{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BUFORD MARTIN","gend":0,"add":"3873 RAVENS NEST BR RD","city":"BANDY","state":"VA","zip":"24602-9998","dob":"1961-06-23","age":"","mstatus":"","insh":"11011375","cliId":"","pno":2769795543,"cno":"","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":"3873 RAVENS NEST BR RD","madd2":"","madd3":"","mcity":"BANDY","mstate":"VA","mzip":"24602-9998","pcpfaxno":"(276) 835-8577","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":[["","00591530710","PROMETHAZINE ","25MG","20.00","Select","Select",""],["","68382013210","TAMSULOSIN ","0.4MG","30.00","Select","Select",""],["","71093011105","GABAPENTIN ","600MG","90.00","Select","Select",""],["","42858000201","OXYCODONE ","10MG","90.00","Select","Select",""],["","68462043518","ACAMPRO ","333MG","180.00","Select","Select",""],["","70436001002","BUPROPN ","150MG XL","30.00","Select","Select",""],["","00173068220","VENTOLIN ","","18.00","Select","Select",""],["","57664047758","METOPROL ","50MG","180.00","Select","Select",""],["","68001033508","LISINOPRIL ","20MG","30.00","Select","Select",""],["","67877024210","QUETIAPINE ","25MG","90.00","Select","Select",""],["","68180096301","ALBUTEROL ","HFA","8.50","Select","Select",""],["","64380080707","IBUPROFEN ","800MG","70.00","Select","Select",""],["","60505025202","TIZANIDINE ","4MG","60.00","Select","Select",""],["","00378668910","PANTOPRAZOLE ","40MG","90.00","Select","Select",""],["","57237007530","ONDANSETRON ","4MG","30.00","Select","Select",""],["","49281063578","FLUZONE ","2021-22","1.00","Select","Select",""],["","68462018905","NAPROXEN ","375MG","60.00","Select","Select",""],["","59746017310","PREDNISONE ","10MG","21.00","Select","Select",""],["","59310057922","PROAIR ","","8.50","Select","Select",""],["","68001036103","MONTELUKAST ","10MG","30.00","Select","Select",""],["","00555015902","CHLORDIAZEP ","25MG","15.00","Select","Select",""],["","23155013525","DOXYCYC ","100MG","20.00","Select","Select",""],["","70461042010","FLUCLVX ","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":["",""],"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":""}]}]}