{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LINDA H COOK","gend":1,"add":"1612 PICKETT STREET","city":"RADFORD","state":"VA","zip":"24141-9998","dob":"1952-10-22","age":"","mstatus":"","insh":"11007789","cliId":"","pno":5406292259,"cno":"","email":"","ename":"","eno":"","pphy":"BADILLO, LESLIE","ppno":5407317624,"pcpadd":"205 ROANOKE ST SUITE 801","pcpcity":"CHRISTIANSBURG","pcpstate":"VA","pcpzip":240733025,"pcpcounty":"","pcpid":"","pcpname":"CARILION FAMILY MEDICINE CHRISTIANBURG","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"APT 6","add3":"","madd1":"1612 PICKETT STREET","madd2":"APT 6","madd3":"","mcity":"RADFORD","mstate":"VA","mzip":"24141-9998","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":[["","68382052601","BUMETANIDE ","1MG","30.00","Select","Select",""],["","33342006015","CLOPIDOGREL ","75MG","90.00","Select","Select",""],["","55111015905","OMEPRAZOLE ","40MG","90.00","Select","Select",""],["","00185012201","NITROFURANTN ","100MG","20.00","Select","Select",""],["","64764008060","AMITIZA ","8MCG","60.00","Select","Select",""],["","47781065410","LEVOTHYROXIN ","112MCG","90.00","Select","Select",""],["","00093321205","CLONAZEPAM ","1MG","90.00","Select","Select",""],["","60505708002","FENTANYL ","12MCG\/HR","5.00","Select","Select",""],["","57237017190","ROSUVASTATIN ","40MG","90.00","Select","Select",""],["","67877022310","GABAPENTIN ","300MG","30.00","Select","Select",""],["","59651017701","DOXEPIN ","100MG","60.00","Select","Select",""],["","68180051703","LISINOPRIL ","40MG","90.00","Select","Select",""],["","31722070210","LOSARTAN ","100MG","30.00","Select","Select",""],["","33342002208","LEVOFLOXACIN ","500MG","10.00","Select","Select",""],["","55111012490","ATORVASTATIN ","80MG","90.00","Select","Select",""],["","65862007701","CIPROFLOXACN ","500MG","6.00","Select","Select",""],["","68180016013","AZITHROMYCIN ","250MG","6.00","Select","Select",""],["","67877021660","CEFUROXIME ","500MG","20.00","Select","Select",""],["","13107001901","HYDROCO\/APAP ","5-325MG","20.00","Select","Select",""],["","00603533932","PREDNISONE ","20MG","15.00","Select","Select",""],["","00054418425","DEXAMETHASON ","4MG","10.00","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":""}]}]}