{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KAREN GOODWIN","gend":1,"add":"861 LYNCH MILL ROAD","city":"ALTAVISTA","state":"VA","zip":"24517-1113","dob":"1966-12-20","age":"","mstatus":"","insh":"11004308","cliId":"","pno":4343008909,"cno":4346081040,"email":"","ename":"","eno":"","pphy":"NELSON-MADISON, LORI","ppno":4342005200,"pcpadd":"2323 Memorial Ave Ste 10","pcpcity":"Lynchburg","pcpstate":"VA","pcpzip":245012652,"pcpcounty":"","pcpid":"","pcpname":"LYNCHBURG FAMILY PRACTICE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"","add3":"","madd1":"861 LYNCH MILL ROAD","madd2":"","madd3":"","mcity":"ALTAVISTA","mstate":"VA","mzip":"24517-1113","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":[["","52817036000","METOPROL ","25MG","60.00","Select","Select",""],["","42571025201","CLINDAMYCIN ","300MG","21.00","Select","Select",""],["","00169750111","NOVOLOG ","100\/ML","60.00","Select","Select",""],["","00469260190","MYRBETRIQ ","25MG","30.00","Select","Select",""],["","60505018301","CARBAMAZEPIN ","200MG","495.00","Select","Select",""],["","60505258008","ATORVASTATIN ","40MG","90.00","Select","Select",""],["","00781808926","AZITHROMYCIN ","250MG","6.00","Select","Select",""],["","50228035390","PREGABALIN ","100MG","90.00","Select","Select",""],["","59310057922","PROAIR ","","8.50","Select","Select",""],["","55111025860","ZIPRASIDONE ","60MG","180.00","Select","Select",""],["","59746038406","TERAZOSIN ","2MG","30.00","Select","Select",""],["","62756026002","ZONISAMIDE ","100MG","360.00","Select","Select",""],["","00169368712","LEVEMIR ","","50.00","Select","Select",""],["","65162037310","OXYBUTYNIN ","15MG ER","90.00","Select","Select",""],["","57599000200","FREESTYLE    MIS READER","READER","1.00","Select","Select",""],["","47781030701","NITROFUR ","50MG","12.00","Select","Select",""],["","57599000101","FREESTYLE    KIT SENSOR","SENSOR","2.00","Select","Select",""],["","69238183201","LEVOTHYROXIN ","75MCG","90.00","Select","Select",""],["","08484073200","PRODIGY ","CODING","200.00","Select","Select",""],["","00186037020","SYMBICORT ","160-4.5","10.20","Select","Select",""],["","90166015615","INSULIN ","1ML\/31G","300.00","Select","Select",""],["","31722095101","OXYCOD\/APAP ","10-325MG","30.00","Select","Select",""],["","00143211250","DOXYCYCL ","100MG","20.00","Select","Select",""],["","00054001829","PREDNISONE ","20MG","10.00","Select","Select",""],["","00832105411","BACLOFEN ","10MG","120.00","Select","Select",""],["","64980051405","TIMOLOL ","0.5% OP","5.00","Select","Select",""],["","00071101668","LYRICA ","150MG","90.00","Select","Select",""],["","71093013206","METFORMIN ","500MG","180.00","Select","Select",""],["","33342010215","MONTELUKAST ","10MG","90.00","Select","Select",""],["","61314063710","PREDNISOLONE ","1% OP","10.00","Select","Select",""],["","17478021502","ATROPINE ","1% OP","2.00","Select","Select",""],["","50111056002","TRAZODONE ","50MG","90.00","Select","Select",""],["","71093012204","GABAPENTIN ","400MG","30.00","Select","Select",""],["","16729000515","SIMVASTATIN ","20MG","90.00","Select","Select",""],["","16729018317","HYDROCHLOROT ","25MG","90.00","Select","Select",""],["","69097012815","AMLODIPINE ","10MG","90.00","Select","Select",""],["","65862084003","MOXIFLOXACIN ","HCL 0.5%","3.00","Select","Select",""],["","55111012701","CIPROFLOXACN ","500MG","13.00","Select","Select",""],["","00781543920","CEFPODOXIME ","200MG","21.00","Select","Select",""],["","49502010202","EPINEPHRINE ","0.3MG","2.00","Select","Select",""],["","08627001601","DEXCOM ","TRANSMIT","1.00","Select","Select",""],["","00310737020","BUDES\/FORMOT ","160-4.5","10.20","Select","Select",""],["","00093317431","ALBUTEROL ","E HFA INH","8.50","Select","Select",""],["","65162047810","NITROFURANTN ","100MG","3.00","Select","Select",""],["","65862018730","ONDANSETRON ","4MG","60.00","Select","Select",""],["","60505100301","KETOROLAC ","0.50%","5.00","Select","Select",""],["","23155065603","DULOXETINE ","60MG","180.00","Select","Select",""],["","00168025815","CLOTRIM\/BETA ","DIPROP","15.00","Select","Select",""],["","67877021905","CEPHALEXIN ","500MG","6.00","Select","Select",""],["","33332041910","AFLURIA ","2019-20","0.50","Select","Select",""],["","50484001030","SANTYL ","250\/GM","30.00","Select","Select",""],["","10572010001","PEG-3350 ","ELECTROL","4,000.00","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":""}]}]}