{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MABEL B NEWELL","gend":1,"add":"857 EVANS CREEK RD","city":"BRODNAX","state":"VA","zip":"23920-9998","dob":"1929-05-27","age":"","mstatus":"","insh":"11004695","cliId":"","pno":4347293486,"cno":4346238517,"email":"","ename":"","eno":"","pphy":"POWERS, GRAHAM H","ppno":4345842000,"pcpadd":"200 E 5th St","pcpcity":"Chase City","pcpstate":"VA","pcpzip":239241456,"pcpcounty":"","pcpid":"","pcpname":"SOUTH HILL FAMILY MEDICINE INC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"857 EVANS CREEK RD","madd2":"","madd3":"","mcity":"BRODNAX","mstate":"VA","mzip":"23920-9998","pcpfaxno":"(434) 447-2240","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":[["","43547035611","LISINOPRIL ","40MG","90.00","Select","Select",""],["","00093317431","ALBUTEROL ","E","25.50","Select","Select",""],["","68180072003","AMLODIPINE ","5MG","90.00","Select","Select",""],["","00093101042","MUPIROCIN ","2%","22.00","Select","Select",""],["","00093078710","ATENOLOL ","25MG","90.00","Select","Select",""],["","16714071503","OMEPRAZOLE ","20MG","90.00","Select","Select",""],["","60505025103","TIZANIDINE ","2MG","16.00","Select","Select",""],["","59310057922","PROAIR ","","8.50","Select","Select",""],["","00378064110","PREDNISONE ","10MG","18.00","Select","Select",""],["","43547040611","CLONAZEPAM ","0.5MG","90.00","Select","Select",""],["","69097094312","GABAPENTIN ","300MG","180.00","Select","Select",""],["","00228234810","PROPYLTHIOUR ","50MG","180.00","Select","Select",""],["","69097052444","DICLOFENAC ","1%","100.00","Select","Select",""],["","13668013501","ESCITALOPRAM ","5MG","90.00","Select","Select",""],["","50111091601","TORSEMIDE ","10MG","180.00","Select","Select",""],["","23155000301","HYDRALAZINE ","50MG","120.00","Select","Select",""],["","68180012202","CEPHALEXIN ","500MG","21.00","Select","Select",""],["","50742061510","METOPROL ","25MG ER","45.00","Select","Select",""],["","50111064703","FLUOXETINE ","10MG","90.00","Select","Select",""],["","16729018317","HYDROCHLOROT ","25MG","90.00","Select","Select",""],["","00574018105","POT  CHLORIDE","10MEQ ER","90.00","Select","Select",""],["","65862039010","ONDANSETRON ","4MG ODT","60.00","Select","Select",""],["","61442012110","FAMOTIDINE ","20MG","180.00","Select","Select",""],["","47335090218","QUETIAPINE ","25MG","5.00","Select","Select",""],["","45802041926","AMMONIUM ","12%","400.00","Select","Select",""],["","65862017760","CEFDINIR ","300MG","5.00","Select","Select",""],["","67877025130","TRIAMCINOLON ","0.10%","30.00","Select","Select",""],["","67877012450","SILVER ","1%","50.00","Select","Select",""],["","60505384801","CELECOXIB ","100MG","30.00","Select","Select",""],["","51672404801","CLOTRIM\/BETA ","DIPROP","15.00","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":""}]}]}