{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BRENDA ARMSTRONG","gend":1,"add":"PO BOX 1719","city":"CLINTWOOD","state":"VA","zip":"24228-1719","dob":"1950-12-21","age":"","mstatus":"","insh":"11010564","cliId":"","pno":2769262744,"cno":"","email":"","ename":"","eno":"","pphy":"DEEL, ROY R","ppno":2769260200,"pcpadd":"364 Hospital Dr","pcpcity":"Clintwood","pcpstate":"VA","pcpzip":242286786,"pcpcounty":"","pcpid":"","pcpname":"DICKENSON MEDICAL ASSOCIATES","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"SOUTHWEST","aligned":"Y","ano":"","add2":"","add3":"","madd1":"PO BOX 1719","madd2":"","madd3":"","mcity":"CLINTWOOD","mstate":"VA","mzip":"24228-1719","pcpfaxno":"(276) 926-6675","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":[["","60505024808","MIRTAZAPINE ","30MG","90.00","Select","Select",""],["","00713067831","NYSTATIN ","100000","30.00","Select","Select",""],["","00054327099","FLUTICASONE ","50MCG","16.00","Select","Select",""],["","27808003702","HYDROCO\/APAP ","10-325MG","90.00","Select","Select",""],["","62037056005","POT  CHLORIDE","10MEQ ER","90.00","Select","Select",""],["","70700026305","LANSOPRAZOLE ","30MG DR","90.00","Select","Select",""],["","16729003410","LETROZOLE ","2.5MG","90.00","Select","Select",""],["","50383026505","LOTEPREDNOL ","0.50%","5.00","Select","Select",""],["","33342002208","LEVOFLOXACIN ","500MG","7.00","Select","Select",""],["","50228043605","NAPROXEN ","500MG","14.00","Select","Select",""],["","51672129802","KETOCONAZOLE ","2%","30.00","Select","Select",""],["","13668010401","ISOSORB ","30MG ER","90.00","Select","Select",""],["","45802008801","ALBUTEROL ","HFA","25.50","Select","Select",""],["","70069005101","DORZOL\/TIMOL ","22.3-6.8","10.00","Select","Select",""],["","24208046325","LATANOPROST ","0.01%","2.50","Select","Select",""],["","62175089143","ATORVASTATIN ","20MG","90.00","Select","Select",""],["","57841130101","MOVANTIK ","25MG","30.00","Select","Select",""],["","59310057922","PROAIR ","","25.50","Select","Select",""],["","57237007710","ONDANSETRON ","4MG ODT","60.00","Select","Select",""],["","42571016242","AMOX\/K ","875-125","20.00","Select","Select",""],["","00456120330","LINZESS ","72MCG","30.00","Select","Select",""],["","50742061710","METOPROL ","100MG ER","90.00","Select","Select",""],["","70710113801","FLUCONAZOLE ","100MG","7.00","Select","Select",""],["","33332042010","AFLURIA ","2020-21","0.50","Select","Select",""],["","66993096045","METRONIDAZOL ","0.75%","45.00","Select","Select",""],["","67877021905","CEPHALEXIN ","500MG","20.00","Select","Select",""],["","70194000330","TRULANCE ","3MG","30.00","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":""}]}]}