{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"WILLIE H GREENE","gend":0,"add":"600 COWARDIN AVENUE","city":"RICHMOND","state":"VA","zip":"23224-2087","dob":"1945-02-08","age":"","mstatus":"","insh":"11002126","cliId":"","pno":8045029702,"cno":"","email":"","ename":"","eno":"","pphy":"DICKERSON, TASHA B","ppno":8042257177,"pcpadd":"304 E LEIGH ST","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":232191410,"pcpcounty":"","pcpid":"","pcpname":"DOMINION MEDICAL ASSOCIATES","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"APT 312","add3":"","madd1":"600 COWARDIN AVENUE","madd2":"APT 312","madd3":"","mcity":"RICHMOND","mstate":"VA","mzip":"23224-2087","pcpfaxno":"(804) 237-0362","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":[["","00093314705","CEPHALEXIN ","500MG","14.00","Select","Select",""],["","00143980305","DOXYCYCL ","100MG","14.00","Select","Select",""],["","68462019005","NAPROXEN ","500MG","60.00","Select","Select",""],["","55111012205","ATORVASTATIN ","20MG","90.00","Select","Select",""],["","00591544305","PREDNISONE ","20MG","15.00","Select","Select",""],["","69097040707","METOPROL ","50MG ER","90.00","Select","Select",""],["","60505082901","FLUTICASONE ","50MCG","16.00","Select","Select",""],["","70010077001","METHOCARBAM ","750MG","60.00","Select","Select",""],["","65162062711","TRAMADOL ","50MG","28.00","Select","Select",""],["","13668010401","ISOSORB ","30MG ER","30.00","Select","Select",""],["","50742062201","NIFEDIPINE ","90MG ER","90.00","Select","Select",""],["","65162010250","GABAPENTIN ","300MG","90.00","Select","Select",""],["","65862018601","CLINDAMYCIN ","300MG","30.00","Select","Select",""],["","45963067611","METOPROLOL ","50MG ER","90.00","Select","Select",""],["","52817033200","CYCLOBENZAPR ","10MG","15.00","Select","Select",""],["","68682036990","DILTIAZEM ","240MG\/24","90.00","Select","Select",""],["","70010049105","METFORMIN ","ORAL TAB","30.00","Select","Select",""],["","49281040565","FLUZONE ","PF 19-20","0.50","Select","Select",""],["","58160082311","SHINGRIX ","50\/0.5ML","1.00","Select","Select",""],["","29300012410","MELOXICAM ","7.5MG","30.00","Select","Select",""],["","70461012103","FLUAD ","2021-22","0.50","Select","Select",""],["","24208029510","TOBRA\/DEXAME ","0.3-0.1%","10.00","Select","Select",""],["","62037059990","CARTIA ","240\/24HR","90.00","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":""}]}]}