{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"K ADNERBREKCORC ","gend":1,"add":"EK 2732TS REPM","city":"LYNCHBURG","state":"VA","zip":"24501-9998","dob":"1959-01-31","age":"","mstatus":"","insh":"00113264","cliId":"","pno":"2243411601","cno":4342580507,"email":"","ename":"","eno":"","pphy":"ALBERS, GREGG","ppno":4348468421,"pcpadd":"2811 Linkhorne Dr Ste A, ","pcpcity":"Lynchburg","pcpstate":"VA","pcpzip":245033354,"pcpcounty":"","pcpid":"","pcpname":"PRIVIA MEDICAL GROUP LLC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"","add3":"","madd1":"2372 KEMPER STREET","madd2":"","madd3":"","mcity":"LYNCHBURG","mstate":"VA","mzip":"24501-9998","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":{"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":[["","59762134801","PREGABALIN","CAP 100MG","180","Select","Select",""],["","63402030830","LATUDA","TAB 80MG","30","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","30","Select","Select",""],["","57664049983","MIRTAZAPINE","TAB 15MG","30","Select","Select",""],["","00591565810","CYCLOBENZAPR","TAB 10MG","42","Select","Select",""],["","00378395277","ATORVASTATIN","TAB 40MG","90","Select","Select",""],["","50111043401","TRAZODONE","TAB 100MG","60","Select","Select",""],["","00173089310","TRELEGY","AER ELLIPTA","180","Select","Select",""],["","16571020106","DICLOFENAC","TAB 75MG DR","60","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","180","Select","Select",""],["","68462025301","ROPINIROLE","TAB 0.25MG","60","Select","Select",""],["","68462024805","RANITIDINE","TAB 150MG","60","Select","Select",""],["","00093083205","CLONAZEPAM","TAB 0.5MG","60","Select","Select",""],["","68180051201","LISINOPRIL","TAB 2.5MG","90","Select","Select",""],["","00003089421","ELIQUIS","TAB 5MG","180","Select","Select",""],["","13668013701","ESCITALOPRAM","TAB 20MG","30","Select","Select",""],["","16729020301","BUSPIRONE","TAB 15MG","90","Select","Select",""],["","00173088210","BREO","INH 200-25","60","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","48","Select","Select",""],["","65862035790","CLOPIDOGREL","TAB 75MG","90","Select","Select",""],["","43598043611","NITROGLYCERN","SUB 0.4MG","100","Select","Select",""],["","00603188016","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","20","Select","Select",""],["","57664050658","METOPROL","TAB 25MG","180","Select","Select",""],["","00093317431","ALBUTEROL","FAT E","8.5","Select","Select",""],["","00378064110","PREDNISONE","TAB 10MG","20","Select","Select",""],["","00310737020","BUDES\/FORMOT","AER 160-4.5","30.6","Select","Select",""],["","13668000805","ZOLPIDEM","TAB 10MG","30","Select","Select",""],["","51862007901","CARB\/LEVO","TAB 25-100MG","90","Select","Select",""],["","65862007601","CIPROFLOXACN","TAB 250MG","6","Select","Select",""],["","70710122501","AMITRIPTYLIN","TAB 10MG","90","Select","Select",""],["","13668001105","CITALOPRAM","TAB 40MG","30","Select","Select",""],["","68180012101","CEPHALEXIN","CAP 250MG","40","Select","Select",""],["","49483060450","IBUPROFEN","TAB 800MG","60","Select","Select",""],["","00186037020","SYMBICORT","AER 160-4.5","20.4","Select","Select",""],["","00093031105","LOPERAMIDE","CAP 2MG","30","Select","Select",""],["","51991081403","AZELASTINE","SPR 0.001","90","Select","Select",""],["","65862057490","MONTELUKAST","TAB 10MG","90","Select","Select",""],["","66993068330","OLANZAPINE","TAB 10MG","30","Select","Select",""],["","24208039915","IPRATROPIUM","SPR 0.0006","45","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","00093005805","TRAMADOL","TAB 50MG","20","Select","Select",""],["","53489011905","DOXYCYCL","CAP 100MG","10","Select","Select",""],["","70710134403","RAMELTEON","TAB 8MG","15","Select","Select",""],["","65862051601","NAPROXEN","TAB 550MG","60","Select","Select",""],["","59310057922","PROAIR","AER ","8.5","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","10","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","28","Select","Select",""],["","68382025601","OXYBUTYNIN","TAB 10MG ER","90","Select","Select",""],["","65862053820","LEVOFLOXACIN","TAB 750MG","7","Select","Select",""],["","00071101568","LYRICA","CAP 100MG","180","Select","Select",""],["","65862060330","MOXIFLOXACIN","TAB 400MG","3","Select","Select",""],["","00597007541","SPIRIVA","CAP HANDIHLR","90","Select","Select",""],["","68180016013","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","00378967193","IPRATROPIUM\/","SOL ALBUTER","360","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","10","Select","Select",""],["","67877054360","CEFDINIR","CAP 300MG","14","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","20","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":""}]}]}