{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TREVA D PHILLIPS","gend":1,"add":"1088 PETERS CREEK DRIVE","city":"STUART","state":"VA","zip":"24171-9998","dob":"1946-09-25","age":"","mstatus":"","insh":"11014371","cliId":"","pno":2766943525,"cno":"","email":"","ename":"","eno":"","pphy":"COLE, RICHARD C","ppno":2766944466,"pcpadd":"18877 JEB STUART HWY","pcpcity":"STUART","pcpstate":"VA","pcpzip":241711019,"pcpcounty":"","pcpid":"","pcpname":"PATRICK COUNTY FAMILY PRACTICE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"","add3":"","madd1":"1088 PETERS CREEK DRIVE","madd2":"","madd3":"","mcity":"STUART","mstate":"VA","mzip":"24171-9998","pcpfaxno":"(276) 694-2909","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":[["","00378020810","FUROSEMIDE ","20MG","90.00","Select","Select",""],["","00378064010","PREDNISONE ","5MG","30.00","Select","Select",""],["","00310737020","BUDES\/FORMOT ","160-4.5","30.60","Select","Select",""],["","68180098003","LISINOPRIL ","10MG","90.00","Select","Select",""],["","00121087316","LACTULOSE ","10GM\/15","600.00","Select","Select",""],["","00054327099","FLUTICASONE ","50MCG","48.00","Select","Select",""],["","00186077660","BRILINTA ","60MG","180.00","Select","Select",""],["","50111064801","FLUOXETINE ","20MG","90.00","Select","Select",""],["","00378967130","IPRATROPIUM\/ ","ALBUTER","360.00","Select","Select",""],["","60505095303","AZEL\/FLUTIC ","137-50","23.00","Select","Select",""],["","65862057490","MONTELUKAST ","10MG","90.00","Select","Select",""],["","65862053750","LEVOFLOXACIN ","500MG","7.00","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":""}]}]}