{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"RAMON L ARROYO","gend":0,"add":"1611 RIO HILL DR APT 302","city":"CHARLOTTESVILLE","state":"VA","zip":"22901-9998","dob":"1939-06-21","age":"","mstatus":"","insh":"11013619","cliId":"","pno":4348066908,"cno":"","email":"","ename":"","eno":"","pphy":"CALLENDER, DAVID M","ppno":4349241774,"pcpadd":"1222 Jefferson Park Ave","pcpcity":"Charlottesville","pcpstate":"VA","pcpzip":229033410,"pcpcounty":"","pcpid":"","pcpname":"UVA PRIMARY CARE RIVERSIDE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"","add3":"","madd1":"1611 RIO HILL DR APT 302","madd2":"","madd3":"","mcity":"CHARLOTTESVILLE","mstate":"VA","mzip":"22901-9998","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":[["","67877022310","GABAPENTIN ","300MG","180.00","Select","Select",""],["","70010000201","COLCHICINE ","0.6MG","90.00","Select","Select",""],["","10702001801","OXYCODONE ","5MG","30.00","Select","Select",""],["","68645054154","FINASTERIDE ","5MG","90.00","Select","Select",""],["","68462015713","ONDANSETRON ","4MG ODT","20.00","Select","Select",""],["","51862036240","FLUOROURACIL ","5%","40.00","Select","Select",""],["","68645051554","AMLODIPINE ","5MG","90.00","Select","Select",""],["","00093206506","CILOSTAZOL ","50MG","180.00","Select","Select",""],["","68645055554","LISINOPRIL ","40MG","90.00","Select","Select",""],["","67877021905","CEPHALEXIN ","500MG","20.00","Select","Select",""],["","65862008501","CEFADROXIL ","500MG","14.00","Select","Select",""],["","55111015930","OMEPRAZOLE ","40MG","90.00","Select","Select",""],["","68645014059","FAMOTIDINE ","20MG","30.00","Select","Select",""],["","68382013201","TAMSULOSIN ","0.4MG","90.00","Select","Select",""],["","00172392670","DIAZEPAM ","5MG","10.00","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":""}]}]}