{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JOSEPH E ROSE JR","gend":0,"add":"PO BOX 552","city":"PENNINGTON GAP","state":"VA","zip":"24277-0552","dob":"1972-10-02","age":"","mstatus":"","insh":"11009679","cliId":"","pno":2768321298,"cno":"","email":"","ename":"","eno":"","pphy":"YEARY, JOSHUA ADAM","ppno":2764454826,"pcpadd":"1446 Dr Thomas Walker Rd","pcpcity":"Ewing","pcpstate":"VA","pcpzip":242488307,"pcpcounty":"","pcpid":"","pcpname":"WESTERN LEE COUNTY HEALTH CLINIC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"SOUTHWEST","aligned":"Y","ano":"","add2":"","add3":"","madd1":"PO BOX 552","madd2":"","madd3":"","mcity":"PENNINGTON GAP","mstate":"VA","mzip":"24277-0552","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":[["","00093081301","NORTRIPTYLIN ","75MG","30.00","Select","Select",""],["","00003089421","ELIQUIS ","5MG","60.00","Select","Select",""],["","68645055254","LISINOPRIL ","10MG","30.00","Select","Select",""],["","65862062405","GEMFIBROZIL ","600MG","60.00","Select","Select",""],["","00832105415","BACLOFEN ","10MG","60.00","Select","Select",""],["","00054040013","DESVENLAFAX ","50MG ER","30.00","Select","Select",""],["","67877022310","GABAPENTIN ","300MG","180.00","Select","Select",""],["","00406012301","HYDROCO\/APAP ","5-325MG","120.00","Select","Select",""],["","59651000330","OMEPRAZOLE ","40MG","30.00","Select","Select",""],["","00093505898","ATORVASTATIN ","40MG","30.00","Select","Select",""],["","69547035302","NARCAN ","","2.00","Select","Select",""],["","00603548321","PROPRANOLOL ","20MG","180.00","Select","Select",""],["","00069046903","CHANTIX ","1MG","56.00","Select","Select",""],["","57237012401","WARFARIN ","5MG","30.00","Select","Select",""],["","68462063945","NITROGLYCERN ","0.4MG","25.00","Select","Select",""],["","68645014059","FAMOTIDINE ","20MG","90.00","Select","Select",""],["","59746017310","PREDNISONE ","10MG","24.00","Select","Select",""],["","65162018910","NAPROXEN ","375MG","14.00","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":""}]}]}