{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ANDREA L RAETHER","gend":1,"add":"718 BLUE RIDGE AVE APT N140","city":"BEDFORD","state":"VA","zip":"24523-9998","dob":"1962-05-09","age":"","mstatus":"","insh":"11016405","cliId":"","pno":4344390537,"cno":5405105056,"email":"","ename":"","eno":"","pphy":"ANDERSON, ANDREW J","ppno":7578752009,"pcpadd":"20304 TIMBERLAKE ROAD","pcpcity":"LYNCHBURG","pcpstate":"VA","pcpzip":245027222,"pcpcounty":"","pcpid":"","pcpname":"CENTRA MEDICAL GROUP","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"","add3":"","madd1":"718 BLUE RIDGE AVE APT N140","madd2":"","madd3":"","mcity":"BEDFORD","mstate":"VA","mzip":"24523-9998","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":[["","00093005805","TRAMADOL ","50MG","240.00","Select","Select",""],["","45802046564","KETOCONAZOLE ","2%","120.00","Select","Select",""],["","00832105410","BACLOFEN ","10MG","180.00","Select","Select",""],["","00527150537","AMPHET\/DEXTR ","20MG","180.00","Select","Select",""],["","70710123001","AMITRIPTYLIN ","150MG","90.00","Select","Select",""],["","45802002146","BETAMETH ","0.05%","60.00","Select","Select",""],["","43598029490","PREGABALIN ","100MG","60.00","Select","Select",""],["","65162052110","PROMETHAZINE ","25MG","60.00","Select","Select",""],["","45802012801","CLINDAMYCIN ","1%","60.00","Select","Select",""],["","33342032980","TRIAMCINOLON ","0.10%","80.00","Select","Select",""],["","60505036302","OFLOXACIN ","0.3%OTIC","10.00","Select","Select",""],["","69097052444","DICLOFENAC ","1%","100.00","Select","Select",""],["","00143122701","DICYCLOMINE ","20MG","360.00","Select","Select",""],["","50111033401","METRONIDAZOL ","500MG","14.00","Select","Select",""],["","65862001501","AMOXICILLIN ","875MG","20.00","Select","Select",""],["","00378064205","PREDNISONE ","20MG","14.00","Select","Select",""],["","68180065208","DOXYCYC ","100MG","30.00","Select","Select",""],["","31722070430","VALACYCLOVIR ","500MG","60.00","Select","Select",""],["","42799080601","IVERMECTIN ","3MG","12.00","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":""}]}]}