{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"VICKIE T BRANHAM","gend":1,"add":"13527 LEE JACKSON HWY","city":"BIG ISLAND","state":"VA","zip":"24526-9998","dob":"1967-08-09","age":"","mstatus":"","insh":"11013061","cliId":"","pno":4342996117,"cno":"","email":"","ename":"","eno":"","pphy":"GIANAKOS, DEAN G","ppno":4342005200,"pcpadd":"2323 Memorial AveSte 10","pcpcity":"Lynchburg","pcpstate":"VA","pcpzip":245012652,"pcpcounty":"","pcpid":"","pcpname":"BIG ISLAND FAMILY MEDICAL CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"","add3":"","madd1":"PO BOX 85","madd2":"","madd3":"","mcity":"BIG ISLAND","mstate":"VA","mzip":"24526-9998","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":[["","52817033200","CYCLOBENZAPR ","10MG","60.00","Select","Select",""],["","00406012505","HYDROCO\/APAP ","10-325MG","90.00","Select","Select",""],["","68180072003","AMLODIPINE ","5MG","90.00","Select","Select",""],["","10702005601","OXYCODONE ","10MG","120.00","Select","Select",""],["","60432026415","FLUTICASONE ","50MCG","16.00","Select","Select",""],["","65862078430","ESOMEPRA ","40MG DR","90.00","Select","Select",""],["","49483060450","IBUPROFEN ","800MG","90.00","Select","Select",""],["","00254302902","LUBIPROSTONE ","24MCG","60.00","Select","Select",""],["","00093742698","MONTELUKAST ","10MG","90.00","Select","Select",""],["","08290320109","BD  PEN NEEDL","31GX8MM","100.00","Select","Select",""],["","00781106110","ALPRAZOLAM ","0.25MG","2.00","Select","Select",""],["","16571020150","DICLOFENAC ","75MG DR","60.00","Select","Select",""],["","68382075810","METFORMIN ","500MG","90.00","Select","Select",""],["","69097084905","ESCITALOPRAM ","20MG","135.00","Select","Select",""],["","00093720198","PRAVASTATIN ","20MG","90.00","Select","Select",""],["","69547035302","NARCAN ","","2.00","Select","Select",""],["","00093100301","BUSPIRONE ","15MG","270.00","Select","Select",""],["","23155050105","HYDROXYZ ","25MG","60.00","Select","Select",""],["","59310057922","PROAIR ","","17.00","Select","Select",""],["","51862094205","DIAZEPAM ","5MG","2.00","Select","Select",""],["","70377002911","ATORVASTATIN ","40MG","90.00","Select","Select",""],["","65162010250","GABAPENTIN ","300MG","90.00","Select","Select",""],["","68180016013","AZITHROMYCIN ","250MG","6.00","Select","Select",""],["","00093314705","CEPHALEXIN ","500MG","30.00","Select","Select",""],["","00603459321","METHYLPRED ","4MG","21.00","Select","Select",""],["","63304069301","CLINDAMYCIN ","300MG","20.00","Select","Select",""],["","00093015001","APAP\/CODEINE ","300-30MG","6.00","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":""}]}]}