{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JUDITH E MELKI","gend":1,"add":"3317 VALLEY VIEW AVENVE","city":"ROANOKE","state":"VA","zip":"24012-9998","dob":"1945-02-19","age":"","mstatus":"","insh":"11008381","cliId":"","pno":5403665882,"cno":"","email":"","ename":"","eno":"","pphy":"MAZEN MADHOUN MD LLC","ppno":5403975319,"pcpadd":"6002 Winnbrook Ln","pcpcity":"Roanoke","pcpstate":"VA","pcpzip":240187907,"pcpcounty":"","pcpid":"","pcpname":"SPRINGTREE HEALTH AND REHAB CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"","add3":"","madd1":"3317 VALLEY VIEW AVENVE","madd2":"","madd3":"","mcity":"ROANOKE","mstate":"VA","mzip":"24012-9998","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":[["","00574402435","ERYTHROMYCIN ","5MG\/GM","3.50","Select","Select",""],["","13668044201","CELECOXIB ","200MG","90.00","Select","Select",""],["","55111064505","OMEPRAZOLE ","40MG","30.00","Select","Select",""],["","57237007710","ONDANSETRON ","4MG ODT","10.00","Select","Select",""],["","68180035206","SERTRALINE ","50MG","30.00","Select","Select",""],["","65162019010","NAPROXEN ","500MG","30.00","Select","Select",""],["","29300012501","MELOXICAM ","15MG","30.00","Select","Select",""],["","69097022316","ALENDRONATE ","35MG","12.00","Select","Select",""],["","61442010201","DICLOFENAC ","50MG DR","20.00","Select","Select",""],["","13668013601","ESCITALOPRAM ","10MG","30.00","Select","Select",""],["","00093314705","CEPHALEXIN ","500MG","28.00","Select","Select",""],["","00115180301","HYDROXYZ ","25MG","112.00","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":""}]}]}