{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CORA B DRAPER","gend":1,"add":"1144 DRAPER ROAD","city":"BEDFORD","state":"VA","zip":"24523-4314","dob":"1963-09-22","age":"","mstatus":"","insh":"11009119","cliId":"","pno":5404921493,"cno":5408746166,"email":"","ename":"","eno":"","pphy":"COHEN, LEONARD J","ppno":5405866818,"pcpadd":"1615 Oakwood St","pcpcity":"BEDFORD","pcpstate":"VA","pcpzip":245231249,"pcpcounty":"","pcpid":"","pcpname":"BEDFORD COMMUNITY HEALTH CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"1613 OAKWWOD STREET PO BOX 688","add3":"","madd1":"1144 DRAPER ROAD","madd2":"","madd3":"","mcity":"BEDFORD","mstate":"VA","mzip":"24523-4314","pcpfaxno":"(434) 947-5971","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":[["","00378023101","ATENOLOL ","50MG","56.00","Select","Select",""],["","23155002506","BUSPIRONE ","15MG","84.00","Select","Select",""],["","00193731150","CONTOUR ","NEXT","50.00","Select","Select",""],["","61442010260","DICLOFENAC ","50MG DR","84.00","Select","Select",""],["","65862069790","VENLAFAXINE ","150MG ER","56.00","Select","Select",""],["","00169406012","VICTOZA ","18MG\/3ML","6.00","Select","Select",""],["","00168000616","TRIAMCINOLON ","0.10%","454.00","Select","Select",""],["","89158500500","CAREFINE ","32GX5MM","100.00","Select","Select",""],["","00169255013","TRESIBA ","200UNIT","9.00","Select","Select",""],["","68180046901","LOVASTATIN ","40MG","28.00","Select","Select",""],["","00310737020","BUDES\/FORMOT ","160-4.5","10.20","Select","Select",""],["","68180052001","LISINOP\/HCTZ ","20-25MG","28.00","Select","Select",""],["","52817021050","CYPROHEPTAD ","4MG","28.00","Select","Select",""],["","00093220301","METOCLOPRAM ","10MG","112.00","Select","Select",""],["","47335075349","LEVALBUTEROL ","1.25MG","360.00","Select","Select",""],["","60505082901","FLUTICASONE ","50MCG","16.00","Select","Select",""],["","69315013610","BENZTROPINE ","0.5MG","56.00","Select","Select",""],["","51991082001","PROPRANOLOL ","160MG ER","28.00","Select","Select",""],["","55111016730","OLANZAPINE ","15MG","28.00","Select","Select",""],["","68382041205","OMEPRAZOLE ","20MG","56.00","Select","Select",""],["","00093317431","ALBUTEROL ","E","8.50","Select","Select",""],["","14539067505","HYDROXYZ ","50MG","120.00","Select","Select",""],["","59762532001","PRAZOSIN ","2MG","56.00","Select","Select",""],["","23155010410","METFORMIN ","1000MG","56.00","Select","Select",""],["","43547035411","LISINOPRIL ","20MG","56.00","Select","Select",""],["","69315011610","FUROSEMIDE ","20MG","28.00","Select","Select",""],["","00173068220","VENTOLIN ","","18.00","Select","Select",""],["","61314054701","LATANOPROST ","0.01%","2.50","Select","Select",""],["","68180035306","SERTRALINE ","100MG","42.00","Select","Select",""],["","00006027731","JANUVIA ","100MG","28.00","Select","Select",""],["","60758080110","TIMOLOL ","0.5% OP","10.00","Select","Select",""],["","67877032105","IBUPROFEN ","800MG","90.00","Select","Select",""],["","53489011905","DOXYCYCL ","100MG","20.00","Select","Select",""],["","68180016106","AZITHROMYCIN ","500MG","7.00","Select","Select",""],["","68180065208","DOXYCYC ","100MG","20.00","Select","Select",""],["","69097094312","GABAPENTIN ","300MG","84.00","Select","Select",""],["","55111012390","ATORVASTATIN ","40MG","28.00","Select","Select",""],["","59310057922","PROAIR ","","8.50","Select","Select",""],["","59746017306","PREDNISONE ","10MG","20.00","Select","Select",""],["","70370204001","INGREZZA ","40MG","28.00","Select","Select",""],["","70710113908","FLUCONAZOLE ","150MG","1.00","Select","Select",""],["","65862001501","AMOXICILLIN ","875MG","20.00","Select","Select",""],["","65862050320","AMOX\/K ","875-125","20.00","Select","Select",""],["","00832105415","BACLOFEN ","10MG","90.00","Select","Select",""],["","08496320401","EASY ","32GX6MM","100.00","Select","Select",""],["","00186037020","SYMBICORT ","160-4.5","10.20","Select","Select",""],["","50383023310","DORZOL\/TIMOL ","22.3-6.8","10.00","Select","Select",""],["","50383090110","HC\/ACET ","OTIC","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":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"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":""}]}]}