLOPRAM ","5MG","60.00","Select","Select",""],["","68645055154","LISINOPRIL ","5MG","90.00","Select","Select",""],["","13107003234","MIRTAZAPINE ","45MG","30.00","Select","Select",""],["","63304007605","POT  CHLORIDE","10MEQ ER","60.00","Select","Select",""],["","55111015930","OMEPRAZOLE ","40MG","90.00","Select","Select",""],["","00185067405","HYDROXYZ ","25MG","120.00","Select","Select",""],["","65862052830","VENLAFAXINE ","75MG ER","30.00","Select","Select",""],["","50383090110","HC\/ACET ","OTIC","10.00","Select","Select",""],["","16729016801","ESCITALOPRAM ","5MG","90.00","Select","Select",""],["","68180044601","QUETIAPINE ","50MG","90.00","Select","Select",""],["","00115552210","FENOFIBRATE ","160MG","90.00","Select","Select",""],["","42858000101","OXYCODONE ","5MG","42.00","Select","Select",""],["","23155065201","METRONIDAZOL ","500MG","30.00","Select","Select",""],["","00143992801","CIPROFLOXACN ","500MG","20.00","Select","Select",""],["","00832532410","POT  CL MICRO","10MEQ ER","60.00","Select","Select",""],["","65162027110","SMZ-TMP ","400-80MG","10.00","Select","Select",""],["","55111015330","ONDANSETRON ","4MG","30.00","Select","Select",""],["","66758017092","KLOR-CON ","10MEQ ER","270.00","Select","Select",""],["","00406012301","HYDROCO\/APAP ","5-325MG","20.00","Select","Select",""],["","65162047810","NITROFURANTN ","100MG","14.00","Select","Select",""],["","50111043303","TRAZODONE ","50MG","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":""}]}]}