{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"VERNON L RAWLINGS","gend":0,"add":"5242 PRUDEN RD","city":"CARRSVILLE","state":"VA","zip":"23315-9998","dob":"1951-01-04","age":"","mstatus":"","insh":"11003535","cliId":"","pno":2523571171,"cno":"","email":"","ename":"","eno":"","pphy":"PONDER, JAMES MICHAEL","ppno":7576532007,"pcpadd":"102 Fairview Dr Ste B","pcpcity":"Franklin","pcpstate":"VA","pcpzip":238511206,"pcpcounty":"","pcpid":"","pcpname":"FRANKLIN CLINIC CORPORATION","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"TIDEWATER","aligned":"Y","ano":"","add2":"","add3":"","madd1":"5242 PRUDEN RD","madd2":"","madd3":"","mcity":"CARRSVILLE","mstate":"VA","mzip":"23315-9998","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":[["","57237010099","METOPROL ","25MG","180.00","Select","Select",""],["","57237000930","MIRTAZAPINE ","30MG","30.00","Select","Select",""],["","67877019905","AMLODIPINE ","10MG","30.00","Select","Select",""],["","31722094101","HYDROCO\/APAP ","5-325MG","12.00","Select","Select",""],["","59310057922","PROAIR ","","8.50","Select","Select",""],["","00093317431","ALBUTEROL ","E","8.50","Select","Select",""],["","67877021901","CEPHALEXIN ","500MG","28.00","Select","Select",""],["","65162003310","APAP\/CODEINE ","300-30MG","12.00","Select","Select",""],["","59746017306","PREDNISONE ","10MG","18.00","Select","Select",""],["","17478076206","DRONABINOL ","5MG","30.00","Select","Select",""],["","00310737020","BUDES\/FORMOT ","160-4.5","10.20","Select","Select",""],["","65862039110","ONDANSETRON ","8MG ODT","30.00","Select","Select",""],["","00143301801","COLCHICINE ","0.6MG","10.00","Select","Select",""],["","65162083366","DICLOFENAC ","1%","100.00","Select","Select",""],["","50383066730","LIDO\/PRILOCN ","2.5-2.5%","30.00","Select","Select",""],["","49884046565","CHOLESTYRAM ","4GM","30.00","Select","Select",""],["","29300022701","METRONIDAZOL ","500MG","6.00","Select","Select",""],["","50383056510","NEOMYCIN ","500MG","6.00","Select","Select",""],["","00023611001","ZENPEP ","10000UNT","90.00","Select","Select",""],["","65862053820","LEVOFLOXACIN ","750MG","7.00","Select","Select",""],["","57237002801","AMOXICILLIN ","500MG","28.00","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":""}]}]}