{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MARY A HIGGINS","gend":1,"add":"20 TROT LANE APT A","city":"LEXINGTON","state":"VA","zip":"24450-9998","dob":"1948-04-21","age":"","mstatus":"","insh":"11003182","cliId":"","pno":5404631540,"cno":"","email":"","ename":"","eno":"","pphy":"HAMILTON, THOMAS F","ppno":5402677421,"pcpadd":"2252 Magnolia Ave","pcpcity":"Buena Vista","pcpstate":"VA","pcpzip":244163122,"pcpcounty":"","pcpid":"","pcpname":"BUENA VISTA MEDICAL ASSOCIATES","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"","add3":"","madd1":"20 TROT LANE APT A","madd2":"","madd3":"","mcity":"LEXINGTON","mstate":"VA","mzip":"24450-9998","pcpfaxno":"(540) 261-3093","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":[["","00093005805","TRAMADOL ","50MG","90.00","Select","Select",""],["","70377000314","SIMVASTATIN ","20MG","90.00","Select","Select",""],["","65862085901","FAMOTIDINE ","20MG","90.00","Select","Select",""],["","00378180510","LEVOTHYROXIN ","75MCG","90.00","Select","Select",""],["","53746051101","SPIRONOLACT ","25MG","90.00","Select","Select",""],["","13668001005","CITALOPRAM ","20MG","90.00","Select","Select",""],["","65862057490","MONTELUKAST ","10MG","90.00","Select","Select",""],["","68180072003","AMLODIPINE ","5MG","90.00","Select","Select",""],["","00378020810","FUROSEMIDE ","20MG","360.00","Select","Select",""],["","68180051303","LISINOPRIL ","5MG","90.00","Select","Select",""],["","69097081312","GABAPENTIN ","100MG","30.00","Select","Select",""],["","00378064110","PREDNISONE ","10MG","30.00","Select","Select",""],["","00093117210","PENICILLN ","250MG","28.00","Select","Select",""],["","70461001903","FLUAD ","2019-20","0.50","Select","Select",""],["","53489011905","DOXYCYCL ","100MG","20.00","Select","Select",""],["","59310057922","PROAIR ","","8.50","Select","Select",""],["","00093310905","AMOXICILLIN ","500MG","21.00","Select","Select",""],["","68180012202","CEPHALEXIN ","500MG","10.00","Select","Select",""],["","00054327099","FLUTICASONE ","50MCG","16.00","Select","Select",""],["","62175061743","PANTOPRAZOLE ","40MG","90.00","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":["",""],"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":""}]}]}