{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"L AHSEINWORB ","gend":1,"add":"     TEERTS EROMLLIF 0051                         ","city":"LYNCHBURG                ","state":"VA","zip":"24501-9998","dob":"1996-07-18","age":"","mstatus":"","insh":"00112569","cliId":"","pno":"3443447719","cno":4344396214,"email":"","ename":"","eno":"","pphy":"RICHARDSON, PATRICIA C","ppno":4343387774,"pcpadd":"1606 REGENTS PARKWAY,","pcpcity":"LYNCHBURG","pcpstate":"VA","pcpzip":245150001,"pcpcounty":"","pcpid":"","pcpname":"PRIVIA MEDICAL GROUP LLC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"UNIT 1                                            ","add3":"","madd1":"1500 FILLMORE STREET                              ","madd2":"UNIT 1                                            ","madd3":"","mcity":"LYNCHBURG                ","mstate":"VA","mzip":"24501-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z39.1","Z34.82","Z34.83","O47.03","Z3A.31","O99.343","F60.3","F32.9","O98.513","B00.9","Z91.018","O09.33","Z38.00","P55.1","D22.5","P08.1","Z23","Z39.2","S99.921A","O99.89","R42","Z3A.10","O47.02","Z3A.26","Z11.4","R52","O47.9","O99.353","M25.531","G56.03","Z3A.32","R06.02","Z3A.38","Z36.2","Z30.011","Z11.3","Z30.09","S60.450A","Z3A.36","M25.532","I10","Z36.89","Z36.5","Z13.32","F33.1","Z36.85","O80","Z3A.00","Z37.0","Z30.9","Z3A.21","O09.32","O99.342","O98.512","D57.3","Z36.3","F33.2","F43.10","Z3A.37","O99.345","F53.0","Z30.013","M79.674","W22.8XXA","Y92.003","K59.00","N92.6","F41.8"," "],"date":["2020-03-17","2020-05-15","2020-07-10","2020-06-11","2020-06-11","2020-06-10","2020-06-10","2020-06-10","2020-06-10","2020-06-10","2021-03-07","2020-07-16","2020-07-24","2020-07-24","2020-07-24","2020-07-24","2020-07-24","2020-09-10","2020-10-25","2020-01-10","2021-03-07","2020-01-10","2020-05-04","2020-05-04","2020-05-06","2020-06-10","2020-07-24","2020-07-05","2020-07-05","2020-07-05","2020-07-05","2020-07-21","2020-07-24","2020-07-21","2021-10-28","2021-10-28","2021-10-28","2020-01-14","2020-07-10","2020-07-05","2020-07-24","2020-05-06","2020-05-06","2020-05-08","2020-05-08","2020-07-10","2020-07-24","2020-07-24","2020-07-24","2020-12-02","2020-03-27","2020-05-04","2020-05-04","2020-05-04","2020-05-04","2020-05-08","2021-06-23","2022-10-17","2020-07-16","2020-09-10","2020-09-10","2020-09-10","2020-10-25","2020-10-25","2020-10-25","2022-03-12","2022-10-28","2022-10-17","2022-10-28"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"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":[]}},{"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":""}]}]}