{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"EUGENE SHAKESPEAR","gend":0,"add":"1804 N 29TH ST","city":"RICHMOND","state":"VA","zip":"23223-9998","dob":"1953-04-14","age":"","mstatus":"","insh":"11007282","cliId":"","pno":8045027122,"cno":8045199307,"email":"","ename":"","eno":"","pphy":"AYALA-SIMS, VERONICA A","ppno":8047800840,"pcpadd":"1300 E MARSHALL STREET","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":232985054,"pcpcounty":"","pcpid":"","pcpname":"GLENWOOD MEDICAL CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"1804 N 29TH ST","madd2":"","madd3":"","mcity":"RICHMOND","mstate":"VA","mzip":"23223-9998","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":[["","65162025410","RANITIDINE ","300MG","90.00","Select","Select",""],["","16729000615","SIMVASTATIN ","40MG","90.00","Select","Select",""],["","00591554401","ALLOPURINOL ","300MG","90.00","Select","Select",""],["","29300017216","MEMANTINE ","HCL 10MG","60.00","Select","Select",""],["","69097083312","SERTRALINE ","25MG","90.00","Select","Select",""],["","00173068220","VENTOLIN ","","18.00","Select","Select",""],["","00173086910","ANORO ","62.5-25","180.00","Select","Select",""],["","00254200801","COLCHICINE ","0.6MG","90.00","Select","Select",""],["","59310057922","PROAIR ","","8.50","Select","Select",""],["","59746000103","METHYLPRED ","4MG","21.00","Select","Select",""],["","43547027609","DONEPEZIL ","10MG","90.00","Select","Select",""],["","00093031101","LOPERAMIDE ","2MG","20.00","Select","Select",""],["","68462040601","INDOMETHACIN ","25MG","30.00","Select","Select",""],["","00054001825","PREDNISONE ","20MG","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":["",""],"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":""}]}]}