{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DANIELLE N REYNOLDS","gend":1,"add":"691 PINECREST AVENUE","city":"BEDFORD","state":"VA","zip":"24523-2844","dob":"1975-02-17","age":"","mstatus":"","insh":"11007030","cliId":"","pno":5408759334,"cno":"","email":"","ename":"","eno":"","pphy":"ANDERSON, ANDREW J","ppno":7578752009,"pcpadd":"20304 TIMBERLAKE ROAD","pcpcity":"LYNCHBURG","pcpstate":"VA","pcpzip":245027222,"pcpcounty":"","pcpid":"","pcpname":"CENTRA MEDICAL GROUP","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"APT A3","add3":"","madd1":"691 PINECREST AVENUE","madd2":"APT A3","madd3":"","mcity":"BEDFORD","mstate":"VA","mzip":"24523-2844","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":[["","23155010705","HYDROXYZ ","50MG","120.00","Select","Select",""],["","53746046605","IBUPROFEN ","800MG","66.00","Select","Select",""],["","00009540001","NICOTROL ","","168.00","Select","Select",""],["","60505257909","ATORVASTATIN ","20MG","28.00","Select","Select",""],["","65162028003","PALIPERIDONE ","ER 1.5MG","56.00","Select","Select",""],["","00527133010","BACLOFEN ","10MG","84.00","Select","Select",""],["","00487950103","ALBUTEROL ","0.08%","360.00","Select","Select",""],["","00054025922","MONTELUKAST ","10MG","22.00","Select","Select",""],["","68462012705","GABAPENTIN ","800MG","112.00","Select","Select",""],["","57664050652","METOPROL ","25MG","56.00","Select","Select",""],["","00603506221","PERPHENAZINE ","8MG","56.00","Select","Select",""],["","00115175701","CYPROHEPTAD ","4MG","60.00","Select","Select",""],["","68382014014","TOPIRAMATE ","100MG","60.00","Select","Select",""],["","55111011230","MOXIFLOXACIN ","400MG","4.00","Select","Select",""],["","55111015901","OMEPRAZOLE ","40MG","56.00","Select","Select",""],["","65862069705","VENLAFAXINE ","150MG ER","18.00","Select","Select",""],["","60505014108","GLIPIZIDE ","5MG","56.00","Select","Select",""],["","16729020216","BUSPIRONE ","10MG","168.00","Select","Select",""],["","00173085910","BREO ","100-25","60.00","Select","Select",""],["","00378075101","CYCLOBENZAPR ","10MG","90.00","Select","Select",""],["","63402031230","LATUDA ","120MG","15.00","Select","Select",""],["","50458059110","RISPERIDONE ","0.5MG","56.00","Select","Select",""],["","43547040711","CLONAZEPAM ","1MG","60.00","Select","Select",""],["","64764075030","TRINTELLIX ","20MG","30.00","Select","Select",""],["","68180051303","LISINOPRIL ","5MG","22.00","Select","Select",""],["","00310737020","BUDES\/FORMOT ","160-4.5","10.20","Select","Select",""],["","27241009990","DULOXETINE ","60MG","56.00","Select","Select",""],["","00093406901","PRAZOSIN ","5MG","30.00","Select","Select",""],["","23155010210","METFORMIN ","500MG","56.00","Select","Select",""],["","67877021905","CEPHALEXIN ","500MG","20.00","Select","Select",""],["","68180016013","AZITHROMYCIN ","250MG","6.00","Select","Select",""],["","13107015430","PAROXETINE ","10MG","28.00","Select","Select",""],["","00456114030","VIIBRYD ","40MG","15.00","Select","Select",""],["","12496120803","SUBOXONE ","8-2MG","14.00","Select","Select",""],["","50458056401","INVEGA ","234\/1.5","1.50","Select","Select",""],["","29300011405","LAMOTRIGINE ","200MG","56.00","Select","Select",""],["","00093598627","EPINEPHRINE ","0.3MG","2.00","Select","Select",""],["","00378021610","FUROSEMIDE ","40MG","90.00","Select","Select",""],["","51991029301","OXCARBAZEPIN ","300MG","42.00","Select","Select",""],["","00069046956","CHANTIX ","1MG","60.00","Select","Select",""],["","31722056501","INDOMETHACIN ","75MG ER","30.00","Select","Select",""],["","00085113204","PROVENTIL ","HFA","6.70","Select","Select",""],["","00378064110","PREDNISONE ","10MG","30.00","Select","Select",""],["","63304069205","CLINDAMYCIN ","150MG","28.00","Select","Select",""],["","13107000334","MIRTAZAPINE ","30MG","30.00","Select","Select",""],["","68546017060","AUSTEDO ","6MG","84.00","Select","Select",""],["","67253090110","ALPRAZOLAM ","0.5MG","90.00","Select","Select",""],["","16729014901","QUETIAPINE ","300MG","56.00","Select","Select",""],["","62756079713","DIVALPROEX ","250MG DR","60.00","Select","Select",""],["","70710113908","FLUCONAZOLE ","150MG","1.00","Select","Select",""],["","00054252625","LITHIUM ","150MG","40.00","Select","Select",""],["","00172392660","DIAZEPAM ","5MG","60.00","Select","Select",""],["","31722072250","LEVOFLOXACIN ","500MG","5.00","Select","Select",""],["","70436005801","BUPROPION ","100MG SR","56.00","Select","Select",""],["","00168025815","CLOTRIM\/BETA ","DIPROP","45.00","Select","Select",""],["","00168005415","NYSTATIN ","100000","30.00","Select","Select",""],["","59746000103","METHYLPRED ","4MG","21.00","Select","Select",""],["","68462034690","LEVOCETIRIZI ","5MG","30.00","Select","Select",""],["","67877021620","CEFUROXIME ","500MG","20.00","Select","Select",""],["","60505082901","FLUTICASONE ","50MCG","16.00","Select","Select",""],["","63304009819","SUMATRIPTAN ","50MG","12.00","Select","Select",""],["","70370108001","INGREZZA ","80MG","28.00","Select","Select",""],["","00603243721","BENZTROPINE ","0.5MG","60.00","Select","Select",""],["","69315090501","LORAZEPAM ","1MG","60.00","Select","Select",""],["","50111043301","TRAZODONE ","50MG","14.00","Select","Select",""],["","68462015813","ONDANSETRON ","8MG ODT","30.00","Select","Select",""],["","68180059306","DESVENLAFAX ","100MG ER","5.00","Select","Select",""],["","00115166001","PROPRANOLOL ","20MG","30.00","Select","Select",""],["","00006003330","BELSOMRA ","10MG","30.00","Select","Select",""],["","43598016630","OLANZAPINE ","10MG","28.00","Select","Select",""],["","53489011905","DOXYCYCL ","100MG","14.00","Select","Select",""],["","31722070530","VALACYCLOVIR ","1GM","21.00","Select","Select",""],["","00143992801","CIPROFLOXACN ","500MG","20.00","Select","Select",""],["","00054008525","ZALEPLON ","10MG","60.00","Select","Select",""],["","13668000801","ZOLPIDEM ","10MG","30.00","Select","Select",""],["","65862042001","SMZ\/TMP ","800-160","20.00","Select","Select",""],["","50383080116","PROMETHAZINE ","6.25\/5ML","105.00","Select","Select",""],["","00245531911","KLOR-CON ","20MEQ ER","90.00","Select","Select",""],["","00116200116","CHLORHEX ","0.12%","473.00","Select","Select",""],["","59310057922","PROAIR ","","8.50","Select","Select",""],["","47781035603","BUPREN\/NALOX ","4-1MG","18.00","Select","Select",""],["","68180065208","DOXYCYC ","100MG","20.00","Select","Select",""],["","00472024260","PERMETHRIN ","5%","120.00","Select","Select",""],["","00591352530","LIDOCAINE ","5%","30.00","Select","Select",""],["","00093540189","OMEGA-3-ACID ","1GM","120.00","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":""}]}]}