{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BRENDA B ROYAL","gend":1,"add":"28 MILLER LANE","city":"SWORDS CREEK","state":"VA","zip":"24649-9998","dob":"1955-04-22","age":"","mstatus":"","insh":"11016268","cliId":"","pno":2769910401,"cno":"","email":"","ename":"","eno":"","pphy":"ABDUL JAWAD, SAMI S","ppno":5406895600,"pcpadd":"6801 Governor Gc Peery Hwy","pcpcity":"Richlands","pcpstate":"VA","pcpzip":246412194,"pcpcounty":"","pcpid":"","pcpname":"CLINCH PROFESSIONAL PHYSICIAN SERVICES LLC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"SOUTHWEST","aligned":"Y","ano":"","add2":"","add3":"","madd1":"PO BOX 205","madd2":"","madd3":"","mcity":"SWORDS CREEK","mstate":"VA","mzip":"24649-9998","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":[["","68001015103","CARVEDILOL ","12.5MG","60.00","Select","Select",""],["","56151014201","TRUEDRAW ","LANC DEV","1.00","Select","Select",""],["","45802046564","KETOCONAZOLE ","2%","120.00","Select","Select",""],["","64764017530","DEXILANT ","60MG DR","90.00","Select","Select",""],["","00713067831","NYSTATIN ","100000","30.00","Select","Select",""],["","68001033508","LISINOPRIL ","20MG","30.00","Select","Select",""],["","69097082112","GEMFIBROZIL ","600MG","46.00","Select","Select",""],["","56151014401","TRUPLUS ","30G","100.00","Select","Select",""],["","00093720210","PRAVASTATIN ","40MG","30.00","Select","Select",""],["","59310057922","PROAIR ","","8.50","Select","Select",""],["","00193731025","CONTOUR ","NEXT","100.00","Select","Select",""],["","57237007630","ONDANSETRON ","8MG","21.00","Select","Select",""],["","16729018317","HYDROCHLOROT ","25MG","30.00","Select","Select",""],["","65862053820","LEVOFLOXACIN ","750MG","7.00","Select","Select",""],["","68001000501","METHYLPRED ","4MG","21.00","Select","Select",""],["","62559049010","DIPHEN\/ATROP ","2.5MG","20.00","Select","Select",""],["","68001044503","POT  CHLORIDE","20MEQ ER","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":["",""],"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":""}]}]}