{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CYNTHIA L PHILLIPS","gend":1,"add":"616 JONESTOWN RD","city":"COVINGTON","state":"VA","zip":"24426-9998","dob":"1976-09-13","age":"","mstatus":"","insh":"11014116","cliId":"","pno":5409585103,"cno":5407472267,"email":"","ename":"","eno":"","pphy":"HENDERSON, ROBERT J","ppno":5408626659,"pcpadd":"2145 Mount Pleasant Blvd SE","pcpcity":"Roanoke","pcpstate":"VA","pcpzip":240143632,"pcpcounty":"","pcpid":"","pcpname":"PATRICIA W HENDERSON DO","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"","add3":"","madd1":"616 JONESTOWN RD","madd2":"","madd3":"","mcity":"COVINGTON","mstate":"VA","mzip":"24426-9998","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":[["","00173069500","ADVAIR ","100\/50","60.00","Select","Select",""],["","68180051201","LISINOPRIL ","2.5MG","30.00","Select","Select",""],["","67877032105","IBUPROFEN ","800MG","15.00","Select","Select",""],["","70954006020","PREDNISONE ","20MG","15.00","Select","Select",""],["","69097094312","GABAPENTIN ","300MG","90.00","Select","Select",""],["","00093083205","CLONAZEPAM ","0.5MG","60.00","Select","Select",""],["","68180071160","CEFDINIR ","300MG","14.00","Select","Select",""],["","00173088710","TRELEGY ","ELLIPTA","60.00","Select","Select",""],["","16729017001","ESCITALOPRAM ","20MG","90.00","Select","Select",""],["","27241011703","FENOFIBRATE ","160MG","90.00","Select","Select",""],["","68382076010","METFORMIN ","1000MG","180.00","Select","Select",""],["","00093768432","OLOPATADINE ","0.20%","2.50","Select","Select",""],["","55111015810","OMEPRAZOLE ","20MG","90.00","Select","Select",""],["","10702000710","CYCLOBENZAPR ","10MG","20.00","Select","Select",""],["","65862042005","SMZ\/TMP ","800-160","14.00","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":["",""],"sub":{"indx":[["","",""],[""],[""],[""],[""]],"comment":[["","",""],[""],[""],[""],[""]],"sub":[]}}},{"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":""}]}]}