{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SHARON J MACALLISTER","gend":1,"add":"1187 ROLLER'S CHAPEL ROAD","city":"JONESVILLE","state":"VA","zip":"24263-7675","dob":"1977-01-10","age":"","mstatus":"","insh":"11017171","cliId":"","pno":2763467993,"cno":"","email":"","ename":"","eno":"","pphy":"COUCH, JILL","ppno":2765463001,"pcpadd":"185 REDWOOD AVE STE 102 ROOM 2037","pcpcity":"PENNINGTON GAP","pcpstate":"VA","pcpzip":242772599,"pcpcounty":"","pcpid":"","pcpname":"JONESVILLE FAMILY HEALTH CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"SOUTHWEST","aligned":"Y","ano":"","add2":"","add3":"","madd1":"1187 ROLLER'S CHAPEL ROAD","madd2":"","madd3":"","mcity":"JONESVILLE","mstate":"VA","mzip":"24263-7675","pcpfaxno":"(276) 546-9702","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":[["","12496120803","SUBOXONE ","8-2MG","21.00","Select","Select",""],["","00378641001","DOXEPIN ","100MG","30.00","Select","Select",""],["","59651000205","OMEPRAZOLE ","20MG","180.00","Select","Select",""],["","16714075801","ATOMOXETINE ","40MG","60.00","Select","Select",""],["","47781035703","BUPREN\/NALOX ","8-2MG","21.00","Select","Select",""],["","65862018730","ONDANSETRON ","4MG","30.00","Select","Select",""],["","16714087402","ATORVASTATIN ","10MG","30.00","Select","Select",""],["","43547040711","CLONAZEPAM ","1MG","60.00","Select","Select",""],["","70010010910","GABAPENTIN ","300MG","42.00","Select","Select",""],["","27241000150","RISPERIDONE ","1MG","60.00","Select","Select",""],["","16571020111","DICLOFENAC ","75MG DR","180.00","Select","Select",""],["","00378020810","FUROSEMIDE ","20MG","45.00","Select","Select",""],["","00555032302","HYDROXYZ ","25MG","120.00","Select","Select",""],["","00093406701","PRAZOSIN ","1MG","30.00","Select","Select",""],["","31722054501","LITHIUM ","300MG","60.00","Select","Select",""],["","16714085303","METOPROL ","50MG ER","180.00","Select","Select",""],["","23155010205","METFORMIN ","500MG","180.00","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":["",""],"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":""}]}]}