{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ELIZABETH I BOWMAN","gend":1,"add":"1401 ORBY CANTRELL HIGHWAY","city":"BIG STONE GAP","state":"VA","zip":"24219-4421","dob":"1962-01-19","age":"","mstatus":"","insh":"11003300","cliId":"","pno":2765244035,"cno":"","email":"","ename":"","eno":"","pphy":"BASHAM, CHRISTOPHER M","ppno":2766790321,"pcpadd":"295 Wharton Ln NE","pcpcity":"Norton","pcpstate":"VA","pcpzip":242731541,"pcpcounty":"","pcpid":"","pcpname":"WELLMONT MEDICAL ASSOCIATES INC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"SOUTHWEST","aligned":"Y","ano":"","add2":"","add3":"","madd1":"1401 ORBY CANTRELL HIGHWAY","madd2":"","madd3":"","mcity":"BIG STONE GAP","mstate":"VA","mzip":"24219-4421","pcpfaxno":"(276) 523-6719","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":[["","00093321205","CLONAZEPAM ","1MG","90.00","Select","Select",""],["","68180072003","AMLODIPINE ","5MG","90.00","Select","Select",""],["","49502010202","EPINEPHRINE ","0.3MG","2.00","Select","Select",""],["","53489011802","DOXYCYCL ","50MG","20.00","Select","Select",""],["","68180071160","CEFDINIR ","300MG","14.00","Select","Select",""],["","71093014005","METHOCARBAM ","500MG","60.00","Select","Select",""],["","49483060450","IBUPROFEN ","800MG","90.00","Select","Select",""],["","68180098103","LISINOPRIL ","20MG","90.00","Select","Select",""],["","65162044210","MECLIZINE ","25MG","60.00","Select","Select",""],["","00603459321","METHYLPRED ","4MG","21.00","Select","Select",""],["","00093310905","AMOXICILLIN ","500MG","15.00","Select","Select",""],["","66685100200","AMOX\/K ","500-125","21.00","Select","Select",""],["","00378064110","PREDNISONE ","10MG","20.00","Select","Select",""],["","70377002911","ATORVASTATIN ","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":""}]}]}