{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"PHYLLIS M JACKSON","gend":1,"add":"2209 RUFFIN ROAD","city":"RICHMOND","state":"VA","zip":"23234-6557","dob":"1955-06-13","age":"","mstatus":"","insh":"11002076","cliId":"","pno":8049729369,"cno":8040467727,"email":"","ename":"","eno":"","pphy":"RYAN, MARK H","ppno":8042307777,"pcpadd":"401 N 11th St","pcpcity":"Richmond","pcpstate":"VA","pcpzip":232191901,"pcpcounty":"","pcpid":"","pcpname":"VCUHS HAYES E WILLIS HEALTH CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"APT A","add3":"","madd1":"2209 RUFFIN ROAD","madd2":"APT A","madd3":"","mcity":"RICHMOND","mstate":"VA","mzip":"23234-6557","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":[["","16729013401","ALLOPURINOL ","100MG","45.00","Select","Select",""],["","00378001805","METOPROL ","25MG","540.00","Select","Select",""],["","00406012305","HYDROCO\/APAP ","5-325MG","15.00","Select","Select",""],["","65162059606","ASA\/DIPYRIDA ","25-200MG","60.00","Select","Select",""],["","68180098103","LISINOPRIL ","20MG","90.00","Select","Select",""],["","65862085901","FAMOTIDINE ","20MG","90.00","Select","Select",""],["","00591544210","PREDNISONE ","10MG","21.00","Select","Select",""],["","59651000205","OMEPRAZOLE ","20MG","90.00","Select","Select",""],["","68462012605","GABAPENTIN ","600MG","135.00","Select","Select",""],["","00054429731","FUROSEMIDE ","20MG","90.00","Select","Select",""],["","55111012305","ATORVASTATIN ","40MG","90.00","Select","Select",""],["","13811071910","NITROFURANTN ","100MG","14.00","Select","Select",""],["","10702001150","HYDROXYZ ","25MG","60.00","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":""}]}]}