{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JOAN E UNDERWOOD","gend":1,"add":"1622 GILMER AVENUE NW","city":"ROANOKE","state":"VA","zip":"24017-9998","dob":"1951-07-29","age":"","mstatus":"","insh":"11010657","cliId":"","pno":5615061541,"cno":"","email":"","ename":"","eno":"","pphy":"NAZLI, AYESHA","ppno":5403620360,"pcpadd":"3716 Melrose Ave NW","pcpcity":"Roanoke","pcpstate":"VA","pcpzip":240172716,"pcpcounty":"","pcpid":"","pcpname":"NEW HORIZONS HEALTH CARE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"","add3":"","madd1":"1622 GILMER AVENUE NW","madd2":"","madd3":"","mcity":"ROANOKE","mstate":"VA","mzip":"24017-9998","pcpfaxno":"(540) 366-5590","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":[["","59310057922","PROAIR ","","8.50","Select","Select",""],["","00173088710","TRELEGY ","ELLIPTA","60.00","Select","Select",""],["","00093317431","ALBUTEROL ","E","25.50","Select","Select",""],["","70377002711","ATORVASTATIN ","10MG","90.00","Select","Select",""],["","00054327099","FLUTICASONE ","50MCG","16.00","Select","Select",""],["","49281012165","FLUZONE ","2021-22","0.70","Select","Select",""],["","50242021501","XOLAIR ","150MG\/ML","2.00","Select","Select",""],["","00093598627","EPINEPHRINE ","0.3MG","2.00","Select","Select",""],["","00378064110","PREDNISONE ","10MG","30.00","Select","Select",""],["","68180012202","CEPHALEXIN ","500MG","28.00","Select","Select",""],["","68180065208","DOXYCYC ","100MG","14.00","Select","Select",""],["","65862018601","CLINDAMYCIN ","300MG","40.00","Select","Select",""],["","65862042005","SMZ\/TMP ","800-160","28.00","Select","Select",""],["","42858010201","OXYCOD\/APAP ","5-325MG","40.00","Select","Select",""],["","49502050002","EPIPEN ","0.3MG","2.00","Select","Select",""],["","24658031205","DOXYCYCL ","100MG","20.00","Select","Select",""],["","65862032904","ALENDRONATE ","70MG","12.00","Select","Select",""],["","65862053750","LEVOFLOXACIN ","500MG","6.00","Select","Select",""],["","69238126601","OSELTAMIVIR ","75MG","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":""}]}]}