{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LISA C KING","gend":1,"add":"C\/O HELEN WOODARD","city":"BRODNAX","state":"VA","zip":"23920-3021","dob":"1963-10-04","age":"","mstatus":"","insh":"11003010","cliId":"","pno":4345325995,"cno":4345323375,"email":"","ename":"","eno":"","pphy":"POWERS, GRAHAM H","ppno":4345842000,"pcpadd":"200 E 5th St","pcpcity":"Chase City","pcpstate":"VA","pcpzip":239241456,"pcpcounty":"","pcpid":"","pcpname":"KENBRIDGE FAMILY MEDICINE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"2206 HUCKSTEP RD","add3":"","madd1":"C\/O HELEN WOODARD","madd2":"2206 HUCKSTEP RD","madd3":"","mcity":"BRODNAX","mstate":"VA","mzip":"23920-3021","pcpfaxno":"(434) 447-2240","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":[["","70377002811","ATORVASTATIN ","20MG","90.00","Select","Select",""],["","00054327099","FLUTICASONE ","50MCG","16.00","Select","Select",""],["","00093172101","WARFARIN ","5MG","90.00","Select","Select",""],["","68382020906","ANASTROZOLE ","1MG","90.00","Select","Select",""],["","00093101042","MUPIROCIN ","2%","22.00","Select","Select",""],["","68382002310","ATENOLOL ","50MG","90.00","Select","Select",""],["","00456150055","SAVELLA ","TITR PAK","55.00","Select","Select",""],["","00378827052","ALBUTEROL ","0.08%","375.00","Select","Select",""],["","65862057490","MONTELUKAST ","10MG","90.00","Select","Select",""],["","52268001201","SUPREP ","PREP KIT","354.00","Select","Select",""],["","68180012202","CEPHALEXIN ","500MG","21.00","Select","Select",""],["","00054001925","PREDNISONE ","50MG","5.00","Select","Select",""],["","66993066430","DULOXETINE ","60MG","90.00","Select","Select",""],["","00173088210","BREO ","200-25","60.00","Select","Select",""],["","67877021660","CEFUROXIME ","500MG","20.00","Select","Select",""],["","00378235193","ESOMEPRA ","40MG DR","90.00","Select","Select",""],["","65162083366","DICLOFENAC ","1%","300.00","Select","Select",""],["","68180016013","AZITHROMYCIN ","250MG","6.00","Select","Select",""],["","58160082311","SHINGRIX ","50\/0.5ML","1.00","Select","Select",""],["","47781030301","NITROFURANTN ","100MG","20.00","Select","Select",""],["","00093031401","KETOROLAC ","10MG","9.00","Select","Select",""],["","49281040020","ADACEL ","","0.50","Select","Select",""],["","00093005805","TRAMADOL ","50MG","30.00","Select","Select",""],["","59310057922","PROAIR ","","8.50","Select","Select",""],["","24208039830","IPRATROPIUM ","0.03%","30.00","Select","Select",""],["","24658031205","DOXYCYCL ","100MG","14.00","Select","Select",""],["","70710113908","FLUCONAZOLE ","150MG","1.00","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":""}]}]}