{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JOSHUA BRINKLEY","gend":0,"add":"517 MONTGOMERY KNOB RD","city":"COVINGTON","state":"VA","zip":"24426-9998","dob":"1981-09-26","age":"","mstatus":"","insh":"11014705","cliId":"","pno":5409588389,"cno":5406913264,"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":"517 MONTGOMERY KNOB 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":[["","50111078751","AZITHROMYCIN ","250MG","6.00","Select","Select",""],["","29300014001","DIVALPROEX ","500MG DR","60.00","Select","Select",""],["","16729017317","AMITRIPTYLIN ","50MG","30.00","Select","Select",""],["","50458056301","INVEGA ","156MG\/ML","1.00","Select","Select",""],["","57237007710","ONDANSETRON ","4MG ODT","15.00","Select","Select",""],["","00378130001","LITHIUM ","300MG ER","60.00","Select","Select",""],["","23155022701","ACYCLOVIR ","400MG","30.00","Select","Select",""],["","59746017509","PREDNISONE ","20MG","15.00","Select","Select",""],["","66993068030","OLANZAPINE ","2.5MG","30.00","Select","Select",""],["","23155002405","BUSPIRONE ","10MG","90.00","Select","Select",""],["","42858000201","OXYCODONE ","10MG","28.00","Select","Select",""],["","16714008310","HYDROXYZ ","50MG","20.00","Select","Select",""],["","69547035302","NARCAN ","","2.00","Select","Select",""],["","00406117003","NALTREXONE ","50MG","30.00","Select","Select",""],["","10702000709","CYCLOBENZAPR ","10MG","20.00","Select","Select",""],["","31722053301","METHOCARBAM ","500MG","120.00","Select","Select",""],["","65862031560","LEVETIRACETA ","1000MG","60.00","Select","Select",""],["","65162083366","DICLOFENAC ","1%","100.00","Select","Select",""],["","16714086701","PALIPERIDONE ","ER 3MG","30.00","Select","Select",""],["","65162019011","NAPROXEN ","500MG","14.00","Select","Select",""],["","69238153205","CLOBETASOL ","0.05%","15.00","Select","Select",""],["","50228018005","GABAPENTIN ","300MG","90.00","Select","Select",""],["","33342002332","LEVOFLOXACIN ","750MG","1.00","Select","Select",""],["","42806033901","AMPHET\/DEXTR ","5MG","15.00","Select","Select",""],["","50383077504","LIDOCAINE ","2% VISC","100.00","Select","Select",""],["","59310057922","PROAIR ","","8.50","Select","Select",""],["","68180096301","ALBUTEROL ","HFA","8.50","Select","Select",""],["","00003089421","ELIQUIS ","5MG","60.00","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":["",""]}},{"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":""}]}]}