{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MICHAEL STUCKEY","gend":0,"add":"707 N HARRISON ST ","city":"RICHMOND","state":"VA","zip":"23220-9998","dob":"1956-04-15","age":"","mstatus":"","insh":"11017244","cliId":"","pno":8049561991,"cno":"","email":"","ename":"","eno":"","pphy":"BACHIREDDY, CHETHAN ","ppno":8046286777,"pcpadd":"75 Francis St ","pcpcity":"Boston                        ","pcpstate":"MA","pcpzip":21156110,"pcpcounty":"","pcpid":"","pcpname":"VCU HEALTH AT THE JACKSON CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"707 N HARRISON ST","madd2":"","madd3":"","mcity":"RICHMOND","mstate":"VA","mzip":"23220-9998","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":[["","70710115001","ISOSORB ","20MG","90.00","Select","Select",""],["","50742061510","METOPROL ","25MG ER","90.00","Select","Select",""],["","65862035790","CLOPIDOGREL ","75MG","90.00","Select","Select",""],["","23155000201","HYDRALAZINE ","25MG","270.00","Select","Select",""],["","00093005805","TRAMADOL ","50MG","30.00","Select","Select",""],["","65862014990","FINASTERIDE ","5MG","90.00","Select","Select",""],["","42806016005","HYDROXYZ ","25MG","60.00","Select","Select",""],["","00173088710","TRELEGY ","ELLIPTA","180.00","Select","Select",""],["","00143992801","CIPROFLOXACN ","500MG","56.00","Select","Select",""],["","00003089421","ELIQUIS ","5MG","180.00","Select","Select",""],["","69097094312","GABAPENTIN ","300MG","90.00","Select","Select",""],["","00143122701","DICYCLOMINE ","20MG","20.00","Select","Select",""],["","70377002911","ATORVASTATIN ","40MG","90.00","Select","Select",""],["","00378180910","LEVOTHYROXIN ","100MCG","90.00","Select","Select",""],["","51862024160","AMIODARONE ","200MG","90.00","Select","Select",""],["","43547040310","FUROSEMIDE ","80MG","90.00","Select","Select",""],["","57237016199","OMEPRAZOLE ","20MG","90.00","Select","Select",""],["","43598043611","NITROGLYCERN ","0.4MG","75.00","Select","Select",""],["","33342032915","TRIAMCINOLON ","0.10%","15.00","Select","Select",""],["","69097052444","DICLOFENAC ","1%","200.00","Select","Select",""],["","00078065920","ENTRESTO ","24-26MG","60.00","Select","Select",""],["","57237001401","TAMSULOSIN ","0.4MG","90.00","Select","Select",""],["","73473030030","CLINDAMYCIN ","1%","30.00","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":""}]}]}