{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LINDA LAMM","gend":1,"add":"7264 SOUTH BARRENS RD APT 102","city":"ROANOKE","state":"VA","zip":"24019-9998","dob":"1962-03-31","age":"","mstatus":"","insh":"11007467","cliId":"","pno":5404006842,"cno":"","email":"","ename":"","eno":"","pphy":"BRACKENRICH, WAYNE L","ppno":5407267414,"pcpadd":"1314 Peters Creek Rd Nw Ste 14","pcpcity":"Roanoke","pcpstate":"VA","pcpzip":240172500,"pcpcounty":"","pcpid":"","pcpname":"CARILION FAMILY MEDICINE NORTH ROANOKE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"","add3":"","madd1":"7264 SOUTH BARRENS RD APT 102","madd2":"","madd3":"","mcity":"ROANOKE","mstate":"VA","mzip":"24019-9998","pcpfaxno":"(540) 265-5515","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":[["","00172208380","HYDROCHLOROT ","25MG","30.00","Select","Select",""],["","45802008801","ALBUTEROL ","HFA","8.50","Select","Select",""],["","42571025201","CLINDAMYCIN ","300MG","80.00","Select","Select",""],["","70377002811","ATORVASTATIN ","20MG","30.00","Select","Select",""],["","63402091130","BROVANA ","15MCG","120.00","Select","Select",""],["","33342004910","IRBESARTAN ","300MG","90.00","Select","Select",""],["","00006027731","JANUVIA ","100MG","30.00","Select","Select",""],["","65162017910","METFORMIN ","750MG ER","60.00","Select","Select",""],["","61442010201","DICLOFENAC ","50MG DR","30.00","Select","Select",""],["","59762501401","SPIRONO\/HCTZ ","25\/25","30.00","Select","Select",""],["","68382005105","MELOXICAM ","15MG","30.00","Select","Select",""],["","67877021620","CEFUROXIME ","500MG","20.00","Select","Select",""],["","00781185220","AMOX\/K ","875-125","20.00","Select","Select",""],["","65862064130","AZITHROMYCIN ","250MG","6.00","Select","Select",""],["","65862017601","PENICILLN ","500MG","40.00","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":""}]}]}