{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BRENDA K TYLER","gend":1,"add":"1037 GREYSTONE AVENUE","city":"RICHMOND","state":"VA","zip":"23224-3317","dob":"1956-09-11","age":"","mstatus":"","insh":"11001612","cliId":"","pno":8045364965,"cno":"","email":"","ename":"","eno":"","pphy":"PAUL, CHRISTINE E","ppno":8047691245,"pcpadd":"4730 N Southside Plaza St","pcpcity":"Richmond","pcpstate":"VA","pcpzip":232241742,"pcpcounty":"","pcpid":"","pcpname":"VCUHS HAYES E WILLIS HEALTH CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"1037 GREYSTONE AVENUE","madd2":"","madd3":"","mcity":"RICHMOND","mstate":"VA","mzip":"23224-3317","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":[["","65862056099","PANTOPRAZOLE ","40MG","60.00","Select","Select",""],["","59310057922","PROAIR ","","8.50","Select","Select",""],["","60505082901","FLUTICASONE ","50MCG","16.00","Select","Select",""],["","23155010210","METFORMIN ","500MG","30.00","Select","Select",""],["","00378214605","SPIRONOLACT ","25MG","60.00","Select","Select",""],["","00378181510","LEVOTHYROXIN ","150MCG","30.00","Select","Select",""],["","00093720210","PRAVASTATIN ","40MG","30.00","Select","Select",""],["","67877022301","GABAPENTIN ","300MG","90.00","Select","Select",""],["","66993058597","FLUTIC\/SALME ","250\/50","60.00","Select","Select",""],["","45802046564","KETOCONAZOLE ","2%","120.00","Select","Select",""],["","68180035202","SERTRALINE ","50MG","30.00","Select","Select",""],["","62559043001","HYDROCORT ","1%","28.40","Select","Select",""],["","00597007541","SPIRIVA ","HANDIHLR","30.00","Select","Select",""],["","00591363630","TROSPIUM ","60MG ER","30.00","Select","Select",""],["","50111033401","METRONIDAZOL ","500MG","42.00","Select","Select",""],["","65862085901","FAMOTIDINE ","20MG","60.00","Select","Select",""],["","23155050001","HYDROXYZ ","10MG","60.00","Select","Select",""],["","65862022660","CLARITHROMYC ","500MG","14.00","Select","Select",""],["","00054429931","FUROSEMIDE ","40MG","60.00","Select","Select",""],["","49502010202","EPINEPHRINE ","0.3MG","2.00","Select","Select",""],["","99073070827","FREESTYLE    TES LITE","LITE","100.00","Select","Select",""],["","00173069600","ADVAIR ","250\/50","60.00","Select","Select",""],["","00168000415","TRIAMCINOLON ","0.10%","60.00","Select","Select",""],["","99073013001","FREESTYLE    MIS LANCETS","LANCETS","100.00","Select","Select",""],["","64980032430","PROCTOZONE ","-HC 2.5%","30.00","Select","Select",""],["","99073070805","FREESTYLE    MIS LITE","LITE","1.00","Select","Select",""],["","62175044601","PEG ","ELECTROL","4,000.00","Select","Select",""],["","64980051505","OFLOXACIN ","0.3% OP","5.00","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":""}]}]}