{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"HEZEKI O WARREN","gend":0,"add":"1831 CLIFFBROOK LANE","city":"RICHMOND","state":"VA","zip":"23227-2433","dob":"2004-03-02","age":"","mstatus":"","insh":"11007295","cliId":"","pno":8049373701,"cno":"","email":"","ename":"","eno":"","pphy":"MCKENNA, SEAN","ppno":8048289300,"pcpadd":"1005 E MARSHALL STREET","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":232980001,"pcpcounty":"","pcpid":"","pcpname":"THE CHILDRENS PAVILION OF VCUHS","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"APT L","add3":"","madd1":"1831 CLIFFBROOK LANE","madd2":"APT L","madd3":"","mcity":"RICHMOND","mstate":"VA","mzip":"23227-2433","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":[["","00781210301","TACROLIMUS ","1MG","270.00","Select","Select",""],["","16729031901","OXYBUTYNIN ","15MG ER","30.00","Select","Select",""],["","00591505210","PREDNISONE ","5MG","30.00","Select","Select",""],["","00781517501","MYCOPHENOLAT ","500MG","120.00","Select","Select",""],["","60505082901","FLUTICASONE ","50MCG","16.00","Select","Select",""],["","57599000101","FREESTYLE    KIT SENSOR","SENSOR","2.00","Select","Select",""],["","64980043810","ATENOLOL ","50MG","60.00","Select","Select",""],["","00088221905","LANTUS ","100\/ML","15.00","Select","Select",""],["","68180072003","AMLODIPINE ","5MG","90.00","Select","Select",""],["","45802073684","CLINDAMY\/BEN ","1.2-5%","45.00","Select","Select",""],["","00169633910","NOVOLOG ","FLEXPEN","15.00","Select","Select",""],["","08290320122","BD  PEN NEEDL","32GX4MM","300.00","Select","Select",""],["","00193731221","CONTOUR ","NEXT","200.00","Select","Select",""],["","57599000200","FREESTYLE    MIS READER","READER","1.00","Select","Select",""],["","00169266015","TRESIBA ","100UNIT","3.00","Select","Select",""],["","08627005303","DEXCOM ","SENSOR","3.00","Select","Select",""],["","73070010315","INSULIN ","FLEXPEN","45.00","Select","Select",""],["","65862041901","SMZ-TMP ","400-80MG","60.00","Select","Select",""],["","67405060403","FLUCONAZOLE ","200MG","60.00","Select","Select",""],["","56151146001","TRUE ","GLUCOSE","200.00","Select","Select",""],["","00172572960","FAMOTIDINE ","40MG","60.00","Select","Select",""],["","55111076260","VALGANCICLOV ","450MG","60.00","Select","Select",""],["","56151014701","TRUPLUS ","33G","200.00","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":""}]}]}