{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BRENDA RUSSELL","gend":1,"add":"922 ROCKLAND AVE NW","city":"ROANOKE","state":"VA","zip":"24012-9998","dob":"1954-03-26","age":"","mstatus":"","insh":"11014962","cliId":"","pno":5404922495,"cno":"","email":"","ename":"","eno":"","pphy":"VOEKLER, SUSANNE E","ppno":5409770900,"pcpadd":"4615 Huntridge Rd","pcpcity":"Roanoke","pcpstate":"VA","pcpzip":240128510,"pcpcounty":"","pcpid":"","pcpname":"LEWIS GALE PHYSICIANS LLC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"","add3":"","madd1":"922 ROCKLAND AVE NW","madd2":"","madd3":"","mcity":"ROANOKE","mstate":"VA","mzip":"24012-9998","pcpfaxno":"(540) 977-0550","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":[["","55111015810","OMEPRAZOLE ","20MG","30.00","Select","Select",""],["","70377000315","SIMVASTATIN ","20MG","30.00","Select","Select",""],["","70954006020","PREDNISONE ","20MG","4.00","Select","Select",""],["","10702001801","OXYCODONE ","5MG","20.00","Select","Select",""],["","67877012450","SILVER ","1%","50.00","Select","Select",""],["","68462012605","GABAPENTIN ","600MG","90.00","Select","Select",""],["","70010006305","METFORMIN ","500MG","40.00","Select","Select",""],["","65162083366","DICLOFENAC ","1%","500.00","Select","Select",""],["","00597002402","COMBIVENT ","20-100","4.00","Select","Select",""],["","00173085910","BREO ","100-25","60.00","Select","Select",""],["","29300012510","MELOXICAM ","15MG","30.00","Select","Select",""],["","00378827052","ALBUTEROL ","0.08%","225.00","Select","Select",""],["","68180016013","AZITHROMYCIN ","250MG","6.00","Select","Select",""],["","00597007541","SPIRIVA ","HANDIHLR","30.00","Select","Select",""],["","99073013001","FREESTYLE    MIS LANCETS","LANCETS","100.00","Select","Select",""],["","65862042005","SMZ\/TMP ","800-160","20.00","Select","Select",""],["","43547035211","LISINOPRIL ","5MG","90.00","Select","Select",""],["","65162052110","PROMETHAZINE ","25MG","30.00","Select","Select",""],["","69547035302","NARCAN ","","2.00","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":""}]}]}