{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KAREN L PRATT","gend":1,"add":"1328 MORNINGSIDE ST SE","city":"ROANOKE","state":"VA","zip":"24013-9998","dob":"1965-04-20","age":"","mstatus":"","insh":"11003591","cliId":"","pno":5403442869,"cno":"","email":"","ename":"","eno":"","pphy":"TU, PRISCILLA","ppno":5404279200,"pcpadd":"2145 Mount Pleasant Blvd Se","pcpcity":"Roanoke","pcpstate":"VA","pcpzip":240143632,"pcpcounty":"","pcpid":"","pcpname":"CARILION FAMILY MEDICINE SOUTHEAST FAMILY MEDICAL","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"APT A","add3":"","madd1":"1328 MORNINGSIDE ST SE","madd2":"APT A","madd3":"","mcity":"ROANOKE","mstate":"VA","mzip":"24013-9998","pcpfaxno":"(540) 562-4278","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":[["","00555032302","HYDROXYZ ","25MG","90.00","Select","Select",""],["","99073070792","FREESTYLE    TES","","100.00","Select","Select",""],["","43547027310","ROPINIROLE ","4MG","30.00","Select","Select",""],["","00093505998","ATORVASTATIN ","20MG","90.00","Select","Select",""],["","59651017301","DOXEPIN ","10MG","30.00","Select","Select",""],["","16714074703","OMEPRAZOLE ","20MG","30.00","Select","Select",""],["","60505015701","BUPROPION ","100MG","60.00","Select","Select",""],["","70010010810","GABAPENTIN ","100MG","90.00","Select","Select",""],["","43547028111","ESCITALOPRAM ","10MG","30.00","Select","Select",""],["","29300011616","TOPIRAMATE ","50MG","60.00","Select","Select",""],["","68645055254","LISINOPRIL ","10MG","30.00","Select","Select",""],["","00555088602","ESTRADIOL ","1MG","22.00","Select","Select",""],["","68180044701","QUETIAPINE ","100MG","30.00","Select","Select",""],["","43547040111","FUROSEMIDE ","20MG","30.00","Select","Select",""],["","00093005805","TRAMADOL ","50MG","120.00","Select","Select",""],["","65862014636","SUMATRIPTAN ","25MG","9.00","Select","Select",""],["","00781518992","LEVOTHYROXIN ","200MCG","66.00","Select","Select",""],["","65162083366","DICLOFENAC ","1%","100.00","Select","Select",""],["","00169406013","VICTOZA ","18MG\/3ML","9.00","Select","Select",""],["","65162025350","RANITIDINE ","150MG","60.00","Select","Select",""],["","59746012106","MECLIZINE ","25MG","120.00","Select","Select",""],["","55111015430","ONDANSETRON ","8MG","30.00","Select","Select",""],["","55111018015","TIZANIDINE ","4MG","180.00","Select","Select",""],["","08290320119","BD  PEN NEEDL","31GX5MM","100.00","Select","Select",""],["","72305020030","EUTHYROX ","200MCG","66.00","Select","Select",""],["","08470043501","COMFORTOUCH ","LANCET","100.00","Select","Select",""],["","72205001290","PREGABALIN ","50MG","60.00","Select","Select",""],["","99073013001","FREESTYLE    MIS LANCETS","LANCETS","100.00","Select","Select",""],["","68382005105","MELOXICAM ","15MG","30.00","Select","Select",""],["","69547035302","NARCAN ","","2.00","Select","Select",""],["","50111033402","METRONIDAZOL ","500MG","20.00","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":["",""],"sub":{"indx":[["","",""],[""],[""],[""],[""]],"comment":[["","",""],[""],[""],[""],[""]],"sub":[]}}},{"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":""}]}]}