{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"NAKISHA D JACKSON","gend":1,"add":"2310 SUMMERHILL AVE","city":"RICHMOND","state":"VA","zip":"23234-9998","dob":"1984-01-09","age":"","mstatus":"","insh":"11003095","cliId":"","pno":2024276727,"cno":2523789422,"email":"","ename":"","eno":"","pphy":"BROOKS-WILLIAMS, MALINDA","ppno":8047800840,"pcpadd":"4730 N Southside Plaza St","pcpcity":"Richmond","pcpstate":"VA","pcpzip":232241742,"pcpcounty":"","pcpid":"","pcpname":"NORTHSIDE MEDICAL CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"2310 SUMMERHILL AVE","madd2":"","madd3":"","mcity":"RICHMOND","mstate":"VA","mzip":"23234-9998","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":[["","65862092205","TRAMADL\/APAP ","37.5-325","20.00","Select","Select",""],["","65162062711","TRAMADOL ","50MG","15.00","Select","Select",""],["","69543038810","KETOROLAC ","10MG","20.00","Select","Select",""],["","13107003134","MIRTAZAPINE ","15MG","90.00","Select","Select",""],["","65862049101","QUETIAPINE ","100MG","30.00","Select","Select",""],["","27241009803","DULOXETINE ","30MG","30.00","Select","Select",""],["","00093117410","PENICILLN ","500MG","28.00","Select","Select",""],["","68462019005","NAPROXEN ","500MG","20.00","Select","Select",""],["","65162046510","IBUPROFEN ","600MG","40.00","Select","Select",""],["","53746010901","HYDROCO\/APAP ","5-325MG","12.00","Select","Select",""],["","00093310905","AMOXICILLIN ","500MG","20.00","Select","Select",""],["","50383077504","LIDOCAINE ","2% VISC","100.00","Select","Select",""],["","65862018501","CLINDAMYCIN ","150MG","30.00","Select","Select",""],["","69547035302","NARCAN ","","2.00","Select","Select",""],["","12496120803","SUBOXONE ","8-2MG","7.00","Select","Select",""],["","65862039110","ONDANSETRON ","8MG ODT","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":["",""]}},{"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":""}]}]}