{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"GARMON C MULLINS","gend":0,"add":"189 DOLLY HOUSE LANE","city":"CLINCHCO","state":"VA","zip":"24226-8780","dob":"1979-08-28","age":"","mstatus":"","insh":"11008736","cliId":"","pno":2763950864,"cno":2762077176,"email":"","ename":"","eno":"","pphy":"ABROKWAH, JAMES","ppno":2768351122,"pcpadd":"163 Number Ten St","pcpcity":"Clinchco","pcpstate":"VA","pcpzip":242268694,"pcpcounty":"","pcpid":"","pcpname":"FULL CARE MEDICAL CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"SOUTHWEST","aligned":"Y","ano":"","add2":"","add3":"","madd1":"189 DOLLY HOUSE LANE","madd2":"","madd3":"","mcity":"CLINCHCO","mstate":"VA","mzip":"24226-8780","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":[["","50458057830","XARELTO ","15MG","30.00","Select","Select",""],["","29300011316","LAMOTRIGINE ","150MG","30.00","Select","Select",""],["","33342006015","CLOPIDOGREL ","75MG","30.00","Select","Select",""],["","52817032000","BACLOFEN ","10MG","60.00","Select","Select",""],["","31722071390","PANTOPRAZOLE ","40MG","60.00","Select","Select",""],["","00173068220","VENTOLIN ","","18.00","Select","Select",""],["","27808003702","HYDROCO\/APAP ","10-325MG","120.00","Select","Select",""],["","24979002702","DILTIAZEM ","180MG ER","30.00","Select","Select",""],["","00487020103","IPRATROPIUM\/ ","ALBUTER","180.00","Select","Select",""],["","50742026003","NIFEDIPINE ","30MG ER","30.00","Select","Select",""],["","00173085910","BREO ","100-25","60.00","Select","Select",""],["","63304044990","FENOFIBRATE ","145MG","90.00","Select","Select",""],["","00093221098","SUCRALFATE ","1GM","60.00","Select","Select",""],["","71093015606","ZOLPIDEM ","10MG","15.00","Select","Select",""],["","55111018010","TIZANIDINE ","4MG","90.00","Select","Select",""],["","00378064110","PREDNISONE ","10MG","20.00","Select","Select",""],["","00093317431","ALBUTEROL ","E","8.50","Select","Select",""],["","67405055005","DOXYCYCL ","100MG","20.00","Select","Select",""],["","67877026410","DULOXETINE ","30MG","30.00","Select","Select",""],["","67877042805","GABAPENTIN ","600MG","90.00","Select","Select",""],["","59310057922","PROAIR ","","8.50","Select","Select",""],["","43547035611","LISINOPRIL ","40MG","90.00","Select","Select",""],["","60505267108","ATORVASTATIN ","80MG","90.00","Select","Select",""],["","43547022406","LEVETIRACETA ","1000MG","60.00","Select","Select",""],["","00093206406","CILOSTAZOL ","100MG","180.00","Select","Select",""],["","00054023525","MORPHINE ","15MG","20.00","Select","Select",""],["","00069046903","CHANTIX ","1MG","56.00","Select","Select",""],["","42571016142","AMOX\/K ","500-125","20.00","Select","Select",""],["","67877021905","CEPHALEXIN ","500MG","21.00","Select","Select",""],["","68180071160","CEFDINIR ","300MG","20.00","Select","Select",""],["","57237023305","SMZ-TMP ","800-160","20.00","Select","Select",""],["","00093172110","WARFARIN ","5MG","60.00","Select","Select",""],["","19515089711","FLULAVAL ","2019-20","0.50","Select","Select",""],["","29033000201","THEOPHYLLINE ","600MG ER","30.00","Select","Select",""],["","33332042010","AFLURIA ","2020-21","0.50","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":""}]}]}