{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BILLY L COLLINS","gend":0,"add":"265 ZEPHYR DR","city":"JONESVILLE","state":"VA","zip":"24263-9998","dob":"1968-11-04","age":"","mstatus":"","insh":"11011790","cliId":"","pno":2764399611,"cno":2764399612,"email":"","ename":"","eno":"","pphy":"LITTON JR, JOHN S","ppno":2765464894,"pcpadd":"1800 Combs RdSte 7","pcpcity":"PENNINGTON GAP","pcpstate":"VA","pcpzip":242771808,"pcpcounty":"","pcpid":"","pcpname":"LITTON FAMILY MEDICINE PC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"SOUTHWEST","aligned":"Y","ano":"","add2":"","add3":"","madd1":"265 ZEPHYR DR","madd2":"","madd3":"","mcity":"JONESVILLE","mstate":"VA","mzip":"24263-9998","pcpfaxno":"(276) 546-4896","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":[["","00406802003","BUPREN\/NALOX ","8-2MG","14.00","Select","Select",""],["","49483060650","GABAPENTIN ","300MG","21.00","Select","Select",""],["","16729017317","AMITRIPTYLIN ","50MG","30.00","Select","Select",""],["","57237007630","ONDANSETRON ","8MG","30.00","Select","Select",""],["","00115169449","EPINEPHRINE ","0.3MG","2.00","Select","Select",""],["","62037099901","POT  CL MICRO","20MEQ ER","60.00","Select","Select",""],["","67877019810","AMLODIPINE ","5MG","30.00","Select","Select",""],["","29300016910","TIZANIDINE ","4MG","90.00","Select","Select",""],["","27241009990","DULOXETINE ","60MG","30.00","Select","Select",""],["","59746017310","PREDNISONE ","10MG","30.00","Select","Select",""],["","00173072020","FLOVENT ","220MCG","12.00","Select","Select",""],["","68180098103","LISINOPRIL ","20MG","180.00","Select","Select",""],["","00597007541","SPIRIVA ","HANDIHLR","90.00","Select","Select",""],["","60505257808","ATORVASTATIN ","10MG","30.00","Select","Select",""],["","00093317431","ALBUTEROL ","E","8.50","Select","Select",""],["","59310057922","PROAIR ","","8.50","Select","Select",""],["","00378043501","BUPROPION ","100MG","60.00","Select","Select",""],["","68001036206","CEFDINIR ","300MG","28.00","Select","Select",""],["","69315011710","FUROSEMIDE ","40MG","30.00","Select","Select",""],["","68462039710","OMEPRAZOLE ","40MG","30.00","Select","Select",""],["","23155050110","HYDROXYZ ","25MG","120.00","Select","Select",""],["","55111016330","OLANZAPINE ","2.5MG","30.00","Select","Select",""],["","59762330403","NITROGLYCERN ","0.4MG","100.00","Select","Select",""],["","65162083366","DICLOFENAC ","1%","100.00","Select","Select",""],["","00228299650","TAMSULOSIN ","0.4MG","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":["",""],"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":""}]}]}