{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MATTHEW J HARDIE","gend":0,"add":"3434 MUDLICK RD SW","city":"ROANOKE","state":"VA","zip":"24018-9998","dob":"1958-12-30","age":"","mstatus":"","insh":"11001986","cliId":"","pno":5407256996,"cno":"","email":"","ename":"","eno":"","pphy":"MATTHEWS, KIMBERLY A","ppno":5402245170,"pcpadd":"3 RIVERSIDE CIRCLE","pcpcity":"ROANOKE","pcpstate":"VA","pcpzip":240164955,"pcpcounty":"","pcpid":"","pcpname":"CARILION CLINIC INTERNAL MEDICINE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"","add3":"","madd1":"3434 MUDLICK RD SW","madd2":"","madd3":"","mcity":"ROANOKE","mstate":"VA","mzip":"24018-9998","pcpfaxno":"(540) 983-8229","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":[["","65862019405","FLUOXETINE ","40MG","180.00","Select","Select",""],["","43547034206","RISPERIDONE ","2MG","90.00","Select","Select",""],["","70377000812","ROSUVASTATIN ","20MG","90.00","Select","Select",""],["","69097012403","TOPIRAMATE ","100MG","180.00","Select","Select",""],["","00093101042","MUPIROCIN ","2%","22.00","Select","Select",""],["","00378181110","LEVOTHYROXIN ","112MCG","90.00","Select","Select",""],["","59762374401","CLINDAMYCIN ","10MG\/ML","60.00","Select","Select",""],["","69097015907","MELOXICAM ","15MG","90.00","Select","Select",""],["","10702001801","OXYCODONE ","5MG","35.00","Select","Select",""],["","49884093547","DICLOFENAC ","1%","100.00","Select","Select",""],["","33332031901","AFLURIA ","2019-20","0.50","Select","Select",""],["","60505384801","CELECOXIB ","100MG","60.00","Select","Select",""],["","68180098003","LISINOPRIL ","10MG","90.00","Select","Select",""],["","00093005805","TRAMADOL ","50MG","30.00","Select","Select",""],["","43598075201","BUPROPION ","150MG SR","180.00","Select","Select",""],["","49281042050","FLUZONE ","2020-21","0.50","Select","Select",""],["","00591565810","CYCLOBENZAPR ","10MG","60.00","Select","Select",""],["","67877056110","METFORMIN ","500MG","180.00","Select","Select",""],["","70436001102","BUPROPN ","300MG XL","90.00","Select","Select",""],["","58160082311","SHINGRIX ","50MCG","1.00","Select","Select",""],["","69547035302","NARCAN ","","2.00","Select","Select",""],["","00006483703","PNEUMOVAX ","25\/0.5","0.50","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":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"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":""}]}]}